Letter from a Pakistani Nursing Student: Compassion is the Heart of Nursing Practice
Once again, DailyNurse is publishing a series of blog posts on nursing issues in the developing world by MScN nursing students at the Karachi, Pakistan campus of the Aga Khan School of Nursing and Midwifery.
These articles were written as part of a class assignment that involved composing and submitting short research articles for publication in a recommended nursing blog or journal. The object: to help them hone their English language communication skills as future nurse leaders in Pakistan’s healthcare system. As their instructor put it, one of the goals of the exercise is to encourage nursing students to become “Change Agents” in healthcare settings and the world. DailyNurse thanks the instructor and all of the Change Agents who submitted articles. We hope you will find the selected posts informative and thought-provoking.
Compassion is considered to be one of the essential attributes of healthcare professionals, particularly nurses. It is regarded as the heart of nursing care and an essential aspect of patient-centered care. Compassion is a powerful and intimate feeling characterized by the ability to understand another person’s emotional condition, or ‘placing oneself in others shoes’ [1]. It entails asking oneself how they would feel and what problems they could encounter if they placed themselves in the shoes of the sufferer. It includes respect for patient’s values, beliefs, and opinions. Florence Nightingale, the founder of modern nursing, also stated compassion as one of the essential attributes of a nurse [2]. However, nursing in these modern times is primarily research and skill-based, with little emphasis on compassion and morality [3].
Being a nurse is not just about taking care of the physical health condition of the patients; it also includes supporting them emotionally and advocating for them. Providing compassionate care can have a great impact on patient outcomes. For some patients and their families, hospitalization can be an emotionally distressful situation as they are away from their home and may feel lonely. In that case, nurse interaction will help to reduce the feeling of loneliness. In addition to loneliness, patients are more prone to experience anxiety related to changes in the environment and health conditions. A nurse can reduce anxiety and make the patient feel comfortable in this vulnerable situation by making an extra effort to be sympathetic. Also, it improves nurse-patient communication and aids in providing holistic care.
Despite being an asset in nursing practice, compassion is often neglected by nurses for several reasons. Certain elements, like cultural constraints, heavy workload, and requisitions in nursing practice restrict it to problem-centered communication exclusively [4]. Lack of nursing workforce, equipment shortage, and lack of time for caring are all regarded as barriers to providing compassionate care. Additionally, exhaustion and lack of motivation and interest are also considered barriers to the provision of compassionate care [6]. A nurse can develop compassion through developing certain skills.
One of the ways is through developing clinical expertise. Clinical expertise is essential not just to understand people’s perspectives, but also to understand how their health state affects their ability to accomplish personal objectives [7]. Therapeutic communication, along with clinical expertise, is considered to be the basis of compassionate care.
Cultural awareness is also regarded as an important aspect of the provision of compassionate care. Cultural awareness can aid nurses in understanding the influence of culture on individual thinking and behavior. Nurses can better understand patients’ views and build an effective nurse-patient relationship by being aware of communication patterns, family role division, spirituality, and customs of other cultures [8].
Additionally, three fundamental characteristics of compassionate care are “noticing,” “connection,” and “response” [9]. Understanding the patient and assisting him in getting relief from his discomfort; establishing a therapeutic relationship with the patient; verbal and nonverbal communication skills; professionalism; being aware of the patient’s needs; and encouraging the patient to participate in health-related decisions are just a few of the qualities that a nurse must possess to provide compassionate care.
Another way through which a nurse can provide compassionate care is by being a listening ear to patients. Active listening encourages patients to pour out their hearts. Even when there is limited time, a small gesture can have a great impact. Using a positive tone of voice and body language to greet patients, and asking them about their health status strikes up a conversation. Taking out time to listen and acknowledge a patient’s thoughts is one of the greatest acts of compassion that a nurse can show.
In a nutshell, compassion is considered to be the core of nursing practice. It contributes to the development of a better nurse-patient relationship and improves patient satisfaction. Nurses can develop certain skills for delivering compassionate care, like clinical expertise, therapeutic communication, cultural awareness, and active listening skills. There is still a need to develop awareness among nurses in relation to the provision of compassionate care. Organizations must nurture nurses’ capacity for compassionate care through organizing compassion training programs and in-service sessions that can improve their understanding. Additionally, these programs should emphasize on the development of therapeutic relationships with patients and family, as well as utilizing a holistic approach to care, which will further aid nurses in internalizing compassion in care. Furthermore, awareness should be provided regarding the identification of specific emotional and psychological needs of patients and their families to ensure holistic care delivery.