How to Keep Caring Without Breaking

Recently, a nurse asked publicly how others cope with empathy fatigue.

It struck me that the question itself was brave.

Empathy fatigue (more often called compassion fatigue) is easy to mislabel. It can present as irritability, detachment, or impatience. It can look like burnout. It can feel like failure. But often, it is something quieter and more specific: the accumulation of caring deeply for a long time.

The subtle internal shift signaling empathy fatigue.

The most dangerous part of empathy fatigue isn’t exhaustion. It’s the subtle shift.

It’s the moment you feel yourself pulling back. The internal eye roll that surprises you. The thought you don’t like having. The faint edge of resentment where compassion once felt natural.

That shift is uncomfortable. But it is also a signal.

In oncology, relationships are not brief. We see patients repeatedly. We learn their children’s names. We know when scans are coming. We recognize the weight in their voices before they say anything at all. Over time, that proximity to suffering accumulates. Grief does not arrive all at once. It layers.

Empathy fatigue is not evidence that we care less. It is often evidence that we have cared continuously.

Left unnamed, however, it can harden into something else. Resentment is not dramatic; it is […]

2026-03-17T11:25:37-04:00March 17th, 2026|Nursing, nursing perspective, Oncology nursing|0 Comments
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National Women’s History Month–What’s Nursing Got to Do With It?

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Back in the late 60s, when I was trying to figure out what I wanted to be when I grew up, one particular piece of advice kept popping up: “Become a nurse. That way, if anything happens to your husband, you’ll be able to get a job and support your family.”

This month we celebrate National Women’s History Month. The theme is Women’s Education–Women’s Empowerment. I think back to that advice and how it captures the journeys of both nursing and women over the last 45 years.

That one piece of advice reflected so many beliefs of the time. The husband (and there should be a husband for any self-respecting woman) is the breadwinner. A woman doesn’t really want to work and shouldn’t work; her role is to take care of husband and home. She doesn’t need the fulfillment of a career—only the ability to pay the bills if she suddenly finds herself alone.

Nursing was the safety net job. Not something to pursue for its own sake—for the intellectual, emotional, and financial rewards it could offer. Women who did pursue it found themselves earning their own paycheck—but still subjugated, the handmaiden to the physician.

Thankfully, that has changed. Women pursue all kinds of careers and are surpassing men in numbers of […]

2016-11-21T13:10:32-05:00March 7th, 2012|nursing history|1 Comment
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No Explanation Required: A Preceptor’s Tale

By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” appeared in the May issue of AJN. She has also contributed a number of thought-provoking posts to this blog (here’s the most recent).

I’ve been precepting a new ICU nurse intern, which I generally enjoy doing. The only downside (from the preceptor’s perspective) is that I’m obliged to call ahead and request “unstable” assignments. This is meant to enhance the clinical aspect of the internship, and it definitely does.  Considering that I work in a trauma center, though, reserving the sickest patient in the unit feels a bit like ordering up a large serving of chaos. And although I can request the assignment, I can’t predict what will be learned.

Our most recent patient was a new admission with a traumatic brain injury. At the start of our shift he had a grim neuro prognosis and was hemodynamically unstable. His condition deteriorated throughout the day and he was eventually diagnosed as brain-dead. His family chose to donate his organs.

Taking care of an organ donor is difficult. Brain-dead patients are inherently unstable, yet certain parameters must be maintained to ensure adequate organ perfusion. It’s tedious and meticulous.  It also requires a shift of perspective—ironically, even though the patient is legally dead, […]

2016-11-21T13:15:13-05:00October 20th, 2010|Nursing, nursing perspective, students|5 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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