Obstacles to compassion-giving among nursing and midwifery managers: an international study

How to implement compassionate leadership in nursing teams

Rationale and key points This article explains how to implement compassionate leadership in nursing teams. Compassionate leadership is an approach that aims to empower and support staff through four main behavioural principles - attending, understanding, empathising and helping. • Compassionate leadership can be practised by all nurses, irrespective of their role or position, and with individuals or groups. • For the nurse, understanding and reflecting on their own leadership style is the starting point for compassionate leadership, after which nurses may consider leading others. • Implementing compassionate leadership can empower teams, enhancing team members' performance, motivation and well-being. • Compassionate leadership can also support improved outcomes for patients, since motivated nurses are more likely to provide high-quality care. Reflective activity 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might help you to introduce compassionate leadership into your nursing team. • How you could use this article to educate nursing colleagues and students about the role of compassionate leadership in nursing teams.

Psychiatric Wards Nurses' Experiences on Self-Compassion, Compassionate Care and Compassion Fatigue: A Qualitative Study

BACKGROUND

Compassion is an important component of providing quality nursing care, and the literature on compassionate care in psychiatric nursing is limited.

AIM

The aim of this qualitative descriptive study was to explore the experiences of psychiatric ward nurses regarding self-compassion, compassionate care and compassion fatigue.

METHODS

A qualitative descriptive study was conducted by thematic analysis with an inductive approach of semi-structured interviews with 16 psychiatric nurses across psychiatric ward in a state hospital, Kirkuk, Iraq, selected through purposeful sampling between 15 October and 15 November 2023.

RESULTS

The analysis of the data, two main themes emerged: 'freedom in difficulties' and 'togetherness of suffering'. These results indicate that psychiatric nurses need individual and organizational resources to provide compassionate care.

CONCLUSION

It is thought that developing programmes to improve the self-compassionate care of psychiatric nurses by institution managers and policy makers may be effective in reducing compassion fatigue and providing compassionate care. In the future research, how religion affects psychiatric nurses' ability to provide compassionate care and the role of belief in coping with compassion fatigue experienced by psychiatric nurses needs to be investigated.

How to deliver person-centred care for people living with heart failure: a multi stakeholder interview study with patients, caregivers and healthcare professionals in Thailand

CONTEXT

Heart failure has high, growing global prevalence, morbidity and mortality, and is a leading cause of death with serious health-related suffering in low- and middle-income countries. Person-centred care (PCC) is a critical component of high-quality healthcare and is particularly vital in the context of a serious illness such as heart failure. However, there are limited data exploring PCC in this population in low- and middle-income settings.

AIM

The aim of this study was to explore how clinical services could respond to the PCC needs of individuals living with heart failure in Thailand, with potential for adaptation in other settings. The specific objectives were (i) to understand the experiences and needs of persons living with heart failure, their caregivers and HCPs; (ii) to explore specific practical actions that can help deliver PCC for heart failure patients in this setting.

METHODS

Cross-sectional qualitative study. In depth, semi-structured interviews were conducted in Thailand with heart failure patients (n = 14), their caregivers (n = 10) and healthcare professionals (n = 12). Framework analysis was conducted with deductive coding to populate an a priori coding frame based on Santana et al's PCC model (2018) and Giusti et al's systematic review (2020), with further inductive coding of novel findings to expand the frame. The study is reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ).

RESULTS

The findings reveal specific practice actions that deliver PCC for persons living with heart failure in Thailand, such as (i) compassionate communication by healthcare professionals; (ii) effective teamwork amongst multidisciplinary healthcare professionals; (iii) proactive responses to physical, psychosocial, relational and information needs of patients and caregivers; (iv) engaging patients and families in symptom management; (v) providing opportunities for patients to be cared for in the community; and (vi) responding to the social determinants of health, illness and healthcare access.

CONCLUSION

Person-centred healthcare systems must aim to address the social determinants of illness and place focus on community- and home-based care. Heart failure patients and caregivers must be supported to self-manage, including how to recognise symptoms and take appropriate action. Delivering PCC in such a way has the potential to improve outcomes for patients, enhance patients' sense of agency and experiences of care, improve health equity, and reduce hospital admissions, relieving pressure on the hospital system and reducing overall costs of care.

