Further research is needed to explore the country and culture differences in the enactment of compassion.

Background Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high‐quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. Aim The aim of this study was to explore the nurses’ views and experiences of a number of compassion‐related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. Methods An exploratory, cross‐sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. Results The majority of participants (59.5%) defined compassion as “Deep awareness of the suffering of others and wish to alleviate it” but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses’ experiences of compassion and their views about teaching of compassion. Conclusion Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. Limitations Self‐report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. Implications for nursing policy Understanding the influence of culture on nurses’ views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

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Aim: To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management. Method: A cross-sectional online survey. Using a snowballing sampling method, 1,217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. Firstly, content analysis of the responses was conducted, and secondly a relative distribution of the identified themes for the overall sample and for each participating country was calculated. Results: Six main themes were identified describing the attributes of a compassionate leader: 1) Virtuous Support, 2) Communication, 3) Personal Virtues of the Manager, 4) Participatory Communication, 5) Growth/Flourishing/ Nurturing, and 6) Team Cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour. Conclusion: The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members' difficulties (especially concerning child- and other caring responsibilities), active support of and advocacy for the staff team, and active problem solving and conflict resolution. While there were differences between the countries' views on compassionate healthcare management, some themes were widely represented among different countries' responses, which suggest key indicators of compassionate management that apply across cultures.