Burnout, Compassion Fatigue, and Secondary Post Traumatic Stress


Published: 01 June 2016

Nursing has many risks associated with it. If people knew how dangerous it could be, they may have thought twice about becoming a nurse. Your body is on the line as the constant barrage of patients requires you to use your back and knees. You are exposed to different diseases that may severely impact your life, and you often go to work sick, putting your health at risk again. No one really understands the psychological impact of nursing until they are in it. There are essentially three types of mental issues that impact nurses, and all of them are different: burnout, compassion fatigue, and secondary post-traumatic stress.

It is important to know which of these you are suffering from because the treatment for each is different. Unfortunately, more and more nurses are finding themselves suffering from one or all of these issues, and they can lead to clinical depression, leaving the profession, and profound unhappiness. If you think you may have one of these issues, you must look at your life and your practice. Experiencing any of them can negatively affect you and your family, and you deserve to address the matter for your own best interests.


Burnout is the catchall term that nurses usually associate with all of these conditions, but it has specific symptoms of its own. Merely because you are struggling does not mean you are burnt out. The primary symptom of burnout is dissatisfaction with the way things are done. For instance, you are not happy with staffing, management, or policies and procedures. You are being asked to do more and more, but you don’t have the physical or mental resources to keep up with the demands.

Most of the time, burnout doesn’t have to do with patients. It has to do with those around you and how the system makes it more difficult to do your job. You may be upset that management practices are making your working conditions unsafe. You may be upset that your back is giving out and there is nothing you can do. You start to care less because it seems nothing changes the tide in favor of nursing. Management keeps asking for more, and you don’t have more to give. You are constantly called in for overtime, kept over when you have other things to do with your life, and disgruntled with your facility. The lack of caring comes from the demands made on you, not on the psychological stresses of nursing.

Nurse Burnout

Compassion Fatigue

Compassion fatigue is probably what most nurses are feeling when they think they are burnt out. While it is true that you can have a devastating combination of burnout and compassion fatigue, sometimes the compassion fatigue is ignored. This particular issue has to do with the feelings associated with being a nurse. It doesn’t mean you can’t care anymore. It doesn’t mean that you have no more compassion to give. It doesn’t mean you can’t hack it as a nurse. It means that you’ve faced patients who are in pain, who are dying, or who are suffering, and you can’t do anything about it. It means you have one patient who has taken all of your emotional stores, and yet you have to move onto the next patient because they need you, too.

Compassion fatigue is more devastating than burnout because it affects your core emotional stability. Nurses aren’t allowed time to grieve. Nurses aren’t really given a time or a place to debrief, share their emotions, or come down from the height of emotional extremism. It is when this continues, month after month, year after year, that the nurse experiences compassion fatigue. No matter what happens to your patient, you have to keep going. No matter how you are feeling, you have to take care of the next patient. It is exhausting, and this is the main point of what compassion fatigue is.

Secondary Post Traumatic Stress

Post-traumatic stress disorder isn’t only diagnosed in those who have experienced a direct trauma. The symptoms can also be expressed in those who have witnessed horrible trauma, and nurses fall into that category. Nurses see people die, acts of violence, and patients who experience pain. Secondary post-traumatic stress disorder can be seen with both burnout and compassion fatigue. The main symptoms are clinical depression, flashbacks, and difficulty in functioning. In general, any symptom that a PSTD patient experiences can also be felt by those who see trauma secondarily.

The problem with these three types of psychological stress injuries is that they are so often confused. Someone who is experiencing compassion fatigue may not find help by finding a new job. However, a nurse with burnout may find that a new job could help with their symptoms. Compassion fatigue and secondary post-traumatic stress disorder usually require a doctor’s intervention. Therapy and possibly anti-depressants may help you overcome the feelings that nursing has caused you. These three often are seen together, but parsing out which you are feeling could help you find treatment that would be best for you.