title: Compassion fatigue in nurses: A metasynthesis.
abstract: OBJECTIVE
  To interpret the body of qualitative work focusing on compassion fatigue to distil a common understanding that could then be applied to nursing care.
  
  
  BACKGROUND
  Complex demands place extraordinary stress on nurses struggling to work in overburdened healthcare systems. The result can be the inability to care well for others, leading to compassion fatigue, burnout and increased numbers leaving the profession. Metasynthesis offers a means of more fully illuminating compassion fatigue and further understanding of practices which might reduce its negative consequences.
  
  
  METHODS
  Metasynthesis.
  
  
  METHODS
  As a method designed to facilitate knowledge development, metasynthesis allowed for integration of qualitative study findings conducted between 1992-2016 using defined search terms. Six databases were searched for articles published in English. Nine papers met the criteria for review and metasynthesis was conducted using the meta-ethnographic approach detailed by Noblit and Hare.
  
  
  RESULTS
  Four themes related to compassion fatigue were found by consensus discussion. The themes included: physical ("just plain worn out") and emotional symptoms ("walking on a tightrope"), triggering factors ("an unbearable weight on shoulders" and "alone in a crowded room"), and measures to overcome/prevent ("who has my back?").
  
  
  CONCLUSIONS
  Compassion fatigue is a concept of documented relevance to those in nursing and represents a basic inability to nurture others and engenders a temporal component. Synthesis of studies provides evidence of the veracity of the concept for application to clinical practice and research related to nursing care.
  
  
  CONCLUSIONS
  Findings provide insight into the clinical milieu needed to prevent compassion fatigue. A theoretical model is presented which can be used to guide future research, as well as the creation of clinical practice policies which might mitigate the development of compassion fatigue and its potential consequences.
authors.affiliation: Department of Nursing Science, University of Johannesburg, Johannesburg, South Africa.
authors.forename: Anna Gw
authors.identifier: http://orcid.org/0000-0002-9828-6574
authors.initials: AG
authors.lastname: Nolte
authors.affiliation: Department of Nursing Science, University of Johannesburg, Johannesburg, South Africa.
authors.forename: Charlene
authors.initials: C
authors.lastname: Downing
authors.affiliation: Department of Nursing Science, University of Johannesburg, Johannesburg, South Africa.
authors.forename: Annie
authors.initials: A
authors.lastname: Temane
authors.affiliation: Department of Nursing Science, University of Johannesburg, Johannesburg, South Africa.|Louise Herrington School of Nursing, Baylor University, Dallas, TX, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Hastings-Tolsma
mesh_terms: D002055:Burnout, Professional / Q000517:prevention & control / Q000523:psychology*; D000068376:Compassion Fatigue / Q000517:prevention & control / Q000523:psychology*; D004645:Empathy; D006801:Humans; D009726:Nurses / Q000523:psychology*; D036301:Qualitative Research
keywords: compassion fatigue; metasynthesis; mixed-methods research; nursing; qualitative