Compassion Fatigue in Nurses: Causes and Effects

This assignment delves into the critical issue of compassion fatigue among nurses. It examines the various factors contributing to this phenomenon, including prolonged exposure to patient suffering, high workload pressures, and emotional demands. The analysis draws upon a comprehensive review of academic literature, highlighting the psychological, emotional, and physical consequences of compassion fatigue on nurses. Understanding these impacts is crucial for developing effective strategies to prevent and manage compassion fatigue, ultimately promoting the well-being and resilience of nursing professionals.

Running Head: Compassion Fatigue in Nursing Practice
COMPASSION FATIGUE IN NURSING PRACTICE
Name of the Student
Name of the University
Author Note

Provides a clear and concise introduction that justifies the choice of topic:
Compassion fatigue is a combination of depleted states of emotional, physical and
spiritual conditions due to the providence of care for patients in significant distress and pain.
Nolte et al. (2017) points out that the complex demands of the patients healthcare needs in
overburdened healthcare system can be a significant stressor on the nurses. This can result in the
reduced ability in the providence of care, compassion fatigue and burnout syndrome (Finzi-
Dottan and Kormosh 2016; Sorenson et al. 2016). Compassion fatigue also associated with the
loss of satisfaction from performing the job properly, as a result of secondary stress (American
Nurse Today 2018). However, Sheppard (2015) and Sorensen et al. (2016) pointed out the lack
of clarity and ambiguity related to our understanding of compassion fatigue. The purpose of this
essay therefore is to explore the effect of compassion fatigue on mental health nurses.
Demonstrates knowledge and understanding of the chosen topic in the context of a
particular nursing specialty:
Emotional stress can be caused due to emotional burden experienced while providing
care for individuals in trauma or distress, and can be due to a single incident of exposure or an
accumulation of stress (The American Institute of Stress 2018). Studies by Hegney et al. (2014)
suggested an association between anxiety and depression with burnout and secondary trauma.
While studies by Khamisa et al. (2015) also pointed out that stress and burnout can impact the
mental well being of the nurse, and can adversely affect the efficiency, productivity and the
quality of care provided by the nurses. Among mental health nurses, exposure to inpatient
aggression and work stress can lead to post traumatic stress and distress (Lee et al. 2015).

The term compassion fatigue was coined by Carla Joinson,, after noticing the reduced
ability of nurses, who experienced psychological stress, to nurture patients. Various authors have
suggested that the state of weariness is due to chronic or long term exposure to trauma, to
challenging circumstances and the continuous service provided by nurses. Compassion fatigue is
different from burnout, both having physical and psychological factors that causes a loss or
reduction in motivation, but differs in their triggers and critical attributes. They further argues
that burnout can be experienced by anyone (triggered by job requirements, job expectations, lack
of resources, interpersonal factors, business or organizational policies, that affects the efficiency
and efficacy of the person), however compassion fatigue is only experienced by those who
actively demonstrate compassion on a daily basis. Mental health nurses, having to care patients
often are exposed to the stress while demonstrating compassion towards the patients and while
supporting or helping their families. Such factors are significant stressors for work.
Different symptoms associated with compassion fatigue, categorized into 3 groups: Work
related symptoms (like avoidance or fear of working, reduced ability to empathize with patient or
family, frequent absenteeism, reduced joy or enthusiasm in work); Physical Symptoms (like
headache, muscle tensions, fatigue, digestive dysfunction, sleep dysfunction, cardiac symptoms);
and Emotional Symptoms (like mood swings, anxiety, restlessness, oversensitivity, substance
abuse or substance dependency, depression, anger, resentfulness, forgetfulness and lack of
attention or focus and lack of objectivity). Harris and Griffin (2015) additionally pointed out the
antecedents of compassion fatigue (like spiritual commitment, emotional investment, and
professional and personal support given to patients) that can reduce inner conviction and
resiliency, thereby causing inadequate performance and reduction in holistic health. The figure

below shows the interactions of the different components towards the causation of compassion
fatigue.
Figure 1: Compassion and Fatigue Concept Map; source: (Harris and Griffin 2015)
Demonstrates the ability to source and appraise the best available evidence to support the
discussion:
Watson’s theory of human caring is based on the empathic relation between the nurse
and patient, in the development of relationship based nursing practice (RBN) (Watson 2012). At
the core of the concept is the utilization of empathy and communication towards the patient and
their family. Three types of relationship that are needed to develop RBN, namely, relationship

