Introduction:

Compassion fatigue is an emotional state in which a person feels pain, demotivation, helplessness and exhaustion as a result of self-dissatisfaction. It often occurs when the care providers who are emotionally attached to the patients, fail to provide effective care to the patients, minimise their pain or save them from suffering or death (Adia, 2023). It has been reported by Borges et al. (2019) that, providing care to patients builds an emotional or empathetic connection between the patients and the care providers, as a result, failure to save the lives of those patients or helplessly watching them suffer can often cause the health care professionals to experience a feeling of pain, sorrow, trauma or suffering.

This topic has been chosen for further research, as CF poses a high risk to not only the lives of the nurse workforce but also to the lives of the care receivers and the health care organisations associated with the affected nurses (Xie et al., 2021). It has been obtained from the study by Cavanagh et al. (2020) that as CF is the reduced capability of providing care to the patients due to frequent subjection to traumatic and negative experiences, it results in high rates of nurse absenteeism, low efficiency and poor quality of care and poor patient health outcomes. The significance of research on CF has also been reported by Baqeas, Davis and Copnell (2021) as the paper reveals that compassion fatigues is caused by negative outcomes, therefore, the consequences of CF are also negative. this not only risks the lives of the nurses where compassion fatigue is born, but also poses a severe impact on the lives of the patent as well as the healthcare organisation. Hence researching on compassion fatigue among nurses is a highly significant approach and contribution to the healthcare sector, as it will help the affected nurses to identify the symptoms of compassion fatigue and would assist them to cope up against this condition.

This research paper aims to explore the causes and impact of CF among nurses using a broad range of existing literature. This research paper will focus on areas such as the prevalence of compassion fatigue, causes or contributing factors of compassion fatigue, consequences and ramifications of compassion fatigue and the possible interventions to overcome or minimise the impact of CF on nurses. This topic is of high significance for the healthcare sector as it directly has been associated with the front-line care providers of health, which is the nurse workforce.

This research will be beneficial for the nurses, health care organisations as well as for patients, as it has provided deep insights into this topic, which can help the nurses understand more about this condition and can use this knowledge to prevent, assess and intervene against CF. The themes that have been generated in this study can make it easier for the targeted people to utilise this source for their beneficial purposes. This research study aims to resolve the issues related to compassion fatigue among the contemporary nurse workforce, as well as for the nurses who will be transitioning into the real life practice soon. As a result of this literature review based research study, the health outcomes of the nurses in terms of physical, mental and emotional health will be improved, and it will be equally impactful and beneficial for the entire healthcare system and the patients associated with.

The first section of this report will provide an overview of the literature search strategy that has been used in this study, such as the information about the databases, keywords or specific search filters used. The second section of this study includes a discussion of a wide range of existing, credible, authentic, reliable and peer-reviewed published literature. The literature review will be presented using the thematic analysis format. Consequently, a section of discussions is situated, in which all the gathered themes will be discussed, synthesised and supported with the theories of management and human resources. Later, an effective summary or a section of solid conclusions along with the recommendations will be presented to remind the significance of the paper to the readers.

This research paper strongly adheres to the principles of confidentiality, consent and publication ethics. This research ensures the protection of the privacy and confidentiality of the persons associated with this research. The identity or any sensitive information of the participants who have participated in previously published articles and have been cited in this research study will be protected under the Privacy Act 1988.

Literature search strategy:

The literature search strategy is an important and critical component of a research study, through which a track of the literature review is maintained. It is a way to design the theoretical research of a paper in a more integrated way. This process of retrieving information helps researchers collect valuable and relatable data for further analysis (Rethlefsen et al., 2021). For this research, the search strategy to extract literature has been opted in a diverse manner. The reason for using a number of different search databases is that it helps in providing more accurate, relevant and updated information, helps in attaining rigorous and factual data and potently impacts the results of the study (Harari et al., 2020). The literature searching databases that have been used to find useful and relevant literature included the National Institutes of Health (NIH), the Wiley Online Library, Science Direct and ProQuest. Out of these searches, 6 articles were retrieved from the NIH database, out of which only 2 articles were selected. From the Wiley database, 10 articles were received as a result, among which only 3 articles were selected. From the Science Direct database, 5 articles were retrieved out of which 1 article was selected as it fulfilled the criteria of inclusion. Similarly, from the Pro Quest database, 3 articles were retrieved out of which only one article was selected for this study. In short, out of 24 articles shown in the result, 7 quality assured articles were chosen as the best fits for this study. The rationale for extracting literature from scientific databases is because these databases contains a variety of relevant healthcare and nursing literature, which are authentic and peer reviewed. Similalrly, this has also been reported by Wanyama, McQuaid and Kittler (2022) that obtaining relevant articles from scientific databases, journals and libraries enhances the quality of research and drives relevant outcomes. The criteria for the inclusion and exclusion, has also been provided in Appendix 1. In addition to this, a brief summary of the articles chosen for the literature search has also been presented in a tabular form in Appendix 2.

