Crit Care Nurs QVol. 35, No. 4, pp. 388–395Copyright c© 20.docx

Crit Care Nurs Q
Vol. 35, No. 4, pp. 388–395
Copyright c© 2012 Wolters Kluwer Health | Lippincott
Williams & Wilkins
Concept Analysis
Compassion Fatigue and Effects
Upon Critical Care Nurses
Belinda Jenkins, BSN, RN, CEN; Nancy A. Warren, PhD, RN
Walker and Avant’s method of concept analysis was used to
delve into the initial understanding
of compassion fatigue, a relatively new concept being explored
with critical care nurses and
other health care professionals. The term was originally used in
1992 involving research exploring
burnout experienced by critical care nurses when a trend
emerged where nurses appeared to have
lost their “ability to nurture.” The term has since been used
synonymously with secondary traumatic
stress disorder. Two important goals exist for this article: First,
theoretically to conduct a concept
analysis of compassion fatigue, thereby providing information
for critical care nurses to understand
the concept as a universal human experience. Second, from a
caring perspective, identifying the
effects related to critical care nurses provides an opportunity to
address physical and somatic
consequences of compassion fatigue that will ultimately become
important to nursing practice,
education, and research. Key words: burnout, compassion

fatigue, secondary traumatic stress
T HE PROCESS that will be followed withinthis article is the
model developed and
implemented by Walker and Avant.1 Eight
stages are outlined within the model, and a
brief explanation is provided of each. The first
stage of the model is to select a concept. Con-
cept selection is very important and should
be one of interest to the authors or related to
the actual work of the authors. This concept
should be manageable yet not too broad. Sec-
ond, the authors should determine the aims or
purposes of the analysis. This section should
answer the question why is this concept im-
portant to the authors. Third, identification of
the uses of the concept that you can discover
Author Affiliations: Belmont University, Nashville,
Tennessee (Ms Jenkins); and Department of Nursing,
University of Tennessee, Martin (Dr Warren).
The authors have disclosed that they have no signif-
icant relationships with, or financial interest in, any
commercial companies pertaining to this article.
Correspondence: Nancy A. Warren, PhD, RN, De-
partment of Nursing, University of Tennessee, 136 H
Gooch Hall, Martin, TN 38238 ([email protected] or
[email protected]).
DOI: 10.1097/CNQ.0b013e318268fe09
in the literature supports the definition of the
concept. During this stage, through available
literature, dictionaries, thesauruses, and col-

leagues, the authors will identify possible uses
of the concept. The review of literature will
provide the evidence-based foundation for the
analysis. During the fourth stage, the defin-
ing attributes will be determined. Through
the literature reviews regarding the concept,
all the similar characteristics emerge. Fifth, a
model case is identified. The model case pro-
vides the reader an example of the defining at-
tributes of the concept; this can be provided
in a borderline, related, contrary, invented,
or illegitimate case. These are provided in
the sixth stage. The seventh stage includes
identification of the antecedents and conse-
quences. Antecedents are defined by Walker
and Avant as those events or incidents that
must occur or take place prior to the occur-
rence of the concept, and consequences are
defined as those events or incidents that occur
as a result of the occurrence of the concept.
The last stage defines the empirical referents,
which are defined as classes or categories of
actual phenomena that by their existence or
presence demonstrate the occurrence of the
concept itself. The goal of this article was
Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized
reproduction of this article is prohibited.
388
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Compassion Fatigue 389

2-fold: Theoretically, to conduct a concept
analysis of compassion fatigue, thereby pro-
viding an understanding of the concept as a
universal human experience and, from a car-
ing perspective, identifying the effects related
to critical care nurses by addressing physical
and somatic consequences of compassion fa-
tigue that will ultimately become important
to nursing practice, education, and research.
Perhaps, an ongoing dialogue regarding com-
passion fatigue and the effects upon nurses in
the critical care unit may facilitate actions to
identify and prevent compassion fatigue.
PERSONAL AIMS OF CONCEPT ANALYSIS
Reflecting upon the experiences of the au-
thors personally gained throughout our nurs-
ing career, we believe that we have felt the
effects of compassion fatigue and witnessed
nursing coworkers showing the effects as
well. Past nursing experiences have included
time in high-stress environments, where mo-
ments in time were crucial, and decisions
made immediately affected the outcome of
the patient—life or death. Past intensive care
unit experiences where seeing uncooperative
patients, interstaff conflicts, dying patients,
and those patients affected by massive trauma
on a daily basis lead to those effects. Over
time, fatigue takes a toll upon critical care
nurses. The outcomes have involved sleepless
nights and still visualizing the faces of the in-
jured or dead when trying to sleep, particu-
larly if the deceased were young and in the

