BACKGROUND: Intensive care units (ICUs) are high-stress environments where nurses frequently encounter futile treatments. These experiences can lead to compassion fatigue (CF) and increase turnover intention (TI) among ICU nurses. AIM: To examine the levels of attitudes towards futile treatment (ATFT), CF and TI among ICU nurses, to explore their relationship and identify the factors influencing ATFT. STUDY DESIGN: This cross-sectional study involved 440 ICU nurses who were members of the Turkish Society of Critical Care Nurses. Data were collected via an online survey using the Attitudes Towards Futile Treatment Scale (ATFTS), Compassion Fatigue-Short Scale (CFS) and Turnover Intention Scale (TIS). Descriptive statistics, correlation analyses and hierarchical regression analyses were conducted to analyse the data. RESULTS: The findings of the study indicated that ICU nurses' ATFTS, CFS and TIS scores were 43.18 ± 6.44, 74.25 ± 23.33 and 8.39 ± 3.03, respectively. There was a significant negative correlation between ATFTS and CFS (r = -0.428, p = .001) as well as TIS (r = -0.204, p = .029). In the final hierarchical regression model, the significant predictors of ATFTS included participation in patient-related decisions (β = -0.148, p = .001), performing futile treatment practices (β = 0.342, p = .001), work burnout (β = -0.165, p = .015), secondary trauma (β = -0.130, p = .011) and TI (β = -0.170, p = .039). CONCLUSION: This study found that ICU nurses' ATFTs are negatively correlated with compassion fatigue and turnover intention. Enhancing ICU nurses' involvement in decision-making and providing psychological and emotional support to manage compassion fatigue and turnover intention may help improve their attitudes towards futile treatment. RELEVANCE TO CLINICAL PRACTICE: The study highlights the critical need to address compassion fatigue and turnover intention among intensive care unit (ICU) nurses to mitigate their negative attitudes towards futile treatments. By improving emotional resilience and involving nurses more actively in ethical decision-making processes, health care institutions can enhance the quality of care provided in ICUs, reduce turnover rates and ultimately support the well-being of the nursing staff.