Health-care leaders' and professionals' experiences and perceptions of compassionate leadership: A mixed-methods systematic review

PURPOSE

The purpose of this study is to identify and synthesise the best evidence on health-care leaders' and professionals' experiences and perceptions of compassionate leadership.

DESIGN/METHODOLOGY/APPROACH

A mixed-methods systematic review was conducted in accordance with the Joanna Briggs Institute methodology for mixed-methods systematic reviews using a convergent integrated approach. A systematic search was done in January 2023 in PubMed, CINAHL, Scopus, Medic and MedNar databases. The results were reported based on Preferred Reporting Items for Systematic Reviews and Meta-analyses. The data was analysed using thematic analysis.

FINDINGS

Ten studies were included in the review (five qualitative and five quantitative). The thematic analysis identified seven analytical themes as follows: treating professionals as individuals with an empathetic and understanding approach; building a culture for open and safe communication; being there for professionals; giving all-encompassing support; showing the way as a leader and as a strong professional; building circumstances for efficient work and better well-being; and growing into a compassionate leader.

PRACTICAL IMPLICATIONS

Compassionate leadership can possibly address human resource-related challenges, such as health-care professionals' burnout, turnover and the lack of patient safety. It should be taken into consideration by health-care leaders, their education and health-care organisations when developing their effectiveness.

ORIGINALITY/VALUE

This review synthesised the knowledge of compassionate leadership in health care and its benefits by providing seven core elements of health-care leaders' and professionals' experiences and perceptions of compassionate leadership.

The impact of organizational compassion in health care on clinicians: A scoping review

BACKGROUND

The unprecedented exodus of workers from the healthcare system is a patient safety crisis. Organizational compassion in health care is the proactive, systematic, and continuous identification, alleviation, and prevention of all sources of suffering.

AIMS

This scoping review aimed to describe the evidence regarding the impact of organizational compassion on clinicians, identify gaps, and provide recommendations for future research.

METHODS

A comprehensive librarian-assisted database search was conducted. Databases searched were PubMed, SCOPUS, EMBASE, Web of Science, PsychInfo, and Business Source Complete. Combinations of search terms regarding health care, compassion, organizational compassion, and workplace suffering were used. The search strategy was limited to English language articles and those published between 2000 and 2021.

RESULTS

Database search yielded 781 articles. After removing duplicates, 468 were screened by title and abstract, and 313 were excluded. One-hundred and fifty-five underwent full-text screening, and 137 were removed, leaving 18 eligible articles, two of which were set in the United States. Ten articles evaluated barriers or facilitators to organizational compassion, four evaluated elements of compassionate leadership, and four evaluated the Schwartz Center Rounds intervention. Several described the need to create systems that are compassionate to clinicians. Lack of time, support staff, and resources impeded the delivery of such interventions.

LINKING EVIDENCE TO ACTION

Little research has been done to understand and evaluate the impact of compassion on US clinicians. Given the workforce crisis in American health care and the potential positive impact of increasing compassion for clinicians, there is an urgent need for researchers and healthcare administrators to fill this gap.

Conectarnos con la compasión para preservar el cuidado humanizado

Este artículo revisa la compasión como requerimiento esencial para la atención humanizada, abordando elementos definitorios desde sus raíces filosóficas y su vínculo con la práctica de la enfermería. Objetivo: reflexionar sobre la compasión como un atributo inherente al cuidado humanizado, según lo reportado en la literatura. Materiales y métodos: artículo de reflexión, para el cual se realizó una búsqueda y la revisión de literatura en bases de datos científicas especializadas, con descriptores y operadores boleanos relacionados con el tema. Resultados: se presentan elementos conceptuales útiles para adoptar la compasión como un rasgo ético que se debe promover en la formación y el trabajo académico en las áreas de ciencias de la salud y, en especial, en enfermería.

Hospital nurses' experiences and expectations of compassion and compassionate leadership

RATIONALE AND AIM

Nurses caring for critically ill patients need compassionate attention and support, especially during exceptional times. The aim of this study was to provide a trustworthy description of nurses' experiences and expectations for compassionate leadership and compassion at a central hospital in Finland. The study was conducted during the early stage of the coronavirus 2019 pandemic.

ETHICAL ISSUES AND APPROVAL

The voluntary nature and anonymity of the survey were stressed in the cover letter, to make sure that participants did not perceive any undue influence caused by participating in the study.

