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Experiences of nurses and other health workers participating in a reflective course on compassion-based care

08 August 2019
Volume 28 · Issue 15



the risk of compassion fatigue in healthcare staff is real, especially when considering the current financial pressures. A course in compassion-based care (CBC) was delivered to mental health staff at a hospital in north-west England, with the intention of rehabilitating ward culture and, subsequently, improving patient experience.


to explore staff experiences of participating in the CBC course.


a qualitative study using semi-structured interviews with participants (n=12) was conducted. All staff attending the course were eligible and were invited to participate. Interview transcripts were thematically analysed.


five themes characterising participant experience emerged from the data: meeting a need; creating the space; reorientation; prioritising self-care; and influencing team dynamics. Data overwhelmingly indicated the success of the CBC course.


the CBC course appeared to have a profound effect on participants; it should be considered for further rollout and evaluation.

Compassion is the lynchpin of healthcare delivery and its promotion has become a pivotal initiative in the NHS, driven by events in recent years including the launch of the 6Cs (Cummings and Bennett, 2012) and publication of the Francis report (2013). Cummings and Bennett (2012) defined it as ‘intelligent kindness’ and acknowledged that patients recognise and appreciate the times when compassion guides their care. The factors enabling and obstructing the delivery of compassion-based care are complex and merit further exploration. A key recommendation by Francis (2013) was the promotion and facilitation of compassionate caring as a vital step in ensuring a high quality of patient care; this underpinned many of the observations made during the public inquiry into the Mid Staffordshire NHS Trust.

The concept of compassion fatigue has emerged in the last 20 years, having been first introduced by Joinson's (1992) exploration of emergency department nurses who had seemingly lost their ability to nurture. Coetzee and Klopper (2010) recognised that there was no standard definition of the term so conducted a concept analysis based on the available literature on the subject. Their findings suggested that developing compassion fatigue is a gradual process, often caused by stress, and therefore potentially reversible. Manifestations of the problem include: diminished job performance (White, 2006; Smith, 2007), burnout (Adams et al, 2006; Benoit et al, 2007), callousness (Mendenhall, 2006; Benoit et al, 2007), emotional overload (Abendroth and Flannery, 2006; Mendenhall, 2006), and desire to resign position (Fahy, 2007; Smith, 2007).

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