When I first became a nurse, 30 years ago, there was no term for what is now known as compassion fatigue in nursing.

The sustained stress of caring for the extremely ill, meeting overwhelming patient and family needs, and managing workplace productivity, staffing, and satisfaction concerns, was simply what came with the job. Nursing school did not prepare us for the relentless stress of catastrophic life events and sustained physical extremes, but it did emphasize that ours is a profession of empathy and caring. Through it all, a nurse is empathetic, supportive, and giving, with a well-defined professional relationship established, which, in theory, protects all parties. 

The truth is, as we know, often very different. Our skills can be our own undoing, as nurses may neglect their own self-care when focusing on the needs of patients.  The term compassion fatigue has only been in play since 1992. It was first described in nursing literature as emotions, behaviors, and physical conditions associated with ongoing exposure to overwhelming work stressors.

Sustained stress without intervention can lead to perceiving work as drudgery—an emotional black hole to be avoided. Attention to the needs of patients can become traumatizing, leading to passivity and disengagement. Work behaviors as a result of compassion fatigue include dreading work or certain patients, feeling less empathy, and work avoidance through increased use of sick days. The physical toll can include gastrointestinal and cardiac symptoms, fatigue, and sleep-wake disturbances. The emotional toll includes anxiety, oversensitivity, depression, anger, and irritability. 

Especially key to our ability to practice safely, compassion fatigue can cause memory problems, poor judgment, and loss of concentration and focus. 

The costs of providing empathic, compassionate care are obvious. Our own self-care, and the care of our patients is at stake. So how do we recognize this critical safety concern, and intervene?

Reducing Compassion Fatigue

First, consider the resources you already have. Employee Assistance Programs (EAP), supervisors, counselors, trusted colleagues, and mentors can help guide you to evaluate your risk. Pastoral care, social work, or EAP departments may offer workshops to provide strategies for coping or tips for enhancing work-life balance. 

Consider exploring a reduction of overtime, changing your work assignments, or developing a nurse mentorship opportunity to lessen stressors. Regular staff conferences that discuss complex care and environmental issues not only address practical concerns, but allow opportunities for nurses to express frustrations, providing a forum for shared support.  

“No Stress Rooms” that are created within care settings may offer a relaxing respite space for staff to de-stress and recharge. Recognizing your own needs for work-life balance, and prioritizing these needs, can contribute to a refreshed perspective.

As nurses, we are intrinsically motivated to put others first; it is one of our greatest strengths, but is not without risks. Recognizing that compassion fatigue not only leads to self-harm, but also potential harm to our patients may be motivation enough for us to recognize, value, and prioritize this issue—for the safety of us all.

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