Category: Compassion

Life expectancy and the number of people living with co-morbid and chronic health conditions are increasing, placing additional pressures on health and care systems (Office of National Statistics, 2015; Government Office for Science, 2016). Although current Scottish documents acknowledge the benefits of trying to keep people in their own homes for as long as possible (The Scottish Government, 2011), there is a current increased demand for care home placements for older people with high dependency needs (Kingston et al. 2017).

Within Scotland over 32,000 older people currently reside or access respite in care homes with 62% requiring nursing care and 62% diagnosed with dementia (NHS National Services Scotland, 2018). However, in the Scottish care home sector are there is a recruitment crisis with care home nurse vacancy levels reaching 31% (Scottish Care, 2018).

Care homes are recognised as physically and emotionally demanding environments with high levels of stress (Islam et al., 2017; Testad, 2010). Recruiting and retaining staff in environments who support individuals with complex care needs can be challenging and is a key priority for nurse managers (Hodgekinson et al., 2011). High turnover among health care professionals can impact negatively on health care systems (Halter et al, 2017), the quality of patient care, staff morale (Roche et al, 2015), and increase costs through the use of agency workers (Scottish Care, 2017). Staff absenteeism also has an impact on health care settings including increased work overload, high carer to patient ratios, and reduced job motivation (Baydoun, Dumit, & Daouk-Oyry, 2016). Previous research studies have identified factors associated with staff turnover including the work environment (Li et al., 2010); perceptions of management (Gromley, 2011); individual factors such as age and kinship responsibilities (Hates et al, 2012); workload stress, job dissatisfaction, and burnout (Halter et al, 2017; Kov et al., 2011).

Burnout has been described as an emotional state defined by reduced personal accomplishment, depersonalisation, and emotional exhaustion (Maslach & Jackson, 1986) wherein professionals are at risk of developing negative or apathetic attitudes towards those in their care (Duffy, Oyebode, & Allen, 2009). High levels of burnout have been found in the nursing profession (Clarke, Finlayson, & Aiken, 2010) due to stressors such as high work load demands, long irregular hours, and exposure to traumatic experiences (Nantsupawat et al, 2016). Burnout has been associated with a number of negative outcomes including increased risk to patients (Marcum, Rusnak, & Koch, 2018), reduced patient satisfaction (Hinderer et al, 2014), increased errors in judgement, and reduced work efficiency (Fennessey, 2016).

Compassion fatigue is another factor that has been associated with staff turnover intention (Sung, Seo, & Kim, 2012). Compassion fatigue is a term that has been interchangeably been described as secondary traumatic stress and vicarious traumatisation (Kapoulitsas & Corcoran, 2015). It occurs when carers experience disengagement and reduced ability to empathise and adequately care for their patients (Coetzee & Laschinger, 2018). In a recent literature review Coetzee and Laschinger (2018) identified a number of models that have been developed to understand compassion fatigue. The compassion stress and fatigue model developed by Figley, (1995, 2002) asserts that empathic ability of the carer is central to understanding compassion fatigue. It is theorised that empathic concern and the need to respond can lean to compassion stress which can be managed by either disengagement or compassion satisfaction. Ongoing exposure to traumatic and emotive memories can result in the carer developing compassion fatigue (Coetzee & Laschinger, 2018).

Valent’s (1995, 2002) framework of secondary stress and trauma asserts that the carers appraisal of their exposure to stress can result in adaptive of maladaptive biological and psychological responses. These responses aim to reduce the impact of chronic strain and trauma, leading to compassion fatigue (Coetzee & Laschinger, 2018).

Stamm (2010) put forward a model that suggested that outcome of the carers experience is impacted by those in their care, alongside their personal and professional environments. Named the professional quality of life model it postulates that outcomes of care can be positive or negative or result in compassion satisfaction or compassion fatigue. Although previously compassion fatigue was considered to be a concept that sits apart from burnout (Marcum et al, 2018), this model theorises it as a term to describe combined burnout and secondary traumatic stress (Coetzee & Laschinger, 2018).

About in 1998-1999, there was a company, named Central Model Agency in Bratislava; they were approaching young “good-looking” people to become models. It was by pure choice of agent to choose someone who would look good on screen. If an approached individual has been accompanied by someone, who did not necessarily match the required criteria. The agent was able to tell them that they do not look good enough for modeling. It was almost 20 male agents who were models themselves. The story shows how men have failed to be compassionate. If they were more compassionate, they would try to think more about their targets. Then, they would realize that no person wanted to walk through a cloud of men desperate to reach targets and would try to thin out their number or put them aside.

