Background The COVID-19 pandemic has placed an unprecedented burden on nurses who have been at the forefront of patient care. The continuous exposure to suffering, death, and overwhelming demands has the potential to lead to compassion fatigue, a state of emotional, physical, and cognitive exhaustion. Research aim The study aimed to explore and understand the phenomenon of compassion fatigue in nurses as the effect of the COVID-19 pandemic. Research design A constructivist grounded theory design was used. Participants and research context (...) The research data were collected from 20 nurses who had been employed in pandemic clinics in Turkey for a minimum of 6 months. Data were collected using a two-step approach: purposeful sample selection followed by theoretical sample selection. Individual interviews were conducted via an online platform with participants who consented to participate in the study from January 16th to April 28th, 2022. The collected data underwent initial, focused, and theoretical coding for analysis. The research findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines. Ethical considerations Ethical approval for the study was received from Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki. Findings The study identified a core category, namely the desire to provide the best care, which was accompanied by five main categories: causes, symptoms, consequences, coping methods, and the benefits of coping methods. Conclusion During the pandemic process, nurses have experienced compassion fatigue due to various factors and have seen its symptoms. Nurses have developed various coping mechanisms individually. However, they have not indicated any institutional-level support. It has become necessary to plan nurse-centered comprehensive interventions that will reduce compassion fatigue. (shrink)

Background: In modern healthcare, the role of solidarity, altruism and the natural response to moral challenges in life-threatening situations is still rather unexplored. The COVID-19 pandemic provided an opportunity to obtain a deeper understanding of nurses’ willingness to care for patients during crisis. Objective: To elucidate clinical expressions of ontological situational ethics through nurses’ willingness to work during a pandemic. Research design, participants and context: A qualitative study with an interpretive design was applied. Twenty nurses who worked in intensive care (...) unit at two Swedish hospitals during the first, second, and third waves of the COVID-19 pandemic were interviewed. The analysis was interpretative and applied a theoretical ethics perspective. Ethical considerations: The study was approved by the Swedish Ethical Review Authority and informed consent was obtained from all participants. Findings: From a philosophical perspective, the nurses expressed sovereign life expressions of mercy and compassion, which arose spontaneously in response to seeing vulnerable fellow humans. They referenced ‘‘the nurse inside me’’ and their choice of profession as motives to provide care. Ontological situational ethics in culture and norms were noted in the constructs of competence, responsibility, solidarity with colleagues and organization; and interest and learning were driving forces. Ethical demand was evident when nurses expressed ideas of meaningfulness in helping their fellow humans; but themes of ambiguity, exhaustion and unwillingness were also present. Conclusions: The nurses showed a high willingness to care for patients during a crisis. Responding to the ethical demand and to care for vulnerable human beings while risking their own health and lives could be interpreted as an inter-human vocation. These spontaneous altruistic actions saved the lives of many patients during the pandemic and need to be understood and supported. (shrink)

Compassion is often understood as central to nursing and as important to ensure quality nursing and healthcare. In recent years, there has been a focus on strategies in nursing education to ensure compassionate nurses. However, it is not always clear how the concept of compassion is understood. Theoretical conceptualisations that lie behind various understandings of compassion have consequences for how we approach compassion in nursing education. We present some ways in which compassion is often understood, their philosophical underpinnings and the (...) consequences these understandings can have for nursing education. We argue that it is useful for nursing education to understand compassion as a cognitive emotion and discuss how such an understanding can inform educational approaches to compassion. (shrink)

Background Maintaining the dignity of patients who attempted suicide is one of the caregivers’ main ethical duties. Yet, in many cases, these patients are not treated with dignity. The concept of dignity is abstract, and there is no research on the dignity of suicidal patients. So, the present study is done to investigate psychiatric nurses’ perception of dignity in patients who attempted suicide. Objective The present study explores the concept of dignity in patients who attempted suicide from the perspective of (...) psychiatric nurses. Research design The present study is a qualitative, descriptive work of research Participants and research context A total of 20 psychiatric nurses from 2 hospitals affiliated with a university of medical sciences in the southeast of Iran were selected via purposeful sampling. Ethical considerations The Research Ethics Committee of the Hamadan University of Medical Sciences approved the study’s protocol, and ethical principles were followed in general. Findings From the findings of the study, three main themes, namely “ respect for personal; identity,” “management of psychological tension,” and “compassion-focused therapy,” with 12 sub-themes were extracted. Discussion and conclusion In the perspective of caregivers, patients who attempted suicide need to be cared for in supportive environments with compassionate and respectful behaviors to control their psychological tensions. These conditions would maintain such patients’ dignity and result in appropriate behavioral outcomes. Policy-makers and administrators can use the present study’s findings to create an appropriate clinical environment in which the dignity of patients who attempted suicide is properly maintained. (shrink)

For healthcare professionals and organizations, there is an emphasis on addressing moral distress and compassion fatigue among clinicians. While addressing these issues is vital, this paper suggests that the philosophical concept of agent-regret is a relevant but overlooked issue in healthcare. To experience agent-regret is to regret your harmful but not wrongful actions. This person’s action results in someone being killed or significantly injured, but it was ethically faultless. Despite being faultless, agent-regret is an emotional response concerning one’s agency in (...) a situation that results in death or significant harm. In healthcare, many clinicians are likely to experience regret for faultless actions that significantly harm or cause the death of a patient. The recognition of agent-regret in healthcare is significant because it differs, conceptually and practically, from moral distress and compassion fatigue. Building on the work of Wojtowicz (Citation2022), we should strive to understand clinicians’ agent-regret by recognizing their agency in the situation, not lessening or removing it. (shrink)

Background With an increasing older population, the pressure on home care resources is growing, which makes it important to ensure the maintenance of quality care. It is known that compassion and ethical sensitivity can improve the quality of care, but little is known about care leaders’ perceptions on ethical sensitivity and compassion in home care and how it is associated with staff competence and thus quality of care. Aim The aim of the study was to explore home care leaders’ perceptions (...) of ethical sensitivity and compassion associated with care quality in home care. Research design, participants, and research context A hermeneutical approach with a qualitative explorative design was used. The data consists of texts from 10 in-depth interviews with home care leaders. Content analysis was used as a method. Ethical considerations The study was conducted following the ethical guidelines of the Declaration of Helsinki and the Finnish Advisory Board of Research Ethics. Research ethics permission was applied for from a Research Ethics Board. Findings One overall theme and four subthemes were found. The overall theme was: “Compassion provides deeper meaning and ethical sensitivity provides means for knowing how to act”. Discussion If nurses fail to be sensitive and compassionate with patients, good and high qualitative home care cannot be achieved. Ethical sensitivity and compassion can be seen as resources in home care but the organization and the care leaders need to provide the support for these to develop. Conclusion This study provides an understanding of the meaning of ethical sensitivity and compassion as sources of strength and their link to quality of care in a home care context. Further studies could focus on how to build compassion and ethical sensitivity into home-based care and how to ensure adequate support for healthcare professionals’ compassion and ethical sensitivity. (shrink)