After a 12-hour shift, a nurse sits in their car, unable to find the energy to walk into their own home. A teacher stares blankly at another email describing a student crisis. A social worker finishes documenting another case of abuse but strangely feels numb rather than heartbroken. None of them entered their profession expecting that caring deeply for others might eventually diminish their ability to care. They have not stopped caring. Rather, the emotional cost of caring has gradually begun to change the way they experience their work and themselves.
Most of us have experienced burnout in our professional lives. Day in, day out, stress, overwork, and intense activity can result in fatigue, apathy, and a loss of desire for your work. Burnout does not fully explain the impact on those who have chosen a profession focused on providing care, such as a nurse, physician, clergy member, social worker, or even a teacher, a profession often grounded in compassion and the desire to ease suffering. Compassion goes beyond empathy, sympathy, and caring; it involves recognizing someone else’s suffering and being motivated to relieve it. There is an inherent risk of something bigger than burnout in these professions: compassion fatigue. Compassion fatigue is generally understood as the combined effects of secondary traumatic stress (STS) and burnout that can develop through sustained exposure to the suffering of others. STS results from caring for individuals who have experienced trauma, and over time, that indirect exposure can itself become traumatizing (Ulaş & Seçer, 2025). Britt Frank (2022) describes trauma as an experience that exceeds the brain’s capacity to process what has occurred. Burnout, in contrast, results from prolonged workplace stress, overwork, and emotional exhaustion. Compassion satisfaction, the sense of purpose and fulfilment derived from helping others, is measured alongside these experiences because it serves as an important protective factor, helping individuals remain resilient despite repeated exposure to suffering.
Research on the concept of compassion fatigue began decades ago, initially identified and coined by C. Joinson (1992), who was working with nurses in the emergency room in the early 90s. Joinson noticed that many emergency room nurses exhibited emotional exhaustion beyond traditional burnout. Later, Charles Figley (1995), whose work focused on traumatology, expanded on the concept, noting that professionals who were exposed to clients who experienced traumatic events such as natural disasters or war were experiencing negative physical, emotional and spiritual symptoms. Both identified that long-term, repeated exposure to caring was often traumatic and overwhelming, resulting in compassion fatigue. Beth Hudnall Stamm (www.proqol.org) further advanced the field by developing the Professional Quality of Life Scale (ProQOL), which measures compassion satisfaction, burnout, and secondary traumatic stress. Today, the ProQOL remains one of the most widely used instruments for assessing the positive and negative impact on professional quality of life of helping professionals. Recent research demonstrates how widespread the problem has become. In 2025, Noor et al. published a literature review finding that 70% of healthcare professionals experience compassion fatigue. The review also looked at other professions, social workers, counsellors, psychologists, and teachers and found significant reports of compassion fatigue.
The available research on compassion fatigue suggests it affects nearly every dimension of well-being. It can impact a person’s emotional, physical, cognitive, behavioral, and spiritual well-being. Emotionally, symptoms can range from feeling detached to depression, sleep disturbances, anxiety, difficulty focusing, diminished self-worth, and substance abuse. Physical symptoms can include GI distress, elevated blood pressure, and chronic fatigue. Cognitive symptoms include difficulty concentrating and making decisions. Behavioral changes may include emotional withdrawal, irritability, or avoidance of situations that once brought professional satisfaction. Spiritually, there is a loss of connection, hope, and meaning. All of these can erode a person’s capacity to perform at work, home, or in the community.
| Concept | Primary Cause | Hallmark Features |
| Burnout | Chronic workplace stress | Exhaustion, cynicism, reduced effectiveness |
| Secondary Traumatic Stress | Exposure to another person’s trauma | PTSD-like symptoms, intrusive thoughts, hypervigilance |
| Compassion Fatigue | Sustained compassionate engagement with suffering | Emotional depletion, reduced capacity for empathy, often includes STS and burnout |
| Moral Distress | Knowing the ethically appropriate action but being unable to take it | Frustration, guilt, anger, powerlessness |
| Compassion Satisfaction | Meaning and fulfillment from helping others | Resilience, purpose, professional fulfillment |
Another concept that is often confused with compassion fatigue is moral distress. While compassion fatigue develops from prolonged exposure to the suffering of others, moral distress occurs when a person knows the ethically right action but, because of organizational, legal, financial, or other constraints, is unable to act. The two experiences can occur simultaneously. A nurse who repeatedly witnesses patients suffering while unable to provide the care that they feel is ethically appropriate experiences both compassion fatigue and moral distress, each intensifying the other. Although distinct, compassion fatigue and moral distress are particularly evident in professional and caregiving roles, where individuals repeatedly face suffering and encounter barriers to providing the care they believe is right. Understanding the distinction is important as each requires different strategies.
