Community mental health nurses' and compassion: an interpretative approach

Abstract

Introduction There is increasing emphasis in policy, research and practice in the UK and internationally on the importance of caring in health care. Compassion needs to be at the core of all healthcare professionals' practice. Recently, health care has received negative attention through media and government reports which cite a lack of compassion in care. Rationale The concept of compassion has received limited attention in community mental health nursing. Aim Based on data taken from semi-structured interviews with community mental health nurses, this paper aims to describe interpretations and perspectives of compassion to gain insight and development of its meaning. Method A naturalistic, interpretive approach was taken to the study. Semi-structured interviews with nine mental health nurses were analysed using Burnard's 14-step model of thematic analysis. Findings The research illuminates the complexity of compassion and how its practice impacts on emotional responses and relationships with self, patients, colleagues and the employing organization. Participants identified difficulties engaging with compassionate practice whilst recognizing it as a driving force underpinning provision of care. Implications for practice Mental health nurses need to be supported to work towards a greater understanding of compassionate care for clinical practice and the need for self-compassion.

Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study

“…Our study also extends the existing literature on workplace and systems inhibitors of compassion (Barron et al., ; Bray et al., ; Brown et al., ; Curtis et al., ; Dewar & Mackay, ; Dewar & Nolan, ; Fernando & Consedine, ; Horsburgh & Ross, ; Jones et al., ; Lown et al., ; Nolan, ; Smith et al., ), recognising that while compassion is inherently relational, these relationships occur and are affected by the broader culture of care that they reside in. Our results stress the critical and often overlooked role that practice cultures, organisations and healthcare systems play in maintaining and enhancing compassion in health care.…”

“…Three foundational domains of compassion barriers and facilitators can be distilled from this disparate literature: personal (Barratt, ; Brown, Crawford, Gilbert, Gilbert, & Gale, ; Gale, Schroder, & Gilbert, ; Hem & Heggen, ; Jones, Winch, Strube, Mitchell, & Henderson, ; Roberts, Warner, Moutier, Geppert, & Green Hammond, ; Van Der Cingel, ), workplace/systems (Barron, Sloan, & Deery, ; Bray, O'Brien, Kirton, Zubairu, & Christiansen, ; Brown et al., ; Curtis, Horton, & Smith, ; Dewar & Mackay, ; Dewar & Nolan, ; Fernando & Consedine, ; Horsburgh & Ross, ; Jones et al., ; Lown, Rosen, & Marttila, ; Nolan, ; Smith, Gentleman, Loads, & Pullin, ) and relational barriers between HCPs and their patients (Fernando & Consedine, ; Jones et al., ; Vivino, Thompson, Hill, & Ladany, ). Insights into the personal domain are currently underdeveloped in comparison with the relational and workplace/systems domains.…”

“…In contrast, facilitators and barriers of compassion related to the workplace/system have received extensive attention and as a result are often considered to be the chief factor in facilitating or inhibiting HCPs’ ability to deliver compassionate care (Barron et al., ; Bray et al., ; Brown et al., ; Curtis et al., ; Dewar & Mackay, ; Dewar & Nolan, ; Fernando & Consedine, ; Horsburgh & Ross, ; Jones et al., ; Lown et al., ; Nolan, ; Smith et al., ). In particular, a positive workplace, where providers felt supported by their employers and from their co‐workers, was felt to facilitate compassionate care (Barron et al., ; Dewar & Mackay, ; Dewar & Nolan, ; Jones et al., ). In contrast, work environments that were described as stressful, busy, negative and resistant to change were identified as inhibiting compassion (Curtis et al., ; Horsburgh & Ross, ).…”

“…In contrast, work environments that were described as stressful, busy, negative and resistant to change were identified as inhibiting compassion (Curtis et al., ; Horsburgh & Ross, ). Other factors impacting HCPs’ ability to provide compassionate care within the workplace/culture of care domain identified in the literature include competing professional demands, limited resources and a lack of time (Barron et al., ; Bray et al., ; Brown et al., ; Curtis et al., ; Horsburgh & Ross, ; Lown et al., ; Nolan, ; Smith et al., ). In addition, economic constraints, overly target/outcome driven healthcare systems and teaching environments focused primarily on knowledge‐based competencies, with little value or dedicated time focused on cultivating skills and practices related to compassion were also identified as barriers (Bray et al., ; Smith et al., ).…”

Conceptual framework for a comprehensive competence in managing challenging behaviour: The views of trained instructors

“…Our findings suggest that knowledge of precipitating factors and trauma‐informed care, which recognizes that a history of trauma is more likely than unlikely, is needed to prevent aggressive situations. Previous research has reported that although mental health nurses recognize compassion to underpin high‐quality care, they may find it difficult to adopt a compassionate approach to care (Barron et al., 2017). Service users' human rights are often compromised in psychiatric nursing (Russo & Rose, 2013; Santos Mesquita & da Costa Maia, 2016; Tölli et al., 2020).…”