between patient and their families, relationship with self, and relationship with colleagues.
Compassion fatigue is experienced by individuals who assists other in distress, and can be
traumatized through their effort to show compassion and empathy to them, and can lead to a
reduced self care and increased self sacrifice. The caregiver mostly experience the stress
emotionally (and not physically) while caring for the patients. The emotional stress further
affects the physical health, leading to different physical symptoms experienced a stressed
individual.
A decline in personal health of the nurse apart from poor performance, medical errors,
poor judgment and a reduced quality of care, and even patient dissatisfaction. This can adversely
affect the responses of the patients, cause financial instability of the organization, and also lead
to a sense of apathy or indifference towards the patients, associated with a sense of hopelessness
or helplessness apart from the physical symptoms experienced by the nurses. This can also lead
to the propensity of the nurses to quit their jobs, which can have serious effect in the providence
of proper care for the patients (Harris and Griffin 2015). This highlights the negative effect of
compassion fatigue on both the nurse as well as the health outcomes of the patient, as well as on
the efficiency of the healthcare system, and necessitates actions to manage the effects of
compassion fatigue in mental health as well as other nursing specializations. Personal coping
strategies, balancing work and life, adequate sleep, healthy and balanced diet, daily physical
exercise and small vacations or breaks can be effective personal intervention strategies to
manage compassion fatigue.
Conclusion:

The overview of the effects of compassion fatigue on the performance, efficiency, and
well being of the nurses, as well as on the health outcomes and perception of the patients
highlights the necessity to study further how the different stressors experienced by healthcare
professionals in a high stress environment can be useful to devise strategies to mitigate these
effects. Mental health nurses are frequently exposed to significant amount of stress while
assisting patients and their families to cope up with the challenges of the health condition of the
patient. This necessitates different intervention strategies that can assist the nurses to cope up
with the stress in their job, and ensure the continued providence of quality care of the patient, as
well as the maintenance of resiliency and psychological well being of the nurses themselves.

References:
American Nurse Today. 2018. Compassion fatigue: Are you at risk? - American Nurse Today.
[online] Available at: https://www.americannursetoday.com/compassion-fatigue/ [Accessed 13
Jan. 2018].
Finzi-Dottan, R. and Kormosh, M.B., 2016. Social Workers in Israel: Compassion, Fatigue, and
Spillover into Married Life. Journal of Social Service Research, 42(5), pp.703-717.
Gilmore, C., 2012. Compassion Fatigue-What it is and how to avoid it. Kai Tiaki: Nursing New
Zealand, 18(5), p.32.
Harris, C. and Griffin, M. (2015). Nursing on Empty. Journal of Christian Nursing, [online]
32(2), pp.80-87. Available at:
http://journals.lww.com/journalofchristiannursing/Fulltext/2015/04000/
Nursing_on_Empty__Compassion_Fatigue_Signs,.8.aspx#R6-8 [Accessed 13 Jan. 2018].
Hegney, D.G., Craigie, M., Hemsworth, D., Osseiran‐Moisson, R., Aoun, S., Francis, K. and
Drury, V., 2014. Compassion satisfaction, compassion fatigue, anxiety, depression and stress in
registered nurses in Australia: study 1 results. Journal of Nursing Management, 22(4), pp.506-
518.
Khamisa, N., Oldenburg, B., Peltzer, K. and Ilic, D., 2015. Work related stress, burnout, job
satisfaction and general health of nurses. International journal of environmental research and
public health, 12(1), pp.652-666.

Lee, J., Daffern, M., Ogloff, J.R. and Martin, T., 2015. Towards a model for understanding the
development of post‐traumatic stress and general distress in mental health nurses. International
journal of mental health nursing, 24(1), pp.49-58.
Nolte, A., Downing, C., Temane, A. and Hastings-Tolsma, M. (2017). Compassion fatigue in
nurses: A metasynthesis. Journal of Clinical Nursing, [online] 26(23-24), pp.4364-4378.
Available at: https://www.ncbi.nlm.nih.gov/pubmed/28231623 [Accessed 13 Jan. 2018].
Potter, R.N., Joyce Divanbeigi RN, M.S.N., Julie Berger DMin, B.C.C., Lori Norris, R.N. and
Sarah Olsen RN, B.S.N., 2010. Compassion fatigue and burnout: Prevalence among oncology
nurses. Clinical Journal of Oncology Nursing, 14(5), p.E56.
Sheppard, K., 2015. Compassion fatigue among registered nurses: Connecting theory and
research. Applied Nursing Research, 28(1), pp.57-59.
Sorenson, C., Bolick, B., Wright, K. and Hamilton, R., 2016. Understanding compassion fatigue
in healthcare providers: A review of current literature. Journal of Nursing Scholarship, 48(5),
pp.456-465.
The American Institute of Stress. (2018). Compassion Fatigue. [online] Available at:
https://www.stress.org/military/for-practitionersleaders/compassion-fatigue/ [Accessed 13 Jan.
2018].
Watson, J., 2012. The theory of human caring: Retrospective and prospective. Caring in nursing
classics: An essential resource, pp.237-270.