The keywords that have been used to perform the literature search included compassion fatigue, compassion satisfaction, community nurses, newly registered nurses, transitioning nurses, and graduate nurses. The inclusion criteria were that the articles to be chosen should have been published within a period of 14 years. Moreover, the language of the articles should be English and the articles can be accessed in an online format. The region of the studies was not specific and any study focusing on compassion fatigue in doctors was excluded. It has been reported by Mohamed Shaffril, Samsuddin and Abu Samah (2021), that in order to conduct research on a specific topic, the literature retrieved by the researchers should be highly specific, relevant and authentic to the topic. Therefore, this was the reason for the exclusion of 17 articles from the search results was that the articles did not fulfil the criteria of inclusion defined for the study.

Literature Review:

Gathering knowledge from different means of sources and using those collected pieces of useful information for analysing and synthesising it, in order to answer a research question is known as a literature review (Snyder, 2019). In this section, a comprehensive and extensive review of the literature has been presented. The literature will be clustered and presented in a thematic structure, as thematic analysis is a method of presenting data in a systematic and organised manner (Peel, 2020). Furthermore, another rationale for using the thematic analysis method for this study is that it is the best way to learn about the perspectives of people on a specific issue, or a topic (Campbell et al., 2021), which in this study aims to assess and analyse the perspectives of nurses on compassion fatigue using the existing findings present in the published studies. The themes that have been extracted from the chosen literature, have been combinedly presented in a tabular form, named as theme matrix and has been attached in the Appendix 3.

Compassion Fatigue:

According to Adia (2023), compassion fatigue was first detected by Joinson in the year 1992, as a noticeable change in the emotional state of the nurse workforce who constantly provide care in emergency wards and accident departments. This fluctuation in the emotional state was due to the environment and nature of the nursing profession. Compassion fatigue has been viewed as a feeling of mental, physiological and emotional inability to function properly due to a feeling of exhaustion, stress and depression. It has also been reported by Cavanagh et al. (2020) that compassion fatigue usually occurs when nurses make excessive use of their empathy and emotions. The author has further mentioned that compassion fatigue is also provoked as a result of a traumatic experience or witnessing the pain of the people to whom the nurses provided care.

According to Borges et al. (2019), it has been found that compassion fatigue not only impacts the well-being and personal and professional lives of the nurse workforce, but the outcomes also pose a potent impact on the patients, the organisation and the economy as well. As this research aimed to explore the causes, consequences, prevalence and intervention of compassion fatigue among nurses, the following themes have been generated from the analysed literature.

Causes of compassion fatigue in the nurse workforce:

In this theme, the factors contributing towards compassion fatigue among nurses will be discussed, the subthemes under this theme include:

Nature of work:

It has been reported by Adia (2023) that, community nurses face difficulties while performing their duties due to the nature of their profession and the environment of the healthcare centres. This includes the pressure of work, duration of providing care and rotational shifts. According to Dowdell et al. (2022), nurses face compassion fatigue as they have to provide continuous care, which often results in physical tiring and fatigue when treating patients with extra care such as substance use patients. Another factor is the increased population of patients, which also makes it difficult for nurses to work, leading to compassion fatigue (Hunsaker et al., 2015). It has also been reported by Hoe, Trickey and McGraw (2023) that extensive working conditions such as providing care in a home setting to vulnerable people also lead to CF when the health of the patients does not improve. As a result of this exhaustion, their energy is reduced, and they get irritated which makes them unable to deliver the same quality of care afterwards.

Lack of Peer Support:

The lack of professional collaboration, guidance and support has been highly reported by the nurses, which plays a major part in developing compassion fatigue among nurses (Adia, 2023). Hunsaker et al. (2015) have revealed that manager support significantly impacts the compassion fatigue scores in the nurse workforce, such as high levels of manager support resulting in lower levels of compassion fatigue. It has also been depicted by Soderlund (2016) that experienced nurse leaders can also play a significant role in minimising or preventing the impact of CF on nurses, as they can detect the symptoms of compassion fatigue and prevent them from growing. Moreover, it has also been imitated by Pérez‐García et al. (2021) that nurses face differences in the opinions and attitudes of the doctors, such as a lack of guidance, support and collaboration of the expert physicians with nurses on the interventions. Perceiving this attitude from higher professionals often leads to exhaustion and compassion fatigue.