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PechaKucha Presentation

Abstract

Background: Intensive care unit nurses (ICU) care for patients in a stressful, high-acuity work environment. They are frequently exposed to emotionally demanding situations. Cumulative occupational stressors place ICU nurses at risk for compassion fatigue. Literature suggests this stress can negatively influence work performance in the ICU; however, there is currently limited research investigating the perceived relationship between compassion fatigue and clinical decision-making skills among ICU nurses.

Purpose: A descriptive phenomenological approach was used to answer the research question: How do ICU nurses perceive their clinical decision-making skills when experiencing compassion fatigue?

Methods: Eighteen ICU nurses at a large academic health system in Michigan were interviewed for this study. Semi-structured interviews were conducted to obtain participants’ lived experiences of making clinical decisions in a critical care setting when grappling with compassion fatigue. The interview data was then analyzed using Colaizzi’s method to identify recurring themes.

Results: The perceived impact of compassion fatigue on clinical decision-making skills in ICU nurses were summarized in nine themes. ICU nurses experienced the following ten themes: (1) cognitive function changes, (2) communication changes, (3) decreased adherence to nursing standards and hospital policies, (4) doing the bare minimum, (5) less analytical-based thinking, (6) decline in delegation and advocacy, (7) making mistakes at work, (8) missed or overlooked assessment finding, and (9) nursing responsibilities forgotten, delayed, or pushed to the wayside.

Discussion: ICU nurses perceive their clinical decision-making skills to be negatively impacted when they are experiencing work-related compassion fatigue. It is important for researchers to also study this topic within other areas of nursing besides the ICU since compassion fatigue has been a long-standing issue within the entire profession. In addition, since compassion fatigue is on the rise among the nursing workforce, it is imperative for nursing leaders to continue to research the full impact of compassion fatigue on nurses and discover future interventions to combat this occupational issue.

Notes

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References:

Alharbi, J., Jackson, D., & Usher, K. (2020). Compassion fatigue in critical care nurses and its impact on nurse-sensitive indicators in Saudi Arabian hospitals. Australian Critical Care,33, 553-559. https://doi.org/10.1016/j.aucc.2020.02.002

Chu, L. (2021). The influence of compassion fatigue on job performance and organizational citizenship behaviors: The moderating effect of person–job fit. Journal of Nursing Scholarship, 53(4), 500-510. https://doi.org/10.1111/jnu.12644

Khatatbeh, H., Al-Dwaikat, T., Rababah, J., Oláh, A., & Pakai, A. (2021). Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling. Journal of Clinical Nursing, 00, 1–10. https://doi.org/10.1111/jocn.16114

Xie, W., Chen, L., Feng, F., Okoli, C. T., Tang, P., Zeng, L., Jin, M., Zhang, Y., & Wang, J. (2021). The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis. International Journal of Nursing Studies, 120, 103973–103973. https://doi.org/10.1016/j.ijnurstu.2021.103973

Yee, A. (2023). Clinical decision-making in the intensive care unit: A concept analysis. Intensive and Critical Care Nursing, 77, 1-8. https://doi.org/10.1016/j.iccn.2023.103430

Zakeri, M. A., Bazmandegan, G., Ganjeh, H., Zakeri, M., Mollaahmadi, S., Anbariyan, A., & Kamiab, Z. (2020). Is nurses' clinical competence associated with their compassion satisfaction, burnout and secondary traumatic stress? A cross-sectional study. Nursing Open, 8(1), 354–363. https://doi.org/10.1002/nop2.636

Description

Intensive care unit nurses (ICU) are at high risk for compassion fatigue which can negatively influence their work performance; however, there is limited research investigating the impact of compassion fatigue on clinical decision-making skills in ICU nurses. A qualitative study was conducted to answer the research question: How do ICU nurses perceive their clinical decision-making skills when experiencing compassion fatigue?

Author Details

Angela Yee, MSN RN AGCNS-BC, PhD candidate

Sigma Membership

Alpha Psi

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Phenomenology

Research Approach

Qualitative Research

Keywords:

Stress and Coping, Workforce, Acute Care, Critical Care Nurses, Decision Making in Clinical Medicine, Secondary Traumatic Stress, Compassion Fatigue

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-09-26

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The Perceived Impact of Compassion Fatigue on Clinical Decision-Making Skills in ICU Nurses

Toronto, Ontario, Canada

Background: Intensive care unit nurses (ICU) care for patients in a stressful, high-acuity work environment. They are frequently exposed to emotionally demanding situations. Cumulative occupational stressors place ICU nurses at risk for compassion fatigue. Literature suggests this stress can negatively influence work performance in the ICU; however, there is currently limited research investigating the perceived relationship between compassion fatigue and clinical decision-making skills among ICU nurses.

Purpose: A descriptive phenomenological approach was used to answer the research question: How do ICU nurses perceive their clinical decision-making skills when experiencing compassion fatigue?

Methods: Eighteen ICU nurses at a large academic health system in Michigan were interviewed for this study. Semi-structured interviews were conducted to obtain participants’ lived experiences of making clinical decisions in a critical care setting when grappling with compassion fatigue. The interview data was then analyzed using Colaizzi’s method to identify recurring themes.

Results: The perceived impact of compassion fatigue on clinical decision-making skills in ICU nurses were summarized in nine themes. ICU nurses experienced the following ten themes: (1) cognitive function changes, (2) communication changes, (3) decreased adherence to nursing standards and hospital policies, (4) doing the bare minimum, (5) less analytical-based thinking, (6) decline in delegation and advocacy, (7) making mistakes at work, (8) missed or overlooked assessment finding, and (9) nursing responsibilities forgotten, delayed, or pushed to the wayside.

Discussion: ICU nurses perceive their clinical decision-making skills to be negatively impacted when they are experiencing work-related compassion fatigue. It is important for researchers to also study this topic within other areas of nursing besides the ICU since compassion fatigue has been a long-standing issue within the entire profession. In addition, since compassion fatigue is on the rise among the nursing workforce, it is imperative for nursing leaders to continue to research the full impact of compassion fatigue on nurses and discover future interventions to combat this occupational issue.