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Introduction Compassion fatigue, characterized by emotional exhaustion and reduced ability to empathize, is a well-recognized challenge among health care professionals in intensive care units. Continuous exposure to critically ill patients, ethical dilemmas and high work demands increases vulnerability to compassion fatigue and reduces compassion satisfaction. Coping strategies are essential for maintaining wellbeing and ensuring high-quality patient care. This study applies group concept mapping to identify coping strategies for preventing compassion fatigue among health care professionals in intensive care units. Methods Group concept mapping, a participatory and mixed method, was used to collect and analyze data. Health care professionals from intensive care units in Sweden participated in data collection through brainstorming coping strategies ( n = 27), followed by sorting ( n = 21) and rating the strategies according to importance ( n = 25) and use ( n = 24). Multi-dimensional scaling and hierarchical cluster analysis were applied to generate a cluster map. Ratings of the strategies’ importance and use were analyzed. Results Analysis of the participants’ sorting generated five clusters: (1) Meaning making through a person-oriented perspective ; (2) Supportive professional practice ; (3) Peer support and empathic teamwork; (4) Work-life balance ; and (5) Personal responsibility . The cluster Peer support and empathic teamwork was rated highest in terms of use, while Supportive professional practice was rated highest in terms of importance but low in use, indicating an implementation gap. The cluster Personal responsibility was rated lowest in both importance and use. Discussion The results demonstrate that coping strategies to prevent compassion fatigue operate across individual, team and organizational levels. While health care professionals value support on an organizational level, such strategies remain underutilized in current practice. Strengthening structures for ethical reflection and feedback alongside promoting support and opportunities for recovery may foster resilience and compassion satisfaction in ICU settings. Sustainable prevention of compassion fatigue requires shared responsibility between individuals and organizations, highlighting the importance of integrated approaches to staff wellbeing.