Compassion Fatigue and Nurse Burnout

By Rose O. Sherman, EdD, RN, FAAN

Last week, I attended the Colorado Organization of Nurse Leaders conference in Vail, Colorado. One of the speakers who is also an Air Force Colonel, Kathleen Flarity, made a strong case for both staff nurses and leaders to be vigilant about the potential for compassion fatigue especially in high stress care environments. In these situations, whether it be on medical evacuation flights or in a busy ER with frequent trauma, nurses cope by suppressing their emotions. But at some point, it become it can become easy for a nurse to cope by disengaging which can lead to burnout. New graduates on high stress units are especially at risk. They often don’t have the life experience to be able to maintain perspective on what is happening to patients under their care. Compassion fatigue can also happen to the nurse leaders working in these units who observe everything that is happening and work hard to support both staff and patient families.

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?

Nurses may not even be aware that they are experiencing compassion fatigue. There is an excellent short youtube video by nurses on this topic which all staff will be able to relate to in their own practice. When nurse leaders see these behaviors in their staff, they need to provide an empathetic intervention. When leader listen to staff stories and ask questions – it can be help staff gain perspective. 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. Nurses in high stress areas can also benefit from stress reducers such as meditation or heart math. 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 and avoiding staff burnout.

Read to Lead

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