Purpose: The purpose of this research study was to describe the shared meaning of compassion fatigue (CF) among registered nurses (RNs) caring for older adults in skilled nursing facilities (SNFs).

Background: Nurses who care for older adults in SNFs expend compassion energy when caring for suffering patients, thus increasing the risk their compassion fatigue. In the most commonly used conceptual model of CF, compassion satisfaction is defined as the positive feelings of providing care and the negative feelings from the environment (burnout) and from one's emotional response (secondary traumatic stress). Symptoms of CF can include physical illness, detachment from patients, work-life imbalance and emotional distress. CF can negatively impact patient outcomes, is associated with decreased quality of care, and can be a reason why nurses leave the profession entirely.

Method: The hermeneutic interpretive phenomenology method was used to describe shared meaning of CF among RNs caring for older adults in SNFs. Eight participants were recruited for participation, with the assistance of key nursing leaders and snowball sampling. Each participant was interviewed three times, and concurrent data analysis helped to formulate mutual understanding of the phenomenon while also informing subsequent interviews. Self-reflection, journaling, record keeping, and use of direct quotes enhanced trustworthiness.

Findings: The participants (N= 8) described their experiences caring for older adults in a SNF. Four shared meanings were abstracted:1) I feel conflicted and that causes my CF; 2) physical and emotional manifestations of CF; 3) CF is infused in every aspect of my life; 4) We are trying to cope with CF. The participants shared the central desire to make a difference in the lives of their patients, which was of paramount importance. When participants felt they were unable to make the desired difference, they began to develop symptoms of CF. Symptoms were compounded when they experienced the death of patients they felt close to. Implications: A comprehensive resiliency program incorporating individual and organizational involvement could positively impact the participants' professional quality of life. Future qualitative and quantitative research is needed to better understand CF and effective interventions among this population of nurses.