From Empathy to Exhaustion: A Qualitative Phenomenological Study on Compassion Fatigue in Emergency Department Nurses

PURPOSE: This study sought to describe the experiences of emergency department nurses with compassion fatigue. DESIGN: A qualitative phenomenological design was used. METHODS: This study was conducted with 10 nurses working in the emergency department in July 2026. Interviews were documented through handwritten notes, expanded into digital format within 24 h, and complemented by observational notes. Data were analysed manually, without the use of qualitative data analysis software. Data analysis was performed in accordance with Colaizzi's seven-stage phenomenological analysis method, including identifying meaningful statements, formulating meanings, developing thematic clusters and validating findings through participant feedback. RESULTS: Among the primary themes of compassion fatigue, 3 secondary themes emerged: emotional strain with regard to a sense of powerlessness, incompetence and guilt as a result of intense empathic involvement, emotional transformation in terms of waning empathetic engagement and distancing from others' feelings and adaptation and self-defence including coping methods such as setting an emotional distance, increasing one's psychic distance from sources of exposure or re-creating work-life balance. CONCLUSION: Compassion fatigue in the emergency department is a dynamic process, which is initiated with empathy and encumbrance of emotional stress over time will transform the nurse's emotion and care giving. These results emphasize the need for context-sensitive and nurse-focused intervention to enhance the emotional resilience of nurses. Framing these interventions around a structured well-being model such as PERMA may offer healthcare organizations a practical, multidimensional pathway for sustaining nurses' emotional resilience and safeguarding compassionate care in high-acuity settings. REPORTING METHOD: This qualitative phenomenological study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (see Supplementary Appendix A). PATIENT AND PUBLIC CONTRIBUTION: Nurses who had cared for patients within high-acuity clinical environments were included in interviews, providing experiential knowledge that informed the data analysis and supported the clinical relevance of findings. IMPACT: Among nurses working in challenging clinical settings, compassion fatigue remains an underdeveloped threat to both nurse well-being and the sustainability of high-quality patient care. Findings of the study illustrates how compassion fatigue evolves out of cumulative emotional strain and how nurses actively manage this by developing emotional boundaries and creating self-protection strategies in order to remain functional within difficult care situations. By shining a spotlight on these lived experiences, the findings highlight the value of organizational awareness and nurse-led supportive interventions in nurturing emotional resilience, safeguarding compassionate care and promoting workforce retention in clinical nursing practice.