Running head: COMPASSION FATIGUE AND NURSING

Compassion Fatigue and its Effect on Nursing

Natasha English
Ethics & Professional Practice
NUPD 703
Centennial College
October 3rd, 2016

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Compassion Fatigue
When one is asked to describe important qualities of a nurse, compassion is often a term
that is used. Compassion is defined as, a feeling of deep sympathy and sorrow for another who
is stricken by misfortune, accompanied by a strong desire to alleviate the suffering
(Compassion, n.d.). While these attributes are incredibly accurate, nurses are becoming more at
risk of losing these characteristics and developing compassion fatigue. Coetzee & Klopper
(2010) describe compassion fatigue as the loss of the ability to nurture and provide
compassionate care, due to repeated exposure to the pain, trauma and suffering of patients, and
also to demanding and poor work environments. This is a threat to the safety of nurses, patients
and the nursing profession, and it is important that it is studied and an action plan implemented
to battle the potentially devastating effects. The effects of compassion fatigue are like a ripple in
a pond. One rock dropped in the water creates a noticeable effect beyond the immediate place
where the rock broke the surface. When compassion fatigue is felt by a nurse, it not only affects
him or her, but goes on to affect the client and their family, and the environment in which the
nurse works and lives.
Compassion Fatigue and its Effect on Nursing
Compassion fatigue has a negative effect on the psychological and physical well-being of
nurses (Ledoux, 2015). It is suggested that nurses are a particularly vulnerable group because
they often enter the lives of others at very critical junctures and become partners, rather than
observers, in patients healthcare journeys (Boyle, 2011). When experiencing compassion
fatigue, nurses are more likely to become ill, experience physical and mental exhaustion, less
likely to hold the required attention span, more likely to become forgetful, and more likely to
suffer from negative emotions such as anger, fear, anxiety, sadness, grief, and vulnerability. It

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also resulted in nurses feeling apathetic, detached and performing ineffectively (Boyle, 2011).
All of these side effects not only create an emotional disturbance within the nurse, but have the
ability to affect everyone around them. It is important to note that compassion fatigue is a
process and has three phases, which are compassion discomfort, compassion stress, and
compassion fatigue; the most serious of the three being the latter (Boyle, 2011).
The negative effects of compassion fatigue not only affect the nurse, but also the patients
for whom they are caring. Ledoux (2015) states that once nurses are suffering from compassion
fatigue, they start to withdraw from their patients. Withdrawing from patients can be dangerous
both physically and emotionally. Nurses can become distracted, which in turn threatens the
safety of the nurses care for the patient. When nurses are distracted errors can occur, poor
judgement is exhibited, and the quality of patient care is compromised (Ledoux, 2015).
Withdrawing from patients can also damage the therapeutic Nurse-Client relationship which the
College of Nurses of Ontario (2006) states is the core of nursing. This is important because a
therapeutic-nurse client relationship involves trust, respect, empathy, and professional intimacy
and has an impact on the patients overall well-being (CNO, 2006). Withdrawing from patients
means that they are just getting the basic care and are lacking that human, emotional side of
nursing since they are just getting the technical side and are not being engaged with (Austin,
Goble, Leier, & Byrne, 2009). This also has the ability to destroy the patients trust in a nurse and
the care theyll be provided. Going beyond that, has the ability to threaten the publics trust in the
nursing profession. All aspects of the therapeutic nurse-client relationship can be affected when
nurses who are experiencing compassion fatigue are caring for patients.
However, this is not an issue which solely affects individuals. The phenomenon of
compassion fatigue has the ability to have a large effect on nursing overall. Austin, Goble, Leier,

