The Relationship Between Second Victim Experiences and Compassion Fatigue Among ICU Nurses: The Chain-Mediating Role of Ego-resiliency and Emotional Contagion

Background ICU nurses are prone to becoming "second victims" after experiencing patient safety incidents, and the mechanism of its relationship with compassion fatigue remains unclear. Based on the Conservation of Resources Theory, this study explores the mediating roles of ego-resiliency and emotional contagion. Methods A cross-sectional design was adopted. A convenience sample of 221 ICU nurses from three tertiary hospitals in Tianjin was surveyed from February to April 2025. The Second Victim Experience and Support Tool, the Ego-Resiliency Scale, the Compassion Fatigue Short Scale, and the Emotional Contagion Scale were used. Structural equation modeling was employed to analyze the chain mediation effects. Results The second victim experience was significantly positively correlated with compassion fatigue (r = 0.476). It not only directly and positively predicted compassion fatigue (β = 0.23), but also exerted indirect effects through the independent mediation of ego-resiliency (β = 0.80), the independent mediation of emotional contagion (β = 0.93), and the chain mediation path of "ego-resiliency → emotional contagion" (β = 0.53). Conclusions The second victim experience leads to compassion fatigue through both the depletion of individual psychological resources and team-level emotional contagion. Interventions should systematically integrate enhancing individual resilience, optimizing team emotional climate, and strengthening organizational support to block the resource depletion pathway and protect nurses' psychological health.