prime of life, or worse yet, a young child. But
as one sees those faces of the injured, not in
a haunting sense, one reviews one’s perfor-
mance and wonders what more could have
been done. What could have been done dif-
ferently, and would different actions have led
to a difference in the outcome of the patient
becomes a consuming question. We have also
felt emotionally and physically drained after a
12-hour work shift and still tired before arriv-
ing at work the next night after resting all day.
While feeling and living these emotions, a con-
cept to identify with the emotions was nonex-
istent. As health care professionals, while tak-
ing care of others, critical care nurses and
health care staff tend to lose sight of taking
care of themselves. In exploring compassion
fatigue and the potential affect upon critical
care nurses, perhaps an enhanced awareness
and understanding of compassion fatigue can
be gained or at least ignite the conversations
of others who have had similar experiences.
LITERATURE REVIEW
Taber’s dictionary defines compassion fa-
tigue as “cynicism, emotional exhaustion or
self-centeredness occurring in a health care
professional previously dedicated to his or her
work and clients2(p499); compassion as deep
awareness of the pain and suffering of oth-
ers: empathy; and fatigue as an overwhelming
sustained sense of exhaustion and decreased
capacity for physical and mental work at the
usual level, and as the condition of an organ or

tissue in which its response to stimulation is
reduced or lost as a result of overactivity. This
definition can cross the lines for many disci-
plines and be used to describe compassion.
A phrase that does loosely describe compas-
sion fatigue is feeling the pain of the world,
with German philosophers addressing this
state as “weltschmertz.”3 While compassion
fatigue has risen in nursing research only re-
cently, nurses have felt the concept world-
wide. Some researchers noted that persons
who work with the suffering end up suffer-
ing themselves, particularly when working
with the suffering over time.4,5 While com-
passion fatigue is noted more in the litera-
ture relating to health care workers, it crosses
over into other disciplines. The concept has
been addressed in social workers, paramedics,
law enforcement personnel, and lawyers. A
lack of empirical studies was noted; however,
the “clinical” law literature has raised aware-
ness of the responses of attorneys working
with difficult or traumatized clients who be-
gan to feel countertransference and identifica-
tion with the victims who were being repre-
sented. Increased awareness of this concept
has prompted the need for additional train-
ing in law schools to assist professionals to
390 CRITICAL CARE NURSING QUARTERLY/OCTOBER–

DECEMBER 2012
prepare for the intense, face-to-face, and
highly personal relationships that evolve from
the attorney-client relationships. Police offi-
cers also reported a greater number of psycho-
logical distress and posttraumatic stress symp-
toms than mental health care professionals.3-6
Law enforcement officers face stress in vari-
ous ways, from working shift work to the na-
ture of the job itself as in continuous exposure
to violence and suffering. Figley4 propounded
that emergency responders and crisis work-
ers were at great risk for compassion fatigue.
Emergency workers and critical care nurses
absorbed the traumatic stress of the victims
who were being assisted, particularly if the
outcome of the nursing interventions still re-
sulted in death. Furthermore, the nurse’s pri-
mary focus is on preserving the life of the
patient at all costs, so addressing the ensu-
ing reactions to death and the reaction of the
family members may be distressing and at op-
posite ends of the spectrum of preservation of
life at all costs. Critical care nurses may suffer
their own grief at losing a patient after giv-
ing all of their self to the preservation of life,
yet family members may require communica-
tions regarding critical interventions provided
by nurses and supporting health care work-
ers. While family members are stressed by the
critical care environment and fear related to
the many tubes and monitors, the critical care
nurses may be stressed and fatigued by family
members’ presence and ensuing questions re-