Compassion

As is widely understood, compassion is a capacity to feel what the others are feeling. For example, he or she also feels the pain when a person sees another person in pain. It is possible to see the very act of modeling itself as the act of compassion. When an individual feels what the other individual feels, he or she creates the other person’s model and attempts to integrate it into their mental procedures. As a result, this affects how the next individual would behave.

Compassion and Anthropology

Although the Bush article Shakespeare is not a purely scholarly article, it gives an insight into how compassion works and the model. The article’s prerequisite is easy. The article’s author, Bohannan (1966), who was an anthropologist studying Tiv, an African tribe, tried to say the tribe Hamlet’s tale. Bohannan had the feeling that Shakespearean tales were universal and could be understood by everyone. She was proved wrong, though, when she tried to say the tribe the tale. From the original, the version of Hamlet told to the tribesmen was totally skewered.

The storytelling was controlled by the culture of the elder and the tribe. This implied that Bohannan’s storytelling was well subject to scrutiny by her audience, unlike Western-style storytelling where the narrator almost has complete control over the tale. She was often interrupted and told how to interpret Hamlet correctly. The tribe was also much more forgiving, though. Although the elders are disrupted many times,

Also, the tribe insisted on the tales had ‘full’ information; this meant that details such as genealogy and how minor characters died were also essential. When Bohannan was unable to offer the information on certain components of the tales (because Shakespeare did not write those sections), the elders would immediately fill in the gap. An elder even took over her storytelling at one point and tried to fill in the subplots that Shakespeare didn’t bother with (Bohannan) coming up with.

Something could be agreed on by both cultures, though: Polonius was a fool.

Although anecdotal, this tale obviously shows how compassion works. Bohannan and the audience do not have each other’s right modeling, which derails the storytelling. As a consequence, the story becomes totally skewered. However, the tribe’s interruption has an interesting effect: the story becomes much richer. Whereas Shakespeare’s stories would not delve too much into minor details, the tribe would try to fill them up as much as possible.

Compassion Control

When individuals speak of compassion, they would mostly speak from the angle of ‘good vs. evil.’ This opinion, however, is somewhat disturbing because it’s hard to speak about what are good and bad. In the hindsight, an apparently excellent action may seem bad. By letting them go, somebody can rescue caged primates, and this may seem like a healthy action. However, if it turns out that the primates need human care and can not survive on their own in the wild, it can also be a poor action.

A fresh measure of compassion is therefore required. The writer proposes to use the skill idea that existed in the literature of Buddhism. Rather than attempting to view compassion from a normative point of perspective, it should be regarded in relation to something like a timeframe, hindsight or action outcome. Skillfulness cannot be officially spelled out, like Darwin’s fitness requirements and Vervaeke’s idea of relevance realization (Vervaeke, Lilicrap & Richards, 2012). One can say, however, that skill is aimed to generate activities suitable to circumstances such as how Darwin’s fitness requirements aim to create organisms capable of surviving the ever-changing world.

Compassion is not the only modeling system used. Other mechanisms also exist. There’s also an empathy that’s a capacity to feel the way others do. When somebody models a destination, empathy shines on the target and compassion is then used to build the model. Also at stake is mindfulness, a notion suggested by Langer (1989). Caution is a capacity to be open about options (Langer, 1989) It is helpful for modeling regulation. In some cases, the target may have more than one possible models and awareness allows the source to alternate between the models. An instance would be an off-duty scotlandyard officer in a late shop hanging around. In this situation, he or she is working with a civilian mindset. Where, he or she is modeling individuals as strangers around him or her. If one of those individuals turns out to be a thief, however, the scotlandyard can move to the modeling of the stranger and apprehend the thief. Mindfulness also cuts down insignificant models, as its job is to ensure that only an adequate number of decisions can be made. Mindfullness in res

Overall, not only is skill the measure of compassion, but it is also a measure of other psychological behavior such as awareness and realization of significance. His vague nature therefore derives from the reality that it is an emerging method itself. Since there is no single skill-consuming method, it must come from different sources.

To connect this with compassion, you first need to learn about compassion for yourself. Self-compassion is about displaying kindness to one-self to better address the adverse elements of one’s self (Neff & Lamb, 2009). In another phrase, in order to communicate with the self, it is an effort to model the self.

A narcissistic person’s self-compassion would be unskilled. His or her self-modeling is great and brittle. A narcissist would then depend on other people’s designs to preserve the model to deal with the fragility of his or her modeling. Since a narcissist lacks empathy, however, he or she often lacks compassion to communicate meaningfully with other individuals and gain skillful models from others. So their fragile self-model can not be saved because it needs other people’s significant models to keep it. A skilled self-expertcompassion would not rely on the other people’s help and would use mindfulness to balance alternative models of self.

