Secondary Logo

Institutional members access full text with Ovid®

The Emotional Cost of Caring for Others

One Pediatric Hospital's Journey to Reduce Compassion Fatigue

Walden, Marlene, PhD, APRN, NNP-BC, CCNS, FAAN; Adams, Greg, LCSW, ACSW, FT; Annesley-Dewinter, Elissa, RN, CCRN; Bai, Shasha, PhD, MS; Belknap, Nici, BSN, RNC-NIC; Eichenlaub, Amy, BSN, RN, CPON; Green, Angela, PhD, RN, CPHQ, FAAN; Huett, Amy, PhD, RN-BC; Lea, Katie, MSN, MHA, NE-BC; Lovenstein, Austin, MA, BS; Ramick, Amy, DNP, RN, ACNS-BC, NPD-BC; Salassi-Scotter, Mary, MNSc, NE-BC; Webb, Tammy, MSN, RN, NE-BC; Wessel, Valerie, MNSc, APRN, CPNP-AC

Journal of Nursing Administration: November 2018 - Volume 48 - Issue 11 - p 545–552
doi: 10.1097/NNA.0000000000000678

OBJECTIVE This study examined the prevalence of compassion fatigue and life stress of pediatric nurses.

BACKGROUND Distressing patient situations over time may affect nurses' professional quality of life and result in compassion fatigue. If not addressed, compassion fatigue may have personal and organizational consequences.

METHODS Using a descriptive, correlational design, a convenience sample of 268 nurses completed a web-based survey.

RESULTS High compassion satisfaction and moderate to low burnout and secondary traumatic stress were described by 49% of participants. Education was statistically associated with burnout and secondary traumatic stress. Life stress scores were significantly associated with age, experience, organizational tenure, and professional engagement. Narrative commentary yielded 5 themes: staffing, recognition, boundaries, expectations, and hopelessness. Organizational initiatives to prevent or mitigate compassion fatigue focused on awareness, balance, and connections.

CONCLUSIONS Nurses are negatively impacted by the emotional cost of caring. Future studies need to identify interventions to minimize compassion fatigue.

Author Affiliations: Nurse Scientist Manager (Dr Walden), Program Coordinator for Center for Good Mourning and Staff Bereavement Support (Mr Adams), Registered Nurses (Mss Annesley-Dewinter, and Eichenlaub), Clinical Educator (Ms Belknap), Director of Nursing Excellence (Dr Huett), Research Coordinator (Mr. Lovenstein), Nursing Research Specialist (Dr Ramick), Vice Presidents Patient Care Services (Mss Salassi-Scotter and Webb), Arkansas Children's Hospital; and Advanced Practice Nurse (Ms Wessel), University of Arkansas for Medical Sciences, Little Rock; Research Assistant Professor (Dr Bai), The Ohio State University, Columbus; Senior Director Patient Safety & Quality (Dr Green), Johns Hopkins All Children's Hospital, St Petersburg, Florida; and Chief Nursing Officer (Ms Lea), Saline Memorial Hospital, Benton, Arkansas.

The authors declare no conflicts of interest.

Correspondence: Dr Walden, Arkansas Children's Hospital, 1 Children's Way, Slot 807, Little Rock, AR 72202 (

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.