METHODS

The participants were 50 intensive care and emergency nurses of a central hospital. An online survey tool with open questions was used to collect data on the meaning of compassion and on nurses' experiences and expectations of compassion and compassionate leadership. Inductive content analysis was used to analyse the data.

RESULTS

The nurses reported a great variety of positive experiences of compassion, although the emphasis in this study seemed to be on the absence of compassion, especially in regard to leadership. The nurses expected individual attention and genuine physical and psychological presence from their immediate supervisors.

STUDY LIMITATIONS

One researcher analysed the data, which can cause some bias in the qualitative analysis.

CONCLUSIONS

Immediate supervisors express compassion by being physically present and by fostering an open dialogue. Compassion received from leaders and colleagues may be reproduced in patient contacts, which can increase patients' confidence and psychological safety. Participatory and simulation-based learning methods, which involve shared reflection, are recommended for compassionate leadership skills.

Compassionate Practices for Nurse Managers in Colombia

Objective: To recognize compassionate practices and the obstacles to their use by nurse managers in Colombia. Method: This is a mixed cross-sectional, descriptive, exploratory, international study with an online survey administered in 17 countries. Data were extracted from Colombia with a sample of 69 nurse managers. Quantitative data were analyzed with descriptive statistics, and qualitative data were processed using the Nvivo software and thematic analysis. Results: 90 % women, mainly from a hospital setting (40 %). Compassionate practices in administrative nursing involve four categories: Listening; supporting and recognizing staff individuality; defining compassion practices, needs, and benefits; receiving compassion and complementary views of compassion and administration where the influence of cultural and organizational patterns become obstacles to compassion. Conclusion: For nursing, compassion demonstrates the intentional ability to recognize the singularity of someone else’s suffering, understand their needs, offer support, and find solutions based on an understanding of what being human means. These aspects require significant changes at the organizational and health legislation levels to mitigate the obstacles to compassion.

Experiences of oncology nurses regarding self-compassion and compassionate care: A qualitative study

AIM

The aim of this study was to explore the experiences of oncology nurses about self-compassion and compassionate care.

BACKGROUND

The concept of self-care is emphasized in detail in the literature, and not much is known about the concept of self-compassion among nurses. Beyond the definitions of self-compassion and compassion in the literature, there is a need to explore and express the meaning of self-compassion and compassion in the context of oncology nursing.

METHODS

This is a descriptive qualitative study. Semistructured interviews were conducted with 19 oncology nurses working in the oncology service of a university hospital. Interviews were analyzed using thematic analysis through an inductive approach. Consolidated criteria for reporting qualitative studies (COREQ) were used to ensure the comprehensive reporting of this qualitative study protocol.

RESULTS

Two themes emerged: (1) compassion through the eyes of oncology nurses and barriers to compassionate care fall under the theme of wounded healers, and (2) self-compassion through the eyes of oncology nurses, barriers to self-compassion, and self-care as a dimension of self-compassion fall under the theme of caring for our suffering: self-compassion.

CONCLUSIONS

Although nurses think that self-compassion is important, they do not show self-compassion. There are personal and organizational barriers to compassionate care and self-compassion for oncology nurses.

IMPLICATIONS FOR NURSING POLICY

These findings show that oncology nurses need personal and organizational resources for their self-compassion. The existence of programs to develop self-compassion can offset the effects of being in a caregiving position. Oncology nurses must request these services from organization, managers and even policymakers. The existence of policies that also consider the mental health of nurses can pave the way for compassionate care.

A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward

Providing healthcare services that respect and meet patients' and caregivers' needs are essential in promoting positive care outcomes and perceptions of quality of care, thereby fulfilling a significant aspect of patient-centered care requirement. Effective communication between patients and healthcare providers is crucial for the provision of patient care and recovery. Hence, patient-centered communication is fundamental to ensuring optimal health outcomes, reflecting long-held nursing values that care must be individualized and responsive to patient health concerns, beliefs, and contextual variables. Achieving patient-centered care and communication in nurse-patient clinical interactions is complex as there are always institutional, communication, environmental, and personal/behavioural related barriers. To promote patient-centered care, healthcare professionals must identify these barriers and facitators of both patient-centered care and communication, given their interconnections in clinical interactions. A person-centered care and communication continuum (PC4 Model) is thus proposed to orient healthcare professionals to care practices, discourse contexts, and communication contents and forms that can enhance or impede the acheivement of patient-centered care in clinical practice.