Compassion fatigue in nursing

4 Ways to Cope with Compassion Fatigue as a Nurse

Like many nurses, I was drawn to this profession by an internal passion to help others and make a meaningful impact on patients’ lives. Helping and supporting people in their most vulnerable time is a unique role that, without awareness, may come at the cost of your own mental health and well-being in the form of compassion fatigue, secondary stress and burnout.

An article published in Health and Social Care in the Community found that up to 49% of nurses are affected by compassion fatigue. With such a high prevalence in nursing, it’s vital to be aware of the signs and symptoms of compassion fatigue and incorporate a self-care routine to reduce the risk.

May is Mental Health Awareness Month, so put yourself in the spotlight and prioritize your own care—it’s impossible to provide adequate care for your patients if you’re not looking after yourself. Let’s delve into compassion fatigue to understand its causes and symptoms and explore coping strategies. 

Understanding Compassion Fatigue

Compassion fatigue, sometimes called secondary stress, is often mistaken for burnout. However, burnout is cumulative fatigue and dissatisfaction, while compassion fatigue is the emotional, physical and psychological impact of helping others. Burnout stems from work-related issues like coworker disagreements, excessive working hours or unsafe staffing. 

Working closely with patients and families while they navigate tragedy, illness and death causes nurses emotional strain and may trigger compassion fatigue. Unlike burnout, which develops gradually, compassion fatigue can strike suddenly.

The Online Journal of Issues in Nursing explains that compassion fatigue is a progressive state of emotional unease that evolves from compassion discomfort to compassion stress to compassion fatigue. Compassion fatigue occurs when nurses give more energy than they can get back. In simpler terms, compassion fatigue occurs when you’re running on empty—you give, and you give, and you give, and you forget to refill your cup.

Identifying Signs of Compassion Fatigue in Nursing

Compassion fatigue in nursing

Understanding what’s wrong can be challenging. There are moments when work seems fine, and interactions with patients and colleagues appear normal. Yet, suddenly, you find yourself endlessly scrolling your phone, crying alone in your car or feeling irrationally angry at loved ones without pinpointing the cause of these emotions.

Recognizing the signs and symptoms of compassion fatigue in yourself, colleagues and loved ones is crucial to address symptoms before they worsen. It’s imperative to be vigilant for these signs in yourself and others, as supporting one another is essential in healthcare. Signs and symptoms to look for include the following:

Physical Signs:

  • Chronic fatigue or exhaustion despite adequate rest
  • Frequent headaches or body aches and pains
  • Changes in appetite leading to weight loss or gain
  • Insomnia or difficulty sleeping, even when tired
  • Weakened immune system, leading to frequent illnesses

Emotional Signs:

  • Feelings of sadness, hopelessness or despair
  • Increased irritability, frustration or anger, especially towards loved ones, without a known trigger
  • Emotional numbness or detachment from others
  • Difficulty concentrating or making decisions
  • Heightened anxiety or feelings of being overwhelmed

Behavioral Signs:

  • Withdrawal from social interactions or activities you enjoy
  • Increased use of substances like alcohol or drugs to cope
  • Engaging in risky behaviors or self-destructive habits
  • Decreased productivity or effectiveness at work
  • Avoidance of situations or people associated with work-related stress

These signs may vary in intensity and may not always be immediately recognizable. Still, they can serve as important indicators that someone may be experiencing compassion fatigue and need support and intervention.

4 Ways to Cope with Compassion Fatigue as a Nurse

Meditation for self-care in nursing

1. Explore Personal Self-Care Strategies

Although massages feel great after long hours on your feet, self-care isn’t just about treating yourself to an occasional spa day. It’s time to change the narrative on self-care to include daily practices that really make a difference in our lives and help you prioritize your mental health. Implementing small, consistent habits is what leads to significant changes. 

Are you feeling stressed after a shift? Get in the habit of taking a walk to unwind. Are you feeling tense and unmotivated? Try a quick five-minute stretch—it can do wonders for your body and mind. Here are some strategies to effectively implement self-care into your busy schedule:

