Compassion fatigue is a real threat to the health of your hospice staff and the efficient functioning of your hospice. Stress and burnout are precursors to a greater problem, and if not dealt with soon and often, they can turn into a more serious, depleted emotional state. When compassion fatigue sets in, your hospice is at risk for decreased quality in patient care, poor survey results and expensive and time consuming staff turnover.

The National Hospice and Palliative Care (NHPCO) organization’s fall conference included a session on compassion fatigue. It described how it differs from stress or burnout:

  • Stress is caused by external factors that result in physical, mental and emotional reaction
  • Burnout is characterized by emotional exhaustion and results in feelings that work isn’t gratifying anymore
  • Compassion fatigue is unique to healthcare workers who work in high stress or emotionally demanding work, especially in the field of hospice and palliative care. 1

This definition points to what several studies have already shown the industry: hospice and home health workers are particularly at risk. “There is compelling evidence that nurses who have repeated exposure to people who are suffering, traumatized, seriously ill, and/or dying are at particular risk.” 2 A study published in the Journal of Hospice and Palliative Nursing identified six reasons for compassion fatigue:

  1. Time pressure
  2. Workload
  3. Demanding patients
  4. Poor working conditions
  5. Working night shifts
  6. Problems in their personal lives

Hospice nurses are constantly called upon to work whenever needed, resulting in long work weeks and little time off. Death has no schedule, so they are often needed on weekends, holidays, or during night shifts. This can lead to the fatigue and burnout that cause high rates of job turnover. The impact of burnout in the industry is staggering: Registered nurses who work in home health care and hospice services have a shockingly short median tenure of 1.17 years.3

There are dire consequences for hospices that fail to combat compassion fatigue:

  • Staff turnover
  • Declining productivity
  • Patient/family disatisfaction
  • Low survey scores
  • Increase costs to re-train and re-staff

Hospices and hospice administrators need to create spaces and activities to help their RNs cope, recover and reinvigorate to help them better meet the challenges of the care they deliver.

Refreshing, rejuvenating tips to combat compassion fatigue

To ward off compassion fatigue among your hospice nursing staff, focus on their physical environment, their need to recover emotionally and their physical well being.

Create a peaceful, pleasant work environment

Having a work environment that is calming, relaxing and beautiful can go a long way toward rejuvenating stressed staff.

  • Buy fresh flowers when the budget permits.
  • Encourage listening to soft music, recorded nature sounds or spa-inspired soundtracks.
  • Decorate your workspace with beautiful and calming nature scenes
  • Set aside an outdoor space for sitting, reflecting and resting

Help them process their grief

Helping the dying and their families can cause hospice nurses to grieve, too. Create ways that they can positively process those emotions:

  • Create a wall of remembrance with photos that reflect the rewards of caring for the terminally ill
  • Start a flower garden and add plants or sow flower seeds in memory of patients
  • Collect and display uplifting prayers or poems

Feed and nourish

Healthy drinks and snacks are a good way to physically support your staff. Hosting breakfasts, barbecues and other meals or treats will help you care for both body and soul. Some healthy healing food options are:

  • Herbal teas
  • Flavored waters or fancy spring water
  • Fruit smoothies
  • Nuts
  • Seasonal fruit baskets

Show appreciation

Showing your gratitude and appreciation is a great way to increase job satisfaction and prevent turnover of your staff. Take time to offer small tokens of gratitude. They don’t have to be expensive or elaborate:

  • Seasonal candles
  • Hand lotion
  • Notepads & pens
  • Scented soaps or antibacterial hand gels

Consider after-hours telephone triage for night and weekend care

AfterHours Triage is a leader in compassionate, world-class after-hours telephone triage for hospice clients, patients, and caregivers. Support from AfterHours Triage can help reduce staff burnout, compassion fatigue and turnover by:

  • Triaging caregiver calls over the phone, gathering necessary information, setting realistic expectations, and contacting on-call nurse when necessary.
  • Alleviating demands on on-call nurses for a better work experience and improved work-life balance.
  • Reducing the number of home visits by resolving most non-emergent calls without contacting on-call nursing staff.
  • Providing much needed support during periods of high call volume, allowing staff resources to be allocated where they are most needed.

Compassion fatigue puts your hospice staff’s health and well-being at risk. A few fresh ideas can help refresh, revive and protect your nurses from burnout. Taking proactive steps to combat compassion fatigue will help you and your staff continue to work in the demanding but ultimately rewarding field of hospice and palliative care.

Finding after-hours support is easier than you think. See how AfterHours Triage can extend your services without extending your staff, contact us or call 888-260-8460.


1 Stried M, Forman D. Compassion Fatigue: Retaining Your IDG TEam. NHPCO Session 8F. September 2015
2 Melvin CS. Historical review in understanding burnout, professional compassion fatigue, and secondary traumatic stress disorder from a hospice and palliative nursing perspective. Journal of Hospice & Palliative Nursing. 2015;17(1):66-72.
3 TurnoverRx: How to cure the retention problems ailing your healthcare organization. CareerBuilder. 2011.