COMPASSION IS FUNDAMENTAL TO CARE DELIVERY
In nursing care, compassion refers to the act of seeing the situation of patients beyond routine procedures or medical scenarios (Wicker & O'Neill, 2010). It is viewed as a nurse’s most precious asset and a fundamental component of personalized care (Davey and Ince, 2000). Pudner (2005) asserts that compassion is one of the most significant strengths of the nursing profession. It entails the delivery of holistic care, including being present and forming meaningful connections with patients (Baughan and Smith, 2013). Notably, empirical evidence indicates that compassion improves the health outcomes of patients (Torjuul, Elstad and Sørlie 2007). It also boosts the satisfaction of patients of the care they receive (Wicker & O'Neill, 2010). Compassion specifically makes patients to feel respected, cared for and appreciated (Davey and Ince, 2000). In this essay, I discuss compassion as a fundamental component of delivery of nursing care in the operating department. I specifically I apply theory and examples to provide an in-depth discussion of the meaning and importance of compassion in nursing practice within the surgical department.
According to Pudner (2005), the practice of operating theatre practitioners in the pre, intra and post-operative stages requires that they demonstrate compassion to achieve desired patient outcomes. During the preoperative care, operating theatre practitioners have professional and ethical obligations of providing compassionate care in the assessment of patients and preparing them emotionally, psychologically and physically for surgical procedures (Torjuul, Elstad and Sørlie 2007). Torjuul and Sorlie (2006) explain that it is through compassionate care and good preparation that patients are able to have positive surgical experiences, which contribute toward the achievement of desired health outcomes. In accordance to Baughan and Smith (2013), nurses show compassion in the preoperative stage by enabling patients to feel safe and to have more control over their emotions and feelings. Torjuul and Sorlie (2006) add that operating theatre practitioners should involve patients in discussions on their surgical procedures while addressing any psychological or emotional issues that would influence health outcomes after surgery.
Compassion is an important element in the practice of operating theatre practitioners because surgical procedures often have life-long effects on patients (Wicker & O'Neill, 2010). Therefore, operating theatre practitioners should show compassion by addressing the specific needs of each patient before surgery. Pudner (2005) demonstrates that nurses show compassion by working to alleviate the fears, concerns or worries of patients prior to surgical procedures. According to Torjuul and Sorlie (2006), compassion entails addressing the questions of patients pertaining to their surgical procedures and recovery through open or honest communication processes. Baughan and Smith (2013) assert that operating theatre practitioners show compassion by taking time to listen to patients without interrupting and helping them to maintain power and control over their worries and illnesses. More importantly, it is the role of operating theatre practitioners to ensure that they preserve the dignity of their patients before, during and after surgery (Wicker & O'Neill, 2010).
The interpersonal relations theory of Hildegard Peplau can be used to illustrate the importance of effective communication between operating theatre practitioners and patients and its contribution to compassionate care. The theory provides that effective relationships between practitioners and patients during therapeutic processes are made possible through effective communication processes and integration of complex factors, such as beliefs, attitudes, values, health care environment and practices into the care process (Peplau, 1997). Torjuul and Sorlie (2006) explain that it is through effective communication processes that nurses demonstrate that they acknowledge the pain and emotions of surgical patients. Baughan and Smith (2013) add that compassionate care is provided by practitioners who acknowledge the distress of patients and implement care interventions designed to alleviate pain, including sharing the suffering of patients through effective communication processes.
Dyadic interpersonal communication model can also be used to demonstrate why effective communication is the key to understanding patients and delivering compassionate care. The model provides that communication processes should be interactive and inclusive of both verbal and non-verbal elements, including emotions, attitudes and perceptions (Hargie, 2010). This is illustrated by the fact that it is through non-verbal cues that operating theatre practitioners are able to demonstrate their emotional connection to patients (Davey and Ince, 2000). Verbal communication processes also enable nurses to encourage surgical patients to be courageous and to meet their comfort needs (Wicker & O'Neill, 2010). The dyadic interpersonal communication model provides that effective communication is defined by its level of clarity (Hargie, 2010). Therefore, operating theatre practitioners should be able to explain things to patients with clarity, honesty and due consideration of the pain they are experiencing.
