Objective To examine the type transition and influencing factors of compassion fatigue among nursing students during clinical internship, so as to develop targeted early management strategies to lower the level of compassion fatigue. Methods A total of 249 nursing interns were selected conveniently, then they were investigated by using the Chinese version of the Compassion Fatigue Scale, the Professional Self-Concept of Nurses Instrument, the Simplified Coping Style Questionnaire, the Perceived Social Support Scale, and the Environment Evaluation Scale for Clinical Nursing Internship during the early stage (≤2 months), the middle stage (5-6 months), and the late stage (≥9 months) of the internship. Results At the commencement, midpoint, and the final stage of the internship, the prevalence of moderate to severe compassion fatigue was 32.1%, 34.1%, and 47.8%, respectively. Latent profile analysis revealed four subtypes of compassion fatigue: high empathetic adaptive type, balanced critical type, burnout-dominant type, and trauma stress-dominant type. From the initial stage to the mid-stage of the internship, the probabilities of the four subtypes retaining their original states were 63.0%, 59.8%, 58.7%, and 0.0%, respectively; from the mid-stage to the final stage, the probabilities of maintaining the original group were 43.8%, 51.3%, 76.2%, and 16.7%, respectively. The logistic regression analysis indicated that, the professional self-concept of nurses facilitated the transition from a burnout-dominant type during the initial phase of the internship, while positive coping style hindered the transformation of a balanced critical type in the later stage of the internship. Conclusion The compassion fatigue experienced by nursing interns escalates throughout their internship. The interns′ professional self-concept and coping styles are significant elements influencing the evolution of compassion fatigue during their internships. Therefore, it is necessary to develop targeted management strategies accordingly to prevent compassion fatigue of nursing interns.