The Experiences of Compassion Fatigue in Oncology and Palliative Care Nursing: A Scoping Review

Oncology and palliative care nursing involves prolonged exposure to suffering, death, and emotionally demanding care, placing nurses at heightened risk of compassion fatigue. Although previous research has identified associated risk and protective factors, less attention has been given to understanding how compassion fatigue develops and is sustained within clinical practice. This scoping review aimed to examine the emotional, relational, individual, and organizational processes shaping compassion fatigue among nurses working in oncology and palliative care settings.

A scoping literature review was conducted following Arksey and O'Malley's methodological framework. MEDLINE, CINAHL, Scopus, Psychology Database, and Web of Science were searched for studies published in English, Italian, and Spanish up to May 2025. The study protocol was registered with the Open Science Framework on August 7, 2025. Descriptive analysis and qualitative content analysis were conducted to synthesize the findings.

Twenty-four studies were included, and five interrelated themes were identified: emotional exposure and relational involvement; mechanisms sustaining compassion fatigue; adaptive and protective processes; personal and professional consequences of compassion fatigue; and Interrelationships between compassion fatigue, burnout, secondary traumatic stress, and compassion satisfaction. Compassion fatigue emerged as a dynamic and multidimensional phenomenon linked to sustained exposure to suffering, death, and ethically challenging care situations. Nurses reported cumulative grief, emotional exhaustion, emotional detachment, and existential distress, while organizational pressures, emotional labor, and limited opportunities for emotional recovery contributed to the persistence of compassion fatigue over time. Protective processes included peer support, professional meaning, self-care, and resilience-promoting strategies. Compassion fatigue was strongly associated with burnout and secondary traumatic stress, whereas compassion satisfaction and supportive work environments acted as partial protective factors.

Compassion fatigue among oncology and palliative care nurses reflects the interaction between individual vulnerabilities and workplace conditions. The findings highlight the need for integrated, multilevel strategies addressing organizational culture, ethical climate, leadership practices, and emotional skills development. Strengthening compassionate leadership, team-based support, and opportunities for reflection may promote nurse well-being, workforce sustainability, and high-quality, compassionate cancer care.