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Compassionate care: not easy, not free, not only nurses
  1. Roberta Bivins1,
  2. Stephanie Tierney2,
  3. Kate Seers2
  1. 1 Department of History, University of Warwick, Coventry, UK
  2. 2 Warwick Medical School, University of Warwick, Coventry, UK
  1. Correspondence to Dr Stephanie Tierney, University of Warwick Warwick Medical School, Warwick Medical School, Coventry, CV4 7AL, UK; stephanie.tierney{at}

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Compassion has historically been defined as an underpinning principle of work conducted by health professionals, especially nurses.1 Numerous definitions of compassionate care exist, incorporating a range of elements. Most include a cognitive element: understanding what is important to the other by exploring their perspective; a volitional element: choosing to act to try and alleviate the other’s disquiet; an affective element: actively imagining what the other is going through; an altruistic element: reacting to the other’s needs selflessly; and a moral element: to not show compassion may compound any pain or distress already being experienced by the other.2 3 Appeals for more compassionate care have become common within international discourses, through initiatives such as Schwartz Rounds established in America, Hearts in Healthcare in New Zealand, and the Asia Pacific Healthcare Hub of Charter for Compassion. In the UK, a policy document called Compassion in Practice outlined 6 ‘Cs’ associated with compassionate care (care, compassion, courage, communication, commitment and competence). It was written in the wake of high profile accounts of negative health services experiences, including the 2013 Francis Report (, which detailed the dehumanising treatment of patients at Mid Staffordshire NHS Trust. Positioned as a solution to neglect and unsafe treatment, contemporary debate around practice and policy often paints compassionate care as an easy, cost-neutral fix for entrenched problems in modern health services. Yet delivering compassionate care is not without costs. First, staff may have to engage in emotionally charged interactions, which can leave them feeling psychologically exhausted and at risk of burnout.4 Furthermore, for health professionals to be able to connect with patients and understand their unique situation, while also addressing fundamental needs (eg, hygiene, feeding) in a non-mechanistic manner, an appropriately resourced workplace is required.5

Nursing, in particular, has been linked to contemporary discussions of …

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