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& Byrne (2009) state that when nurses start to experience this fatigue, they are more likely to
leave the profession. This is a problem because it further exacerbates the issue of nurses being
overworked. With nurses leaving the profession after experiencing compassion fatigue, it places
more work on the nurses who remain and the stress level experienced remains high. Also, it
could be a deterrent for those who want to become nurses as not everyone is be willing to enter
into a profession in which their mental and physical well-being is threatened.
Strategies for Transformation and Future Practice
After examining what compassion fatigue is and how it can affect everyone involved, its
clear that creating strategies to combat the effects of compassion fatigue is paramount. Coetzee
& Klopper (2010) discussed the following two strategies. The first is to educate students about
compassion fatigue, the clinical manifestation, risks, and causes, while they are still in their
formal nursing education programs. By doing this, new nurses will be able to enter the workforce
with a sound knowledge of what to look for, and how to avoid it by using self-care strategies.
Coetzee & Klopper (2010) also suggest that by introducing it during the nursing programs, the
students may be able to become active in developing preventative measures. The second strategy
suggested was providing in service training for nurses in the workforce. This could entail how to
recognize compassion fatigue and what strategies to employ to combat it. Based on the fact that
compassion fatigue is a progression through three levels, it is also important for the nurse
managers and resource nurses to have a sound understanding of the clinical manifestations of
each stage so that early interventions can be implemented.
Based on what was discussed previously, it seems as though better managed facilities
would also contribute to lowering the risk of compassion fatigue. By improving schedules,
placing less demand on nurses, and ensuring the availability of the required materials and

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equipment, there could be a positive effect on the stress and well-being of nurses. While it
wouldnt alleviate the stress of dealing with the emotional pain, suffering, and trauma of their
patients, it would remove some of the other components that lead to compassion fatigue.
Lastly, perhaps compassion fatigue should not be dealt with only at the individual,
educational, or workplace levels. Recently the Ontario government implemented a plan to assist
first responders with dealing with post-traumatic stress disorder (PTSD). It recognizes PTSD as a
work-related issue and gives first responders the ability to gain more assistance through channels
such as WSIB benefits and faster access to treatment (Ontario Passes Legislation, 2016).
Extending these benefits to nurses who are suffering from compassion fatigue could help get
them the treatment they need before it progresses to the point where the nursing care no longer
becomes safe, or they leave the profession.
Conclusion
Compassion fatigue is a serious and unfortunately common phenomenon affecting nurses in all
aspects of the nursing environment. Since empathy and intimate relationships are a crucial part
of nursing, it seems as though its an unavoidable consequence for many. Being exposed to
others pain and suffering seems like a difficult feat on its own, but when other elements are
factored in such as long shifts, lack of resources, and a stressful work environment, it becomes
clear why recognizing and understanding compassion fatigue is an important task. Without the
proper resources and strategies in place, patient safety is a risk. Patients deserve to have nurses
who are dedicated to maintaining the therapeutic nurse-client relationship, free from errors. Not
only do patients deserve to have the best care, but the nursing profession deserves to have nurses
who are not suffering. By examining, understanding, and taking action on compassion fatigue,
the future of nurses and nursing would look much brighter.

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6
References

Austin, W., Goble, E., Leier, B., & Byrne, P. (2009). Compassion fatigue: The experience of
nurses. Ethics & Social Welfare, 3(2), 195-214. doi:10.1080/17496530902951988
Boyle, D. A. (2011). Countering compassion fatigue: A requisite nursing agenda. The Online
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bleofcontents/vol-16-2011/no1-jan-2011/countering-compassion-fatigue.aspx
Coetzee, S. K., & Klopper, H. C. (2010). Compassion fatigue within nursing practice: A concept
Analysis. Nursing and Health Sciences, 12(2). 235-243. doi:10.1111/j.14422018.2010.00526.x
College of Nurses of Ontario (2013). Therapeutic nurse-client relationship. Practice Standard. 119.
Compassion [Def. 1]. (n.d.). In Dictionary.com, Retrieved September 30, 2016, from
http://www.dictionary.com/browse/compassion.
Ledoux, K. (2015). Understanding compassion fatigue: understanding compassion. Journal Of
Advanced Nursing, 71(9), 2041-2050. doi:10.1111/jan.12686
Ministry of Labour (2016, April 5). Ontario passes legislation to support first responders with
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