Compassion Fatigue in Nurses: Signs, Prevention, & Self-Care

Is it possible to love your work without losing yourself in it? Yes. Even in nursing.

Nursing is time and again said to be “one of the most rewarding and challenging professions in health care.”

Compassion fatigue shows up when a nurse—although they deeply care about their job—begins to experience “declining empathetic ability from repeated exposure to others’ suffering.”

Unfortunately, compassion fatigue is becoming more common due to nursing burnout and nursing shortages. Other factors contribute to compassion fatigue as well, such as the lack of mental health resources.

Despite the odds, nurses keep on nursing on (and we are so glad they do).

Here are some tips to keep compassion fatigue at bay while practicing the self-care you deserve as a nurse:

The double-edged sword of devotion

Picture this: You finish charting after your shift officially ended, sigh. On top of this, on your way out, a patient wants extra assurance that they will be okay, and their worried family has questions about their status.

Leaving at this vulnerable time just doesn’t feel right (even though you're technically off shift) and not getting paid for it, but you care.

Meanwhile, you have your best friend's birthday party to attend, which is across town, and being late is not how you operate. In fact, you are a perfectionist and extremely empathetic.

What’s a nurse to do?

Situations like these are starting to show up more and more in hospitals and healthcare settings throughout the country.

Compassion and resilience are 2 of a nurse’s greatest strengths, but there are pitfalls to these characteristics. When nurse guilt and boundaries are not well managed, it can create an inner turmoil that can lead to compassion fatigue.

What is compassion fatigue?

So, what is compassion fatigue anyway?

The term compassion fatigue was coined in the nursing world in the early 90’s by a registered nurse named Carla Joinson.

In “Compassion Fatigue as Bruises in the Soul: A Qualitative Study on Nurses,” the authors found that many researchers refer to the following definition for compassion fatigue:

“A state of exhaustion and dysfunction, biologically, physiologically, and emotionally, as a result of prolonged exposure to compassion stress”

In “Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized,” Charles R. Figley, Ph.D., suggests that compassion fatigue is synonymous with secondary traumatic stress disorder (STSD).

While these descriptions still hold, more studies reveal what compassion fatigue really entails, how it affects nurses, and how to notice the signs.

What are the most common signs of compassion fatigue?

If you are a nurse, you most likely work in a setting that involves being surrounded by trauma, day in and day out.

Luckily, you likely have a personality that is both empathetic and incredibly impermeable (like a filter that is able to separate the good stuff from the bad stuff).

After years of being exposed to other people’s suffering, however, compassion fatigue may slowly start to creep in. At first, it could start with mood swings or having trouble sleeping. Later on, it could explode into depression and anxiety.

The good news is that if you catch compassion fatigue early, this is unlikely to occur.

Here are the most common signs of compassion fatigue.

Physical signs of compassion fatigue

Fatigue
Exhaustion
Insomnia
Headaches
Brain fog

Emotional signs of compassion fatigue

Feelings of detachment (from reality); a “floating feeling”
Increased anxiety or depression
Decreased empathy or the ability to feel compassion for one’s suffering
Feeling powerless or helpless
Hypersensitivity
Thinking too much about your patients
Feeling emotionally drained

Having compassion and empathy is a good thing.

However, the emotional toll of nursing by being subjected to high stress and charged environments that deal with trauma every day needs to be managed in a healthy way.

Compassion fatigue prevention

The question is, how can nurses begin to prevent compassion fatigue before it even rears its ugly head?

Often, compassion fatigue is a wake-up call for nurses to make a change in their routines.

Sometimes these changes can be as little as adding a quick 3-minute breathwork and meditation before signing on or off shift.

Other times, a nurse may need to implement a bigger change if compassion fatigue has already set in and they are experiencing depression or anxiety.

If you feel like compassion fatigue is affecting your daily nursing duties, here are some tips to stop it in its tracks and get back to the compassionate, healthy nurse you know you can be.

** Disclaimer: This information is for educational purposes only and is not a substitute for professional medical or mental health care. If symptoms persist or interfere with daily life, please consult a qualified healthcare provider.

1) Build a support system

Seek out support among your peers and see if they have managed, gone through, or healed compassion fatigue themselves. Find an online community board where you can talk about your experience with compassion fatigue.

Set up a meeting with your manager and explain the feelings you are having. When things feel really heavy, reach out to a licensed therapist for help and set up weekly check-ins to process your feelings.

2) Make self-care a priority

Self-care for nurses is the key to a healthy nursing life. It’s easy to forget that when you work as a busy bee nurse. Yet, self-care doesn’t have to take up hours of your day.

Here are some great self-care practices to strengthen your mental health in nursing:

Do breath work before signing into your shift. Inhale for 5 counts through your nose and exhale for 6 counts through your mouth.
Incorporate a mantra either during your breathwork or in a quiet 5-minute reflection before you go on shift, i.e., “I am a great nurse and will embrace today’s triumphs and losses.”
Exercise, even if it’s a 10-minute run, walk, jog, swim, or yoga practice, before or after work.
Nourish your body with protein-packed snacks. Think peanut butter, nuts, string cheese, and water—lots and lots of water.

Remember, self-care should never be put on the back burner. Integrate a small self-practice into your daily routine and stick with it until it becomes a habit; you will notice the changes right away.

3) Set firm boundaries

Boundaries in nursing are not always easy. Handling patients and their families, your colleagues, and manager requests may seem mind-boggling at times. It’s important to understand the difference between professionalism and friendliness to avoid getting too emotionally involved.

For example, don’t share personal or intimate information with patients about your life. Another example is to maintain a fun and empathetic relationship with your nurse colleagues, but have your “own” set of friends outside of work with whom you can share more personal details about your life.

When your shift has ended, honor your time, even if a colleague or a patient asks you to stay longer. In the end, prioritizing your mental health will be better for your patients and your team.

4) Take a break or work fewer hours

If you are feeling totally burned out, and you feel it in your gut, it may be time to take a break from nursing. If you have some extra savings, you could speak with your manager about taking some time off.

Another option is to work fewer hours or look into workplace flexibility. Options like per diem scheduling give nurses more control over when and how often they work, making it easier to balance professional dedication with personal well-being. This also provides for a more sustainable nursing career since you are able to manage your schedule as you like.

Whatever you do, listen to that little voice inside that says, “Hey, it’s time to take a break.”

Last but not least: Be kind to yourself

What’s the full-circle reflection of this lesson? Don’t wait until it’s too late. Learn how to honor yourself (ahem: self-care) and your professional duties.

Not all nursing days will feel like you're walking on fluffy clouds while saving the world. In fact, there will be many hard days during your nursing career, but many rewarding days as well.

The best you can do is recognize when something feels “a little off” in your body and mind. As they say, “nip it in the bud” before a small problem spirals to a bigger one.

Remember: You’ve got what it takes.

Need some workplace flexibility in nursing? Try per diem nursing; build your hours around your schedule, and have more free time.

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