Hospital nurses' experiences and expectations of compassion and compassionate leadership

Rationale and Aim: Nurses caring for critically ill patients need compassionate attention and support, especially during exceptional times. The aim of this study was to provide a trustworthy description of nurses' experiences and expectations for compassionate leadership and compassion at a central hospital in Finland. The study was conducted during the early stage of the coronavirus 2019 pandemic. Ethical Issues and Approval: The voluntary nature and anonymity of the survey were stressed in the cover letter, to make sure that participants did not perceive any undue influence caused by participating in the study. Methods: The participants were 50 intensive care and emergency nurses of a central hospital. An online survey tool with open questions was used to collect data on the meaning of compassion and on nurses' experiences and expectations of compassion and compassionate leadership. Inductive content analysis was used to analyse the data. Results: The nurses reported a great variety of positive experiences of compassion, although the emphasis in this study seemed to be on the absence of compassion, especially in regard to leadership. The nurses expected individual attention and genuine physical and psychological presence from their immediate supervisors. Study Limitations: One researcher analysed the data, which can cause some bias in the qualitative analysis. Conclusions: Immediate supervisors express compassion by being physically present and by fostering an open dialogue. Compassion received from leaders and colleagues may be reproduced in patient contacts, which can increase patients' confidence and psychological safety. Participatory and simulation-based learning methods, which involve shared reflection, are recommended for compassionate leadership skills.