garding what happened. Because the nurses
are so involved with the physical care of the
patient, they frequently have inadequate time
to response to family members’ emotional
needs, thus adding more stress to a complex
situation. Family members may have unrealis-
tic goals and expectations of the critical care
nurses and assign blame tacitly or overtly to
the nurses for the loss of their loved one while
in the trust of the nurses.
Compassion fatigue has been described as
a natural consequence of caring between 2
people, one who has been traumatized (the
critical care patient) and the other who is
affected by the first’s traumatic experience
(the critical care nurse). It can have a sud-
den onset compared with burnout, which is
a gradual progression caused by repeated ex-
posure to chronic stressors. Caregivers tend
to focus most of the attention to the per-
son who is directly involved in the incident
and fail to pay attention to their own needs.
Compassion fatigue may change the personal
and professional lives of the most caring of
health care workers, social workers, and per-
sonal support workers alike. These changes
were noted as difficulty concentrating, intru-
sive imagery, loss of hope, exhaustion, and
irritability, which many critical nurses seem
to have experienced.7,8
In review of the literature, defining charac-
teristics emerge repeatedly that describe com-
passion fatigue. Dr Charles Figley, PhD, has

studied the effects of compassion fatigue. In
his studies, Dr Figley found many common
characteristics that occur prior to compas-
sion fatigue. In 2001, Figley developed an al-
gorithm for compassion fatigue, which flows
from left to right when printed. The algorithm
is called the compassion fatigue process, with
the left side of the chart presenting the care-
giver exposed to suffering, empathic ability,
and concern for the patients. These 3 charac-
teristics lead the nurse to respond; however,
the critical care nurse may feel detachment
or, conversely, feel a sense of satisfaction with
the care provided. Over time, this leads to a
residual compassion stress. If this continues,
then the repeated exposure can possibly lead
to the caregiver feeling compassion fatigue
from prolonged exposure to suffering and de-
mands of caring for another person.
Whatever discipline, whether a critical
care nurse, physician, social worker, emer-
gency responder, law enforcement officer, or
lawyer, the defining antecedent that is most
evident is the continuous and repeated expo-
sure to stressors. This repeated exposure can
lead to emotional exhaustion. Working long
hours, with gradual results and exposure to
sensitive information can have an emotional
toll on the caregiver.8,9 When caregivers ex-
perience compassion fatigue, the end result
can also be a loss of empathy and a deper-
sonalization. Depersonalization refers to the

process where the client is viewed as less
than human. In a national study of persons
experiencing compassion fatigue, one-third
reported having experienced high levels of
depersonalization. Whenever a person is ex-
periencing depersonalization, a dramatically
increased risk of incorrectly interpreting in-
formation that is disclosed to the caregiver
becomes apparent. Often when compassion
fatigue is experienced, a change in ethical
and clinical values appears. For critical care
nurses, evidence of compassion fatigue can
be lack of appropriate documentation in the
chart, or noting that the patients’ best inter-
ests are not readily apparent in the nursing
care. Negative feelings toward the patient can
lead to substandardization of care.
Compassion fatigue is a progressive and fi-
nal end result that evolves over time. Empir-
ical referents that are present after the nurse
has prolonged, and continuous and intense,
contact with patients will experience symp-
toms both of mental and physical traits. The
mental symptoms include feelings of burnout,
absence of energy, accident proneness, and
emotional breakdown feelings.9,10 Emotion-
ally, the person with compassion fatigue will
be irritable, emotionally overwhelmed, with
desensitization and lack of enthusiasm for pa-
tient care. The physical symptoms can in-

clude weight loss/gain, loss of strength, re-
duce output, diminished performance, loss of
endurance, and an increasing in physical com-
plaints such as stomach pains and headaches.
Spiritually, the person with compassion fa-
tigue will experience a lack of spiritual aware-
ness or lethargy.
RELATED CONCEPTS
In the literature review, related concepts
were often noted and should be presented
within this article. Along with compassion fa-
tigue, a term that is often used interchange-
ably is secondary traumatic stress, which is
secondary traumatic stress as the result of
knowledge about a traumatizing event expe-
rienced by another and the subsequent stress
resulting from helping or wanting to help
the traumatized person. Secondary traumatic
stress may be nearly identical to posttrau-
matic stress disorder, where secondary trau-
matic stress resulted from effects happening
to those emotionally affected by the trauma
of another person; posttraumatic stress disor-
der only exists when the person is directly
affected by trauma and by being in harm’s
way.11,12
Burnout is another closely related concept
that is often described within the same lit-
erature as compassion fatigue. Shakespeare
mentions burnout within the lines of the
play The Passionate Pilgrim, written in 1599,
as demonstrated by the words “She burn’d

