Compassion Fatigue Among U.S. Military RNs Post Overseas Deployment

Purpose: Describe the meaning of compassion fatigue (CF) as experienced by the U.S. military registered nurse (RN) post-deployment from Iraq and Afghanistan. Background: CF is characterized by deep emotional and physical exhaustion, and may resemble posttraumatic stress disorder (PTSD). Often this causes a shift in confidence and clouds RN perceptions. Symptoms include difficulty concentrating, intrusive imagery, hopelessness, exhaustion, and irritability leading to profound alterations in one's view of the world, patients, family, and friends. Outcomes include depersonalizing patients, poor coping mechanisms, lowered standards, clinical errors, and blurring boundaries, all can contribute to a toxic work environment and RNs leaving the profession. Method: Hermeneutic phenomenological methodology facilitated a description of CF in words and meaning expressed by U.S. military RNs (i.e., Army, Navy). The sample was obtained through the snowball method and aided by key informants. Data were collected through interviews and observations with each active duty or reservist RN (N = 8) on three occasions. Participants described their military and nursing backgrounds and experiences of CF through hermeneutic interview. Analysis was ongoing during the interview process and included continual questioning, reflecting, and validating. This process allowed for understanding through engagement of text (e.g., dialogue, transcriptions). Journaling and self-reflection assisted with trustworthiness. Findings: Participants shared many experiences. While some had unique experiences, their feelings and perceptions resonated with other participants and informed the emergence of four shared meanings and shared concerns: (a) the term CF does not fit me, manifested by expressions of the meaning of CF; (b) compassion fatigue as all encompassing, manifested by physical, emotional, relational, and spiritual experiences; (c) compassion fatigue will not interfere with my military duty, manifested by the pervasive military lens that the meaning of the experiences are filtered, and (d) compassion fatigue affects people long after deployment . . . gone, but not forgotten, manifested by the lasting effects of CF. Implications: While CF among military RNs has many similarities with the general nursing population, the practice environment appears to create additional triggers and manifestations. This study provides an understanding of the progression of CF in this population. Implementing interventions before and after trauma exposure can preserve the care in military caregivers