Recognizing Compassion Fatigue

By Elaine S. DeMeyer, RN, MSN, AOCN®, BMTCN® - Last Updated: April 22, 2022

Oncology nurses experience stress from many different directions—time pressures, nursing shortages, complex cancer treatments, an aging population with chronic conditions, COVID-19, and growing national and international tensions. High stress means that not only do emotions run high, but also results sometimes in severe consequences. These stressors put oncology nurses at risk for many different conditions, including compassion fatigue.

Never-ending compassion fatigue can lead many nurses to consider leaving oncology and even abandoning nursing altogether. This fatigue is not only detrimental to nurses—it can result in negative patient outcomes with lower quality of care. Therefore, early detection of personal and professional suffering from compassion fatigue is critical to a nurse’s well-being and patient care. Organizations may benefit from lower staff turnover and higher nursing and patient satisfaction that all translates into healthcare cost control.

What Is Compassion Fatigue?

“Compassion fatigue” describes profound physical, emotional, or spiritual distress that can occur from providing care for people with emotional or physical pain and suffering themselves. It is “the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period.” Compassion fatigue may be referred to as “the cost of caring” for others in distress.

Even though they may have similar outcomes, compassion fatigue and burnout are not the same. Burnout results from the external environment, whereas compassion fatigue arises from nurses’ internal feelings of frustration and guilt that they cannot relieve the patients’ or caregivers’ hurt. Compassion fatigue can lead to secondary traumatic stress and post-traumatic stress disorder (PTSD).

What Are the Signs of Compassion Fatigue?

Signs and symptoms of compassion fatigue can develop suddenly or gradually over time, and as an oncology nurse, you should acknowledge your risk and reality of how quickly compassion fatigue may develop. Compassion fatigue can affect your health, your work, or your relationships. It can cause signs and symptoms in multiple areas of life—physical, emotional, social, social, spiritual, and behavioral.

It can impact job or career satisfaction, even leading to resignation. You may notice subtle changes in yourself, like feeling detached from team members, experiencing irritability, or complaining about patients, caregivers, or colleagues. Often, the person seems to have developed low compassion or sympathy for patients. Team members may notice that a colleague seems to be “unhappy” or “moody.” Some people have frequent illnesses due to the stress on their immune systems.

Consequences of Compassion Fatigue Symptoms
  • Insomnia (often a first sign)
  • Problems with eating (over or under)
  • Difficulty concentrating
  • Headaches or muscle tension
  • Nausea, indigestion, or upset stomach
  • Fatigue or lack of energy
  • Frequent illnesses
  • Depression
  • Anxiety
  • Mood swings, anger, outbursts, irritability
  • Feeling drained or exhausted
  • Crying more than previously over patient’s condition
  • Isolation
  • Intolerance
  • Mistrust
  • Loss of purpose
  • Hopelessness
  • Impatience
  • Nightmares
  • Inability to cope
  • Blaming others

With every day and every interaction, nurses are at risk of developing compassion fatigue. You may start to feel helpless, hopeless, or powerless. Help take the stigma out of compassion fatigue by learning more about it and talking about your feelings. Explore nursing resources and those specific to oncology nurses. Compassion fatigue should not be the “cost of caring” for patients with cancer and their loved ones. Start your journey today to confront it.


Oncology Nurses’ Compassion Fatigue, Burn Out and Compassion Satisfaction

How to Recognize and Prevent Burnout Among Nurses

Preventing and Alleviating Compassion Fatigue Through Self-Care: An Educational Workshop for Nurses

The Cost of Caring: 10 Ways to Prevent Compassion Fatigue

Understand & Overcome Your Compassion Fatigue: An Online Guide