Compassion Fatigue and Connection: The Lived Experiences of Intensive Care Unit Healthcare Workers Navigating Family Dynamics in High-Stress Environments

Abstract

This study explored the lived experiences of ICU healthcare workers in managing emotionally demanding interactions with patients’ families. It focused on emotional labor, cultural expectations, professional boundaries, patient-centered care, and the psychological impact of family communication in critical care settings. The study employed a qualitative phenomenological design. Twelve ICU healthcare workers participated, composed of three nurses, three physicians, two nursing aides, two medical technologists, and two respiratory therapists from public and private hospitals. Data were gathered through semi-structured interviews, small group discussions, and field notes. Colaizzi’s method was used to analyze the participants’ lived experiences. Findings revealed ten major themes: navigating emotionally demanding family interactions; encounters of heightened emotional distress; immediate emotional and work-related impact; challenges in critical care communication; emotional spillover into personal life; cultural expectations and emotional labor; influence of Filipino family expectations on care; emotional regulation and professional composure; extending care beyond clinical responsibilities; and conflict between family wishes and patient-centered care.

The study concluded that ICU healthcare workers experienced family interaction as an essential but emotionally demanding part of critical care. Their experiences reflected the need to balance compassion, cultural sensitivity, professional boundaries, patient safety, autonomy, dignity, and emotional resilience. The study recommends structured family communication protocols, designated family spokespersons, regular debriefing, peer support, communication training, ethics consultation, palliative-care collaboration, and mental-health services for ICU personnel. Hospitals should balance Filipino family-centered values with international standards on patient rights, informed consent, confidentiality, safety, and dignity.