Torjuul and Sorlie (2006) define compassion in nursing care as the act of being moved by the pain of patients. Pudner (2005) illustrates that it is important to show compassion to patients in today’s health care settings that are more focused on outcomes, competency, efficiency and productivity than the needs of patients. However, there are specific ethical and political challenges that limit the extent to which operating theatre practitioners provide compassionate care. For example, the values instilled or taught in nursing school influence the attitudes of nurses towards compassionate care (Davey and Ince, 2000). In addition, the extent to which nurses provide compassionate care is influenced by ethical dilemmas and associated negative effects, such as compassion fatigue and burnout (Wicker & O'Neill, 2010). Notably, there are specific barriers that impact negatively on the delivery of compassionate care in surgical departments. For example, nurses may distance themselves from patients due to fear of depression that is associated with prolonged contact with patients in extreme pain and suffering (Torjuul, Elstad and Sørlie 2007).
Torjuul and Sorlie (2006) demonstrate that organizational culture also impacts the delivery of compassionate care. For example, in health care settings where professional distance is considered to be optimal, nurses may refrain from developing emotional connections with their patients (Wicker & O'Neill, 2010). Torjuul and Sorlie (2006) add that operating theatre practitioners often lack enough time to engage with patients in meaningful conversations and in the delivery of compassionate care. This is attributed to problems with nurse staffing or poor nurse-patient ratios (Davey and Ince, 2000). Pudner (2005) illustrates that nursing staffing is often influenced by political factors, such as staffing policies. Therefore, the propensity of operating theatre practitioners to provide compassionate care is influenced by factors within both health care settings and the external environment in the health sector.
The NHS Constitution for England provides that compassion, dignity, respect and patient-centered care should be the main guidelines of how patients should be treated (Department of Health, 2013). Therefore, compassion is among the factors that influence the practice of high standards of care, as provided by the NHS Constitution. Baughan and Smith (2013) state that operating theatre practitioners have a professional mandate of ensuring that they care for surgical patients with compassion. The 7Cs of providing caring conversations can be used to illustrate how operating theatre practitioners can provide compassionate care as required by the NHS Constitution (Department of Health, 2013). For instance, operating theatre practitioners should be courageous, curious, collaborative and able to connect emotionally, to compromise, to celebrate and to consider other perspectives in the delivery of compassionate care to surgical patients (Department of Health, 2013). Courage is specifically important as it allows operating theatre practitioners to overcome barriers to compassionate care, such as depression and burnout.
The findings of the public inquiry of the Mid Staffordshire NHS Foundation Trust of 2008 and the recommendations of the Francis report provide significant insights on the changes health care organizations and practitioners should implement in the context of compassionate care (Department of Health, 2013). In line with the recommendations of the Francis report, compassion in health care is achieved through putting patients first, instilling a culture of care, improving quality, encouraging transparency, accountability and effective leadership (Department of Health, 2013). Therefore, operating theatre practitioners should show compassion by ensuring that their patients become top priority in the delivery of care. This is important as it allows for prevention of avoidable harm to patients and ensuring that their dignity is upheld (Wicker & O'Neill, 2010). Examples of ways through that operating theatre practitioners can provide compassionate care include respecting the personal space of patients, engaging in positive talk, assessing and meeting the comfort needs of patients and collaborating with family members to establish an environment of love and normalcy (Davey and Ince, 2000).
Torjuul and Sorlie (2006) recommend that operating theatre practitioners should apply the holistic approach of providing compassionate care to all patients. This entails addressing all elements that influence the outcome of care, including the preferences, culture, beliefs and interests of patients. Legal and ethical frameworks providing for the care of patients, such as the protection of rights and preservation of dignity should also be integrated into all care process (Davey and Ince, 2000). Pudner (2005) asserts that holistic compassionate care is characterized by attributes such as care for the wellbeing of patients, sensitivity, distress tolerance, empathy and non-judgment. Torjuul and Sorlie (2006) indicate that lack of training is a notable barrier to the delivery of compassionate care within surgical nursing environments. This is related to the fact that the attributes of holistic compassionate care are depicted by nurses with specific skills, such as attention, imagination, reasoning and effective management of emotions (Wicker & O'Neill, 2010).