with love, as straw with fire flameth . . . . She
burn’d out love, as soon as straw outbur-
neth . . . .”13(p159) Burnout has been described
as a prolonged response to chronic emotional
and interpersonal stressors on the job and de-
scribed with the term “burnout,” which en-
compasses the physical, emotional, and men-
tal exhaustion caused by long-term involve-
ment in emotionally demanding situations.
Burnout develops gradually over time and pro-
gressively worsens, with symptoms includ-
ing fatigue, illness, disillusionment, cynicism,
anger, difficulty sleeping, and a sense of help-
lessness and/ or hopelessness.
Emotional contagion is defined as an af-
fective process in which an individual observ-
ing another person experiences emotional re-
sponses parallel to that person’s actual or
anticipated emotion.4,13 “Vicarious trauma-
tization” is a term closely related and of-
ten used interchangeably with compassion fa-
tigue. The construct of vicarious trauma states
that the psychological distress that occurs
over prolonged exposure to trauma actually
changes the cognitive aspect of perspective of
the caregiver related to such life issues as in-
timacy, trust, safety, self-esteem, and control.
Nurses experiencing vicarious traumatization
no longer feel grounded in the world around
them; they begin to question the meaning of
life, risk losing a sense of purpose, and hope-
lessness may ensue.
The above-mentioned related concepts
were found in the literature and used

DECEMBER 2012
interchangeably. The concepts are all used
to across a continuum to address the effects
upon the critical care nurses as well as the
persons receiving the care.
DEFINING ATTRIBUTES
The repeated characteristics that occur de-
scribing critical care nurses and compassion
fatigue include the following attributes:
• Depersonalization
• Reduced output/endurance/diminished
performance
• Loss of empathy
• Poor judgment
ANTECEDENTS AND CONSEQUENCES
Antecedents were specifically defined as
events or incidents that must occur or be in
place prior to the occurrence of the concept.1
Antecedents that have been identified reflec-
tive of critical care nurses and compassion
fatigue include, but are not limited to:
• Caregiver exposed to suffering

• Continuous and intense contact with pa-
tients
• High-stress exposure
• High use of self within one’s work
Consequences as events or incidents that
occur as a result of the occurrence of the con-
cept are defined.1 The following were identi-
fied as consequences directly resulting from
compassion fatigue that effects critical care
nurses:
• Loss of empathy
• Increase loss of work days due to physical
complaints, stomach pains, headaches
• Weight gain/loss
• Accident proneness
• Emotional breakdown
MODEL CASE
The following is a model case regarding
a critical care nurse that contains all the at-
tributes:
Nurse A works in a critical care unit of a medium-
volume clientele hospital. The critical care unit on
average admits 5 to 6 patients a day and for the
local area is known for the trauma care provided.
Nurse A works as the weekend charge nurse and
is currently working her sixth 12-hour shift due
to a colleague who is currently out for medical
leave and desperately needing to supplement her
income. While the critical care is very busy, nurse
A is attentive to her patients’ needs and serves each

patient with her skills and attends to the emotional
and physical needs of each. Three nights ago dur-
ing nurse A’s shift, a motor vehicle collision (MVC)
with multiple trauma victims arrived. Nurse A, be-
ing the charge nurse, assisted in each of the unit
rooms and provided additional support to the nurs-
ing staff. The victims included a mother and her 3
younger children ranging in ages from 13 to 19
years. The 2 older children were from out of town
and home from college for a visit with their mother
and younger sibling. The mother and the 2 older
children died, and the youngest child was in crit-
ical condition and later sent by helicopter to an
area trauma center. Nurse A listened to the younger
child ask about the mother and about the 2 older
siblings. Nurse A was empathetic to the questions
and was feeling sadness and concern for the oth-
ers involved in the MVC. Since that night, nurse A
has had trouble sleeping, having nightmares, and
replaying the night over in her head. Nurse A does
not call her patients by name anymore, she refers
to them as “belly pain in room 3” or as “drunk guy
in room 4,” and she makes cynical remarks about
her patients in the nurse’s station. Since that night,
her work performance has been less than optimal.
Nurse A has been making charting mistakes, writ-
ing on the wrong chart, and caught herself before
making a critical medication error. When assessing
a patient during the early morning, nurse A told a
35-year-old patient who was having a myocardial
infarction that he probably had indigestion from
food slipped in by a family member. When she
is off work, she cares for her elderly mother and
is currently raising her grandchildren after taking
custody from their mother who cannot stop her
current drug habit.

