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AIMS: To investigate the mediating role of spiritual well-being in the association between compassion fatigue and moral resilience among nurses. BACKGROUND: Nurses are inevitably placed in situations of compassion fatigue. Their moral resilience and spiritual well-being may play a crucial role in mitigating the impacts of compassion fatigue. Nonetheless, spiritual well-being, which mediates the influence between compassion fatigue and moral resilience, remains scarce among nurses. DESIGN: Cross-sectional and correlational design. METHODS: Nurses (n = 465) from four government-owned tertiary hospitals in Saudi Arabia were recruited and completed three self-report scales from July to December 2023. Descriptive statistics (e.g., mean, standard deviation, frequency, and proportions) and inferential statistics (Spearman rho and structural equation modeling) were used for data analysis. RESULTS: The emerging model afforded acceptable model fit parameters. Moral resilience had a negative effect on compassion fatigue (β = -0.05, p = 0.003) and a positive influence on spiritual well-being (β = 0.51, p = 0.003). Spiritual well-being negatively influenced compassion fatigue (β = -0.90, p = 0.003). Moral resilience had a moderate, negative, indirect effect on compassion fatigue through the mediation of spiritual well-being (β = -0.47, p = 0.002). CONCLUSION: Our study offered a model that validated the mediating role of spiritual well-being in the association between moral resilience and compassion fatigue. Moral resilience directly and indirectly influences spiritual well-being and compassion fatigue, respectively. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Healthcare institutions that employ nurses must continually assess compassion fatigue levels and provide necessary interventions. Nurses, nurse managers, and healthcare institutions may leverage moral resilience to improve nurses' spiritual well-being while averting the negative effects of compassion fatigue. Healthcare institutions may incorporate spiritual care into their mainstream support interventions to enhance their compassion, reduce fatigue, and enhance their mental well-being.
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