Compassion Fatigue - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Empathy and therapeutic caring are at the heart of nursing. But we sometimes care too much and if we do, what are consequences? I remember when I began working as a young nurse that I worried all the time about my patients and their welfare. I would call the unit on my off duty hours to talk with the charge nurses about how “my veterans” were doing. Several annoyed charge nurses must have spoken with my Head Nurse because she spoke with me about what I was doing. She told me that “I love that you care so much and that you are willing to give so much of yourself” BUT “you will not be able to sustain this – you need to learn to let go.” She worked with me on a strategy to think about things on my way home from work but then clear my head before I went into the house. I did not know it at the time but she was doing me a tremendous favor in helping me to avoid compassion fatigue and potentially disengagement from my work. The problem of compassion fatigue may be greater today because so many nurses provide care to sick and elderly family members in addition to their own work. They may have very little downtime from care giving.

What is Compassion Fatigue?

Compassion fatigue has been defined as a combination of physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress. It can occur in nurses working in any specialty area. Nurses with compassion fatigue can experience symptoms that are physical, emotional and/or work related. Physical symptoms can include difficulty sleeping, headaches, digestive problems, muscle tension and fatigue. Emotional symptoms can include depression, anger, irritability, loss of objectivity, mood swings, anxiety and reduced concentration. Work-related symptoms can include absenteeism, lack of joyfulness and lowered empathy.

What are the Consequences?

Left untreated, compassion fatigue can lead to burnout, disengagement and turnover. Substance abuse can also be a consequence of compassion fatigue. Nurses may not realize when they are experiencing compassion fatigue – this is where a perceptive leader becomes so important.

How Can Nurse Leaders Help Staff?

When nurse leaders see these behaviors in their staff, they need to provide an empathetic intervention. My head nurse wisely stopped me from becoming overly involved but once compassion fatigue has set in, the interventions needed may be different. Helpful strategies could include: changing the work assignment or shift; recommending time off or reducing overtime hours; encouraging attendance at a conference; or becoming involved in a project of interest. In serious cases, the nurse may need to be referred to an employee assistance program.

Leaders value highly empathetic and caring nurses yet there can be a dark side when nurses become overly involved in their work. Recognizing and preventing compassion fatigue in staff is an important step to establishing a healthy work environment.

Read to Lead

Lombard, B. & Eyre, C. (2011). Compassion Fatigue: A Nurse’s Primer. Online Journal of Issues in Nursing. Volume 16.