Compassion Fatigue

Written by Anastasia Prech and Sara Prech

Compassion Fatigue- Why it’s highly likely you’re dealing with it as a nurse in 2022 and what to do about it.


It’s a tough time to be a nurse, am I right? As nurses in 2022, it’s safe to say we have collectively been through more than we bargained for these last few years. We are dealing with stress and burnout at unprecedented levels. And something tells me you have received one too many emails suggesting that you acquire a positive attitude and take care of yourself. Although these messages come with good intentions, there is something missing. In order to truly take care of ourselves in today’s nursing world, we need to acknowledge that there is more to the story and start there. 


What is Compassion Fatigue?

Compassion fatigue is also called secondary post traumatic stress disorder (PTSD), or secondary traumatic stress. Let that sink in for a minute. Although trauma might seem like it has become somewhat of a buzzword today, we need to acknowledge that as nurses we are dealing with it ourselves. Secondary PTSD affects us as a result of our own exposure to the traumatic experiences of others, in this case our patients (Bellicoso, 2017). If you were fortunate enough to not have experienced traumatic stress before the pandemic, I’m willing to bet that’s over, and by now you are well acquainted. Symptoms of compassion fatigue can include exhaustion, frustration, depression, and fear, as well as others like headaches, insomnia, and even gastrointestinal distress (Bellicoso, 2017). 


How is it Related to Burnout?

Compassion fatigue is related to, but differs distinctly from, stress and burnout in terms of symptoms and causes. Compassion fatigue is preceded by empathy and relates to our relationships with others. Burnout is preceded by feelings of hopelessness and difficulty with work (Bellicoso, 2017). The experience of burnout includes anger, frustration, cognitive weariness, and emotional and physical fatigue (Bellicoso 2017). Burnout also relates more to the work environment, job duties and perceived support by management and the organization. 


How to Overcome Compassion Fatigue

Although it may surprise you, self compassion is the most important element of preventing and recovering from compassion fatigue and burnout (Alvis, 2020). And even though self care has become quite a buzzword these days, it is among the most important predictors of compassion resiliency (Alvis, 2020). Overcoming compassion fatigue successfully involves taking a holistic approach, incorporating a variety of strategies, and making stress management and self compassion a daily practice. 


Here are four steps! 

Step one, start with how you think. 

This means learning about how our minds work and why. They may not have taught us this in school, but we are all wired towards the negative (Hanson, 2011). Once we are aware of this, we can work to counter it by intentionally focusing on good experiences and being present and mindful. It is equally important that we avoid negative rumination. Otherwise our stress response will continue to activate, causing us to continue to experience the physiological consequences of stress. We can also train our minds to focus on gratitude. You’ve heard it before, but you may not know that creating a practice of gratitude actually helps you to be more compassionate towards yourself, enhances your mental health, and even your cognitive functioning (Rao, 2017). Our favorite free app for mindfulness practice is called  Healthy Minds. It is science based, approachable, and specifically helps to train compassion as a skill. 

Step two, breathe.

When was the last time you stopped what you were doing and just paid attention to your breath? Incorporate breath work into your day and watch your life change. No really, try it! Slowing down your breathing, and particularly increasing the length of your exhales helps activate your parasympathetic nervous system. Aim for about five to seven breaths per minute (Storoni, 2017). Any combination of patterned breathing can be helpful. We recommend our own method that we call 3-4-5. Inhale for four counts, exhale for five counts, and hold for three counts. This is simple to remember and accessible even if you have never done breath work before. You can also try box breathing; inhaling for four, holding for four, exhaling for four, and holding for four. A more advanced pattern is 4-7-8, which involves inhaling for four counts, exhaling for seven, and holding for eight. Our best tip for breath work and lengthening the exhale is to pretend like you are blowing out through a straw! 

Step three, move. 

Gentle movement helps relieve stress. Walking, light stretching, and yoga all provide benefits for both body and mind. Even laying down while positioning your legs “up a wall” can be relaxing, as well as facilitate circulation. Gentle exercise can even lower your cortisol levels (Storoni, 2017). Another study demonstrated that regular exercise may improve the stress response as it relates to the prefrontal cortex and rumination (Storoni, 2017). 

Step four, be.

When was the last time your attention wasn’t focused on something? For most of us, from the time we wake up until the time we go to sleep there is a war for our attention. This prevents us from slowing down, being present, and truly taking time to relax. Try scheduled inactivity, which is a fancy way of saying, do nothing! Schedule periods of ten minutes to sit and do nothing. Then reflect or journal and reap the benefits of spending time on yourself.  Also, try scheduling white space into your day. Allow yourself time to take breaks and rest between tasks. Allow yourself even small amounts of time to do nothing at all. 

Increasing awareness of compassion fatigue in nursing, how it differs from burnout, and what to do about it is the first step. Overcoming compassion fatigue requires making stress management and self compassion a daily practice. With the right tools you can create a personalized routine that you look forward to!




About the Authors

Anastasia Prech and Sara Prech are registered nurses and board certified nurse coaches (NC-BC) who specialize in helping nurses overcome stress and burnout. They are also certified compassion fatigue professionals (CCFP). Their passion is educating fellow nurses and other healthcare professionals on all things wellness and working 1:1 with individuals to help them live their healthiest lives.

Instagram – @saraandanastasia
Tiktok – @saraandanastasia
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Alvis, D (2020). Compassion fatigue certification training for healthcare, mental health, and caring professionals. Pesi. 

Bellicoso, D., Trudeau, M., Fitch, M. I., & Ralph, M. R. (2017). Chronobiological factors for compassion satisfaction and fatigue among ambulatory oncology caregivers. Chronobiology International, 34(6), 808–818.

Hanson, R. (2011). Just One Thing: Developing a Buddha brain one simple practice at a time. Oakland, CA: New Harbinger.

Rao, N., & Kemper, K. J. (2017). Online training in specific meditation practices improves gratitude, well-being, self-compassion, and confidence in providing compassionate care among health professionals. Journal of Evidence-Based Complementary & Alternative Medicine, 22(2), 237–241.

Storoni, M. (2017). Stress Proof: The scientific solution to protect your brain and body – and be more resilient every day.

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One thought on “Compassion Fatigue”

  1. I absolutely LOVED this blog. Not only is it evidence based, but it also incorporates practical interventions that we can implement in our day to day activities. You’re correct that it’s a tough time to be a nurse. Yet, I wouldn’t want to be anything else!

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