  • Regular Physical Activity: When exercising, ditch the all-or-nothing mindset and adopt an all-or-something attitude. Working 12-hour shifts can be exhausting. Instead of aiming for intense workouts before or after work, opt for a walk, yoga or somatic exercises to release tension and rejuvenate your body.
  • Adequate Sleep: Resources everywhere tell you the importance of consistent sleep schedules to promote health and well-being. However, maintaining sleep schedules is tricky as a nurse doing shift work and night shifts. While it may not always be easy, it’s crucial to be aware and implement simple solutions that maximize your rest. Aim to be in bed early if you’re on a day shift. For night shifts, prioritize a nap beforehand. Be mindful not to overload your schedule the day after work—rest or at least allow some downtime to recharge. It’s all about finding a balance that works for you.
  • Balanced Nutrition and Hydration: Eating enough food to fuel your mind and body on a 12-hour shift requires planning. Plan meals for shifts and prep food the night before to avoid rushing around in the morning, which usually leads to poor food choices. Have a big water bottle on shift to ensure you’re constantly hydrating. 
  • Mindfulness, Breathing and Meditation: Learn techniques to ground yourself at work when feeling stressed. Incorporate deep breathing throughout the day to promote calmness. Make meditation a part of your daily routine to quiet the mind. Just a few minutes each day can make a big difference.
  • Relaxation Techniques: Finding time for relaxation is essential, even amid a busy schedule. Whether listening to soothing music, practicing muscle relaxation or indulging in a favorite hobby, carving out time for relaxation can help you recharge and rejuvenate.

2. Embrace Professional Support Systems

Being in a helping profession can make it challenging to ask for help yourself. Sometimes, it means taking a step back to view your behavior from an outside perspective.

Acknowledging when you need professional mental health support is essential for your well-being as a nurse. Seeking help from mental health professionals offers specialized care tailored to your needs. Remember, seeking support is a sign of strength, not weakness.

Another great option is peer support groups, which create a safe space for nurses to share experiences, exchange advice and offer encouragement. Some ways to find or start a peer support group include:

  • Inquiring within your workplace or nursing organizations for existing groups
  • Utilizing online platforms or social media to connect with nurses interested in forming a group
  • Establishing clear goals and guidelines for the group, ensuring confidentiality and mutual respect
  • Seeking guidance from mental health professionals or organizations experienced in facilitating support groups

By embracing professional support systems, we strengthen our resilience and foster a supportive community among fellow nurses. 

3. Maintain Professional Boundaries

Establishing professional boundaries is essential for nurses’ well-being and the quality of care we provide. Effective communication is critical to setting and upholding these boundaries with patients and colleagues. Balancing empathy with professional detachment requires self-awareness and mindfulness. 

One effective technique for maintaining professional boundaries is to take a pause. Briefly pausing before responding to requests or situations that may test your boundaries allows you to assess whether the request aligns with your professional responsibilities and personal limits. Use this time to formulate a clear and assertive response, ensuring your boundaries are respected while maintaining professionalism and empathy.

 4. Perform Regular Self-Assessments

Performing regular self-assessments allows you to remain attuned to your well-being and tackle compassion fatigue. By being knowledgeable in coping strategies, you can navigate the demands of nursing while building resilience. 

A quick self-assessment may include the following:

  1. Reflect on recent patient interactions: Do I feel emotionally drained or detached?
  2. Monitor physical symptoms: Am I experiencing headaches, fatigue or changes in appetite?
  3. Evaluate work-life balance: Am I constantly working overtime? Do I have time for self-care?
  4. Assess coping strategies: Are my current coping methods effective? Do I need to explore new ones?

If you notice you’re feeling different after asking yourself these questions, you can proactively seek resources and tools to help combat compassion fatigue before it becomes a bigger problem.

Educational Resources and Tools

Compassion and self-care in nursing

Recommended Books:
Online Resources and Tools:

Debriefing the Front Lines

  • For nurses, by nurses; they offer structured debriefing sessions, continuing education workshops and sobriety support.

Don’t Clock Out

  • Peer support groups
    • Nursing support group every Thursday at 7 p.m. EST 
    • Healthcare support group every Monday at 8 p.m. EST 

Healthy Nurse, Healthy Nation

  • The American Nurse Association Enterprise developed this program to help nurses connect with others for support, advice and sharing with the goal of improving their personal wellness through mental health, physical activity, nutrition, rest, quality of life and safety.

Addressing compassion fatigue is crucial for your well-being and effectiveness as a nurse. By taking care of yourself, you can recognize and manage compassion fatigue. Remember, looking after yourself isn’t selfish. Let’s make our mental health a priority so we can continue making a positive impact on our patients’ lives.

Explore employer reviews on Vivian and evaluate which company provides the most comprehensive benefits package, particularly in mental health support. You might be surprised by what you discover.

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Amanda Farquharson, BSN, RN

Amanda Farquharson, BSN, RN is a registered nurse, travel nurse, writer and wellness warrior. She practices from a holistic lens with a focus on health promotion and prevention. Amanda has been actively engaged with the wellness community for over 15 years, supporting and developing activities that strengthen individuals' and communities' emotional, mental, spiritual and physical health.

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