The attributes in the aforementioned model
case evidenced by nurse A represent traits
of experiencing depersonalization. She is no
longer calling her patients by their name but
by “belly pain in room 3 or drunk guy in
room 4.” She is working her sixth 12-hour
shift, so her endurance levels are subpar. Her
work performance is no longer optimal, as ev-
idenced by charting mistakes and a near miss
on a medication error. Nurse A is making poor
judgment skills by dismissing the chest pain
as indigestion.
The following is a borderline case, with an
explanation to follow:
Nurse B also works in the same critical care unit
as a relief charge nurse. Nurse B has worked for
the past 4 nights and was working when the above-
mentioned MVC case came in. Nurse B took care of
the 13-year-old young teen who was flown to the
area level 1 trauma center. Nurse B was very atten-
tive in her care of the young patient and assisted
the flight crew upon arrival. Nurse B has been off
for 3 days now and is returning to work. Nurse B
has stated that she is still tired and does not feel
well and has a headache. She also states that she

has not been sleeping well since the last night she
worked. Upon arrival of her shift, she has taken re-
port from the day shift nurse, and all her rooms are
full. Nurse B’s charge nurse asks for report on her
patients and she just says “all the same, just a differ-
ent day.” Nurse B sticks her head in each room, not
addressing the patient’s needs, and rolls her eyes
when a family member wants to talk to her about
her loved one. Nurse B then takes all her patients
charts and finds a quiet area to review and evalu-
ate what still needs to be done. Nurse B realized
that some of her patients were missing laboratory
work, and intravenous antibiotics have not been
hung as of yet. Nurse B knows by hospital protocol
that intravenous antibiotics must be hung within 4
hours of the doctor’s order, and she has less than 1
hour to get the medications hung. Nurse B settles
in for the night and proceeds with her patient care.
This is a borderline case in that nurse B is
experiencing depersonalization, by not giv-
ing the report on each of her patient, just
states “ all the same, just a different day.”
Nurse B is performing at subpar work perfor-
mance by not addressing her patients’ needs
and by rolling her eyes at patient family mem-
bers. Nurse B is not experiencing bad judg-
ment skills or making mistakes in providing
care. Not making mistakes is what defines this
model as a borderline case.
The following is an example of a contrary
case and will be discussed after the example:
Nurse C also works in the same critical care unit
and works as a staff nurse. She has worked there for

the past year after graduating from nursing school.
Nurse C is exposed to the same working conditions
but only works her three 12-hour shifts per week as
scheduled. She is juggling the same workload and
institutional requirements as nurse A but does not
have the responsibilities of a charge nurse. Nurse
C loves her job and feels tremendous satisfaction
each day when she goes home. Nurse C feels a
sense of rewardment, knowing that she has helped
each of her patients improve in some way. Nurse
C has a smile on her face; she calls each patient by
his or her name and addresses him or her when she
enters into the room. She does not mind spending
extra time talking with family member present and
writes down phone numbers and is willing to call
family members if the need should arise. Nurse C
has a connection with her patients, and she takes
pride in sharing the pain that her patients have but
sparks feelings of kindness, tenderness, and gen-
tleness along with understanding of the patients’
direct needs. Nurse C feels an overwhelming sense
of reward when a patient suffers less because of
the selfless care she has provided during her shift.
Nurse C feels that any negative experiences are far
less than the positive experiences she has at work
and feels a tremendous satisfaction with her job
and looks forward to caring for the next patient.
While nurse C has the same repeated expo-
sure as the model case, she is flourishing in
the same environment. She is having mean-
ingful experiences with her patients and fam-
ily members and looks forward to assisting
the next patient. In compassion fatigue, the
nurses will gradually distance themselves; this
is not the case in the contrary example pro-

vided.
EMPIRICAL REFERENTS
In Dr Figley’s research, the lack of a mea-
surement instrument for compassion fatigue
became readily apparent and from that re-
search a scale was developed. Originally,
this scale was called the Compassion Fatigue
Stress Test, but with noted close proximity to
other concepts, a revision of the scale was de-
veloped. Several revisions have taken place
but the Professional Quality of Life Scale,
DECEMBER 2012
Version 5 (ProQOL 5), is the final and most
current scale. The ProQOL 5 is a questionnaire
that includes 30 questions with the answers
scaled to respond: 0 equals never and 5 equals
very often. The questions in the ProQOL 5
range from “I believe I can make a difference
in my work” to “because of my [nursing], I
have felt ‘on edge’ on certain things.” The
ProQOL 5 rates the participant as either com-
passion satisfaction or compassion fatigue.10
All of the research indicated the importance
of determining those critical care nurses who
are vulnerable to compassion fatigue and to

