The nuance of compassion: An exploration using reflexive thematic analysis of how NHS staff working in Older Person’s Mental Health talk about their experience and understanding of compassion

Wilson, Rebecca

Abstract

According to NHS Wales, compassion is one of the core values of health care (Wales.nhs.uk, 2020) and can be defined as the emotional response to another’s pain or suffering, involving an authentic desire to help (Goetz et al., 2010). Caring for the health and well-being of others is intrinsically compassionate behaviour (West, 2017), however, at times, the NHS appears to be marked by a lack of compassion. The Staffordshire inquiry, which saw a substantial rise in patient death rates, highlighted how a lack of compassionate care can lead to patient suffering, and concluded that there was a need for more patient-centred and compassionate care (Francis, 2010). The Parliamentary Review of Health and Social Care in Wales (H&SC) (2018) highlighted the need for change in health and social care provision, claiming the need to bring health and social services together with a focus on the needs of individuals and a greater emphasis on wellbeing (HEIW, 2020). ‘A Healthier Wales: Our Workforce Strategy for Health and Social Care’ is a long-term workforce strategy that sets out the vision, ambition and approaches that put wellbeing at the heart of the plans for both H&SC Wales. ‘Together for Mental Health’ is a strategy that seeks to implement these improvements alongside ‘A Healthier Wales workforce strategy’ within mental health services across Wales (Cymru.gov.uk, 2020). Health and Education and Improvement Wales (HEIW) claim that this workforce strategy is the opportunity to develop a compassionate culture with a focus on creating leaders who demonstrate collective and compassionate leadership. This initiative is based on the idea that creating compassionate leaders within healthcare, can and will, result in a compassionate culture (West, 2017). With older people’s mental health wards within the NHS catering to both older adults who are living with a dementia diagnosis, and/or currently experiencing distressing mental health symptoms, they are often challenging places to work, with there often being high levels of risk and aggression (Berkowitz, 1993). This can be specifically the case for nurses and healthcare support workers who are more likely to be assaulted whilst working on inpatient wards for elderly people living with a dementia diagnosis, than those working in other inpatient settings (RCP, 2008). This research thesis was designed to gain a greater understanding of mental health nurses' and healthcare support workers’ experience of working in an older person’s mental health in-patient ward in Wales. This study aimed to explore nurses’ experience and awareness of their personal, professional and organisational compassion, and, their views on how this may affect both patient care and job satisfaction. Interviews with fourteen nurses and healthcare support workers who work on OPMH inpatient services within SBUHB were completed and data was analysed via reflexive thematic analysis. Analysis of the data relating to participants’ descriptions of compassion resulted in the development of three overarching themes. The first theme, Compassion is Relational, includes how compassion influences and shapes relationships with patients, colleagues, managers and people in general. Within this theme, three subthemes were created; i) “We are just numbers, they don’t care, ii) Togetherness: “Everybody helps each other out”, and iii) Genuine desire to care. The second theme, Compassion is Contextual, highlights how compassion can vary between cultural, social and individual factors, but how it can also be affected by environmental and situational factors such as workplace ambience and the nature of the diagnosis. Within this theme, three subthemes were created; i) Compassion or efficiency, ii) The toll of caring: compassion fatigue in dementia and mental health, and iii) Existential Angst. The final theme, Compassion is Personal, includes a person’s experiences, beliefs, and values and how these can shape and determine their ability to form self-compassion. Within this theme, three subthemes were created; i) Wounded healing, ii) The compassionate self: Mindfulness, empathy, and self-reflection, and iii) “It’s just who I am, it’s innate. This study has provided insights into aspects of compassion that may often be overlooked. That compassion doesn’t always have to be a ‘grand gesture’ where you solve complex issues or cure or aid suffering for others. Whilst it can be these things, it is also being open, non-judgemental, taking time to turn up for and be present for and engaging in the smaller, everyday acts of relational support. It has also highlighted the importance of self-compassion and how self-awareness and reflection in a noncritical way can also aid your compassion for others.

• Thesis Type: Thesis
• Deposit Date: Dec 17, 2023
• Publicly Available Date: Feb 21, 2024
• Public URL: https://uwe-repository.worktribe.com/output/11530695
• Award Date: Feb 21, 2024