Mixed method - How do medical-surgical nurses provide compassionate care to patients in the face of adversity?

Abstract

<p>Compassion is a quality that is the very essence of nursing. Nurses, as professionals, seek to alleviate suffering. It is through providing compassionate, connected care that nurses can relieve their patients&rsquo; suffering. In the midst of adversity such as taking care of ill and dying patients, especially in the Covid-19 pandemic, nurses have been challenged with providing compassionate care despite the increased toll that this may have on them. There is evidence that exposure to these events can cause compassion fatigue and burnout. When these signs of compassion fatigue or compassion burnout are not addressed, nurses have decreased job satisfaction and are at risk of leaving the profession altogether. Despite this dichotomy in the research, compassionate care is still being delivered to patients regardless of the population that they care for or adverse events that they face. The research shows that compassionate care has been provided during adversity that focused on dying patients, traumas, critically ill, and emergency room patients, but there was limited research on compassionate care delivered to medical-surgical patients.</p> <p>The purpose of this mixed-method study was to understand the process of how medicalsurgical nurses provide compassionate care despite the adversity they face. The explanatory sequential design was used as the mixed method, in which there were two phases. A quantitative instrument was used as a self-assessment of compassion competence that an intensity-purposeful sample of medical-surgical nurses from the Academy of Medical Surgical Nurses completed. The quantitative findings suggest that regardless of working nights, the increased number of patients, higher percentage of direct patient care, and working mandatory overtime, the medicalsurgical nurses still assessed themselves with high compassion competence. To further explore and encourage reflection on compassionate care, a smaller sample of medical-surgical nurses who completed the Compassion Competence Scale were interviewed to describe their process of providing compassionate care despite the adversity they faced. Three categories were explored: adversity, why medical-surgical nurses provide compassionate care, and how medical-surgical nurses provide compassionate care. From these categories, an overarching category of altruism was identified. Quantitative and qualitative methods were used to triangulate results. Findings from the quantitative analyses were concurrent with the findings from the qualitative analyses. With the exception of one item from the Compassion Competence Scale, the instrument items upheld the prominent categories discovered in the qualitative data. Applying the grounded theory of altruism and supporting data from this mixed-method study provides nurses and nurse leaders valuable information to encourage the retention of nurses, reminding them of the importance of compassionate care in their practice and the badge of honor that nurses wear every day.</p>