When Caring Hurts: Exploring Compassion Fatigue among Neonatal Intensive Care Unit Nurses

Abstract

Compassion fatigue among neonatal intensive care unit (NICU) nurses is a critical occupational concern shaped by emotional, physical, relational and environmental demands, necessitating a deeper understanding of how nurses experience and manage this phenomenon to sustain resilience, well-being, and compassionate care. This study explored the lived experiences of NICU nurses in government hospitals in the southern Philippines using an existential transcendental phenomenological design guided by Moustakas’ framework. Seven purposively selected nurses participated in semi-structured interviews, with data supplemented by field notes and analyzed through horizonalization, clustering of significant statements, textural and structural descriptions, and synthesis of the essence of the experience. Six major themes emerged: navigating emotional and physical demands while sustaining compassion; managing environmental pressures such as sensory overload and spatial intensity; the temporal development of resilience through repeated exposure to critical care; relational anchors including colleagues, patients, and families; material and technological aspects of care as both stressors and sources of hope; and the development of resilience and professional identity through experiential learning, reflective practice, and intentional self-care. Compassion fatigue was described as an embodied, relational and contextually situated experience influenced by organizational, environmental, and personal factors. Nurses mitigated its effects through adaptive coping strategies, relational support, and continuous professional growth. The findings highlight the need for supportive work environments, structured mentorship, stress-reduction interventions, and resilience training, while suggesting further multi-site research to enhance the transferability of results beyond the study’s limited sample and regional scope.