the experience of compassion fatigue is a serious challenge within caregiving professions. scholars agree that although the symptoms of compassion fatigue are similar to burnout and secondary stress disorder, there is no agreement on what distinguishes compassion fatigue from similar experiences. the terms compassion fatigue, secondary traumatic stress disorder, and burnout have been used interchangeably in the literature. the aim of this research was to develop a theoretical understanding of compassion fatigue, its process, and its relationship with compassion, which can inform nursing research and education. this research is a grounded theory investigation into the relationship between lived experience of compassion fatigue, patient engagement styles, and their knowledge of and attitude towards compassion among direct care nurses who worked during the covid-19 pandemic in canada. as part of this study, an anonymous survey among direct care nursing professionals from different parts of canada functioned as the participant recruitment platform for the subsequent grounded theory interviews. the main inclusion criteria were specified as the nurses’ who experienced of compassion fatigue any time during their career and who worked or are working during covid-19. the principal methodology of this is the grounded theory approach of gioia et al. (2013), located within the constructivist paradigm of charmaz (2006). as the main part of the data collection process, in-depth interviews were done with 27 direct care nurses from different parts of the country; the majority came from the provinces of ontario, alberta, and british columbia. the preliminary literature review and anonymous survey data indirectly informed the formulation of the research problem and questions and contributed towards cross checking of the emergent grounded theory model and other findings. [...]