quickly address the symptoms. Knowing who
is vulnerable can lead to preventing compas-
sion fatigue among the critical care nurses.
NURSING IMPLICATIONS FOR CRITICAL
CARE NURSES
Prolonged exposure that consists of contin-
uous and intense contact with patients expe-
riencing life or death trauma, serious illnesses,
and sudden critical events in the critical care
unit can lead to compassion fatigue. The criti-
cal events require nurses to stay on guard and
perform at optimal levels continuously for a
minimum of 12-hour shifts and ensuring that
patients have the best outcomes becomes a
cumulative process. If the stress that follows is
not addressed appropriately, then the nurses
may evolve to a state where the results are be-
yond the nurses’ endurance level, the energy
expended has surpassed the restored reserve,
and recovery power is lost.
Research clearly supports that working
with patients who are in pain, suffering, at
the end of life, or may have been coded and
expired may take an added toll on the physical
and mental health of nurses. The experiences
of critical care nurses who have had a patient
expire in the critical care unit may differ from
the experiences of nurse who had a patient
expire in other hospital settings.14 Unlike the
typical medical-surgical settings, critical care
unit nurses may experience death from se-
vere, sudden, traumatic events, which require
quick, yet thorough, interventions. Initially,

family members may not be allowed to remain
in the room with the seriously injured patient.
When allowed to visit, family members may
see more sophisticated, intimidating equip-
ment connected to the patient than would
be seen in other areas of the hospital. Family
members may be reluctant to touch or com-
municate verbally with the patient because of
the many tubes and monitors. Nurses, on the
contrary, have the difficult task of overseeing
the patient and equipment, while providing
communications to the family. While the fam-
ily members are stressed, the nurse maybe just
as stressed, or more so, because of interacting
with both the patient and family. Given the
complexity of factors that may influence the
outcome of the patient, especially if the out-
come is death, nurses may feel compassion
fatigue. While it is unrealistic to expect criti-
cal care nurses to address every aspect of the
family needs, when death occurs as the out-
come, nurses may begin to respond by com-
passion fatigue and return to the old nagging
questions of “ What could I have done better?”
Nurses began to second-guess their responses
or become hypercritical of the care provided.
Native American’s have a saying that each
time you heal someone, you give away a piece
of yourself until, at some point, you will re-
quire healing.13 When compassion fatigue is
apparent in the critical care unit, chronic ab-
senteeism, high workers’ compensation costs,
high turnover rates, and interpersonal con-
flicts between nurses are evidenced. Healing

from compassion fatigue takes time and dedi-
cation among the staff to recognize the effects
of compassion fatigue. Employers should take
time to educate themselves about compassion
fatigue and its effects, teaching the staff by
continuing education to overcome the every-
day stressors that nurses in the critical care
setting deal with routinely on a daily basis.
Strategies should be introduced to help heal
our healers.
Nurses at all levels must support each other,
respect the contributions of all involved in
patient care, and reach out to others, particu-
larly nurses in need of nurturing and renewal.
Evidenced-based practice is required to iden-
tify the most pressing issues affecting the
occurrence of compassion fatigue and iden-
tify the association between personal stres-
sors, professional stressors, and workplace
stressors that contribute to specific negative
behaviors. This valuable information may be
used in educational programs both to pre-
pare new graduates for the exposure to suf-
fering and to provide treatment programs and
supportive measures to prevent compassion
fatigue. Positive beliefs about self, a healthy
self-concept, understanding other people and

their cultures, continuing to address needs,
and listening to what the mind and body are
telling one are just a few ways to begin to
avoid compassion fatigue. Self-awareness and
balance are keys to maintaining health and the
ability to assist in the healing of others.
In conclusion, the intent of the authors with
this initial report is to provide an avenue of
beginning dialogue in the hopes of finding an-
swers. Critical care nurses may be reluctant to
deal with the emotions associated with com-
passion fatigue; perhaps, many may even find
difficulty admitting they are suffering from the
symptoms. Stressors associated with compas-
sion fatigue may be reduced, perhaps, signifi-
cantly if appropriate and timely interventions
are identified and provided.
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