Torjuul, Elstad and Sørlie (2007) assert that compassion is the act of being kind to patients by understanding their difficulties, being warm and committed towards overcoming their pain. Baughan and Smith (2013) state that operating theatre practitioners should be prepared for a wide range of setbacks in their effort to provide holistic compassionate care. They include ethical dilemmas resulting from the cultural values that inhibit the achievement of health care goals. For example, nurses within surgical departments often experience situations where patients become non-compliant to prescribed medications on the basis of their cultural or religious beliefs. In such situations, nurses should show compassion by being kind and demonstrating their commitment towards alleviating the pain of patients (Torjuul, Elstad and Sørlie 2007). Collaboration with family and friends and effective communication processes are also used to overcome barriers to holistic compassionate care, including non-compliance (Davey and Ince, 2000).
Baughan and Smith (2013) demonstrate that compassion plays an important role within the surgical department as it enables patients to become calmer and prepares them psychologically for their procedures. Nurses show compassion by integrating the diverse factors affecting the experiences of patients, especially cultural and religious beliefs, into care processes (Torjuul, Elstad and Sørlie 2007). A holistic approach which integrates the beliefs of patients into the care delivery is important as it assures them that their procedures will go well, which is the prerequisite to patient satisfaction of the health care services (Davey and Ince, 2000). According to Pudner (2005), patients who are treated with compassion, including respect for their values and preference, often recover well after surgical procedures. Torjuul, Elstad and Sørlie (2007) add that surgical procedures and the associated painful experiences of patients and family members are more bearable when nurses show compassion.
Torjuul and Sorlie (2006) assert that compassion in nursing practice is the expression of sympathy for the misfortune of illness upon patients, which motivates nurses to do their best to alleviate pain and suffering. Baughan and Smith (2013) illustrate that compassionate care is important as it allows nurses to soothe their patients and to motivate their desire for a better health situations. According to Torjuul and Sorlie (2006), compassion allows nurses to preserve the dignity of patients. This is because compassion empowers nurses and enables them to provide the kind of care they would provide for themselves or their family members. Notably, compassion also enables nurses to provide unbiased care to patients, regardless of their cultural backgrounds, beliefs or values (Davey and Ince, 2000). Pudner (2005) explains that compassion is the prerequisite to holistic care as it enables nurses to go beyond essential care to provide services that are aligned with the unique circumstances and needs of patients.
In conclusion, compassion is the act making emotional connections with patients and having a desire to alleviate their pain. Compassion is specifically vital in operating theatre practice as it provides opportunities for focusing on the needs of patients, leading to personalized care, positive health outcomes and a high level of patient satisfaction. Compassionate care is specifically important in modern health care market that is increasingly focusing on competency, productivity, efficiency and the use of technology as opposed to the unique needs of each patient. The ability of nurses to provide compassionate care is influenced by the values instilled or learned in nursing school. Notably, fear of depression and compassion fatigue often limits the willingness of nurses to provide compassionate care. This essay demonstrates that operating theatre practitioners are able to provide compassionate care when they understand and appreciate the diverse needs of patients, which are influenced beliefs, values and preferences. Finally, it is through effective communication and collaboration with patients and family members that operating theatre practitioners are able to provide compassionate care which respects the rights of patients and upholds their dignity.
References
Baughan, J. and Smith, A., 2013. Compassion, Caring and Communication: Skills for Nursing Practice. Routledge.
Davey, A. and Ince, C.S., 2000. Fundamentals of operating department practice. Cambridge University Press.
Department of Health, 2013. Patients First and Foremost: The Initial Government Response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Vol. 8576). The Stationery Office.
Hargie, O., 2010. Skilled interpersonal communication: Research, theory and practice. Routledge.
Peplau, H.E., 1997. Peplau's theory of interpersonal relations. Nursing science quarterly, 10(4), pp.162-167.
Pudner, R., 2005. Nursing the surgical patient. Elsevier Health Sciences.
Torjuul, K. and Sorlie, V., 2006. Nursing is different than medicine: ethical difficulties in the process of care in surgical units. Journal of Advanced nursing, 56(4), pp.404-413.
Torjuul, K., Elstad, I. and Sørlie, V., 2007. Compassion and responsibility in surgical care. Nursing Ethics, 14(4), pp.522-534.
Wicker, P., & O'Neill, J. (2010). Caring for the perioperative patient. Oxford: Wiley-Blackwell.
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