Abstract
To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.
Highlights
Compassion is described as a core value in the Code of Ethics for Nurses of the International Council of Nurses (2012), and compassionate practices have been consistently associated with patient satisfaction (McClelland & Vogus 2014)
Obstacles to compassion are attributed to manager, systemand staff- related factors that vary across countries
An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important, and the use of a model of culturally competent and compassionate leadership in health care is called for
Summary
Compassion is described as a core value in the Code of Ethics for Nurses of the International Council of Nurses (2012), and compassionate practices have been consistently associated with patient satisfaction (McClelland & Vogus 2014). The creation of a supportive working environment that cultivates compassion has been recognized as a substantial enabling factor for the practice of compassion, leading to the promotion of compassionate leadership in health care (West & Chowla 2017). The role of the leader–manager in creating a supportive and compassionate environment has been discussed in the past two decades (Jezuit 2002), but our knowledge of how nurse managers understand compassion, how they practice it and what may hinder them from providing it to their team members is limited. Another study explored barriers to compassion among nursing managers and found that key barriers were related to the managers’ values and personality, the culture of the organization where they worked and the staff they worked with (Singh et al 2018). A phenomenological study on the lived experiences of nurse executives found that personal and spiritual beliefs drove their practice of compassion and caring (Stepp 2019)
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