Critical care nurses' lived experience of compassion fatigue in the intensive care unit: A phenomenological study

Compassion fatigue is the state of exhaustion that hinders the ability to engage in caring relationships. Nurses dealing with the complexities of the acute clinical environment and recurrent exposure to patient suffering are susceptible to compassion fatigue. When nurses have compassion fatigue, high-quality care is compromised. However, there is scarce literature examining the experiences of compassion fatigue among critical care nurses in the intensive care unit.

The aim of this study was to explore the lived experiences of compassion fatigue among nurses in the intensive care unit.

A hermeneutic phenomenological approach was used, guided by the works of Gadamer. Eleven participants were recruited through purposive and snowball sampling following appropriate ethics approval. In-depth, semistructured interviews were conducted with 11 nurses embedded within the critical care environment. Thematic analysis was used to capture the experiences of these nurses.

The findings resulted in the identification of the following major themes: (i) "Empty cup"; (ii) "A real risk"; and (iii) "Put your own oxygen mask on first". These themes are further explored through a series of subthemes. Compared to a metaphorical "empty cup", nurses ran out of compassion in a gradual, oblivious manner from the continuous process of giving. This was compounded by being challenged by the coronavirus (COVID-19) pandemic and feeling disrespected and unappreciated, with emphasis on workplace aggression. Insights from the nurses indicate areas to prioritise in clinical practice, education, and management in an effort to prevent compassion fatigue.

Being an empty cup offered a way to conceptualise the nurses' experience of compassion fatigue. Nurses suggested a need for tailored interventions that prioritise the wellbeing of nurses inclusive of supportive work environments. It is suggested that these approaches might make progress in the prevention of compassion fatigue and provision of humane, person-centred care.