While compassion fatigue has been widely observed among professional caregivers, research has now identified the impact of caregiving on families. There are currently 63 million people in the United States who provide ongoing care to a family member with a chronic illness (Home/Caregiving in the US, 2025). Family caregivers include parents of children with disabilities, adults caring for aging parents, spouses, grandparents, siblings, and military caregivers. The Alzheimer’s Association estimates that there are 13 million people providing care to someone with Alzheimer’s and other dementia-related diseases (Alzheimer’s Association, 2026), and Lynch et al. (2017) research has found that these caregivers are at risk for compassion fatigue. It is the long-term impact of caring for someone with a chronic illness, regardless of the disease, that results in compassion fatigue. Many family caregivers have ongoing responsibilities of running a household and working. For those caring for a family member with a chronic illness, it requires managing doctor’s appointments and financial needs. Caregivers may face behavioral issues when caring for someone with dementia or a mental health disorder, resulting in interactions with the emergency services, the legal system and the healthcare community. Lack of support for caregivers or respite care creates isolation and despair. Family caregivers may have underlying beliefs that they should be able to manage things on their own, that their self-worth is tied to the family member getting better, and that they should put the family member first and themselves last. Caring for a family member with a chronic illness often involves coordinating medical appointments, managing medications, navigating insurance and financial issues, and responding to behavioral changes or medical crises. Unlike professionals, family caregivers do not always have education or training, no defined workday, paid leave, or opportunity to step away from caregiving responsibilities, making recovery especially difficult.
Compassion fatigue rarely develops overnight and often begins quietly. The nurse no longer celebrates a patient’s recovery, the teacher who stops looking forward to Monday mornings, or the family caregiver who begins to feel guilty because they dread another medical appointment. These reactions are often interpreted as failures when, in fact, they are signs that the emotional cost of caring has accumulated over time. Over time, there is a negative impact on society with a significant number of professionals and family caregivers developing physical, emotional and spiritual distress. The consequences extend far beyond the individual caregiver. Organizations experience increased turnover, workforce shortages, early retirement, reduced quality of care, and patient safety concerns. Families may experience strained relationships, financial hardships, social isolation, and, in difficult situations, neglect or abuse.
Although compassion fatigue was first identified in healthcare, its reach now extends far beyond clinical settings. As the number of professional and unpaid caregivers grows, compassion fatigue has become an increasingly important public health concern with implications for workforce stability, family well-being, and quality of care delivered across society. Anyone whose role requires sustained compassion, including educators, family caregivers, first responders, clergy, and community volunteers, may be vulnerable to its effects. What is encouraging is that compassion fatigue is not a personal weakness, nor an inevitable consequence of caring. With awareness, supportive workplaces, healthy boundaries, opportunities for recovery, and evidence-based interventions, people can continue providing compassionate care without sacrificing their own well-being. Recognizing compassion fatigue is the first step toward prevention, resilience, and the long-term capacity to care for ourselves and others.
References
Alzheimer’s Association. (2026). Alzheimer’s Disease Facts and Figures. Alzheimer’s Disease and Dementia; Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/facts-figures
Frank, B. (2022). The Science of Stuck. Penguin.
Home | Caregiving in the US. (2025). Caregivingintheus.Org. https://www.caregivingintheus.org/
Joinson, C. (1992). Coping with compassion fatigue. Nursing 22(4), 116-122.
Lynch, S. H., Shuster, G., & Lobo, M. L. (2017). The family caregiver experience–examining the positive and negative aspects of compassion satisfaction and compassion fatigue as caregiving outcomes. Aging & Mental Health, 22(11), 1424–1431. https://doi.org/10.1080/13607863.2017.1364344
Noor, A. M., Suryana, D., Kamarudin, E. M. E., Naidu, N. B. M., Kamsani, S. R., & Govindasamy, P. (2025). Compassion fatigue in helping professions: a scoping literature review. BMC Psychology,13(1), 349. https://doi.org/10.1186/s40359-024-01869-5
Stamm,B.H.(n.d.) Professional quality of life scale (ProQol).www.proqol.org
Ulaş, S., & Seçer, İ. (2025). Secondary traumatic stress and burnout in healthcare professional: systematic review and a meta-analysis based on correlation coefficient. Scientific Reports,15(1), 34680. https://doi.org/10.1038/s41598-025-06950-6
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