Social representation theory

Historical Origin of the Concept

There is a connection between the concept of social representations and the concept of ‘collective representations’ by Durkheim, which refers to common ways of conceiving, thinking and evaluating social reality (Nemedi, 1995).

However, this notion by Durkheim is too static in relation to how we should understand modern society, according to Moscovici (2000). He argues that it does not capture the dynamics of and changeable personality, nor the variability and plurality of social cognitions of the era we now life in. Therefore, he indicates the fresh notion of ‘social representation’ to include all this. As stated by Markova (2003: 121), social representations can even be regarded as evolving through communication as ‘thought in motion.’

Moscovici researched the spread in French culture of psychoanalytic thinking by the press and the conversion into common sensory social depictions (Moscovici 2007/1961). Such health and unhealthy depictions are typical places where science expertise has an significant part to play. Climate change is a modern problem of great importance where we can observe how science, politics, mass media and everyday knowledge meet and new social representations arise.

Individuals also contribute to the creation of social representations in the interplay between social structure and individual, according to Moscovici (2000). In contemporary so-cities the person has some autonomy and they can be modified simultaneously by assimilating social representations. Individuals are ‘free’ from traditionally binding social structures such as family, social class, and religion that were previously guided by thought and behavior (Beck & Beck-Gernsheim 2001; Giddens 1994). There is a higher degree of decision about alternative ways of living and how to get there.

As put by Moscovici:

Individuals are faced by the organizations to which they belong with a wide range of specific expertise. Each person has to create his or her choice in a truly open representation market. (Moscovici 1984a: 963)

The theory of social representations by offering the person some space prevents social determinism and opens up procedures of conversion. But the person is still predominantly integrated in social constructions and created.

Moscovici seeks to emphasize how depictions emerge through social interaction and communication between people and organizations with the epithet ‘social.’ ‘Social’ also indicates that representations ‘ content is social. Historical, cultural and economic contexts, conditions and methods are reflected in distinct ways.

Perhaps the clearest way to overview problems with the theory of social representations is to list a set of basic concepts with discursive psychology disagreements and to indicate the arguments for discursive psychological approach.

1. Action

One of the main distinctions between the theory of social representation and discursive psychology is the way they characterize action and the comparative significance they attach to it. In Diskursive Psychology, action is conceptualized in terms of the vast array of practical, technical, and interpersonal activities individuals undertake while living their relationships, doing their employment, and participating in diverse cultural fields. Action (practices, doing things–the exact word is not intended to hold weight here) is essential to the life of people, and therefore central to understanding those lifes. Wagner was not the first to notice that no elaborate account of action is provided by Social Representation Theory (cf. Wagner, 1998). This inability to theorize action is at the core of a spectrum of issues; it contributes in specific to methodological blind spots, promotes drift towards cognitive reductionism, and places important constraints on the theory of the key idea of representation.

2. Representation

In both Social Representation Theory and Discursive Psychology, representation is a significant concept. In every view, however, it has almost the reverse function. Representations in Social Representation Theory are mainly cognitive phenomena (although sometimes they are regarded as cultural artifacts) that allow individuals to make sense of the globe. To allow intra-group communication and provide a technical definition of the limits of social groups, the collective nature of this sense making is taken. Representations of discursive psychology are discursive objects that individuals build in speech and texts. Analysis has not focused on the role of depictions in making sense (although in theory this is not excluded), but on how representations are built as strong and factual, and how they are used in and oriented towards behavior (assigning blame, inviting, etc.). Representations are handled exactly as they are manufactured, conducted and built for their role in operations. Discursive psychologists therefore treat the exercise of knowledge as the key to understanding depictions (Potter, 1996).

3. Communication

In Social Representation Theory, facilitating intra-group communication is one of the main roles of social representations. The communication metaphor is dismissed in Diskursive Psychology as insufficient to address the complexities of action and interaction. We doubt that scientists in Social Representation Theory would be very successful if they tried to create sense of a conversational interaction transcript, say, if they tried to discern’ messages’ and locations where they are’ transmitted’ from speaker to speaker. Indeed, scientists in the theory of social representation merely prevented this issue by ignoring interaction and dismissing discussion as’ babble’ (Moscovici, 1985). Conversation thus has the anomalous stance of being at the core of Social Representation Theory as the engine for the generation and refinement of depictions and yet being a subject that has received no analytical attention and where the appropriate literature has been ignored in conversation analysis (Hutchby & Wooffitt, 1998; Sacks, 1992).

4. Cognition

The retention of key components of perceptual-cognitivism was one of the characteristics of Social Representation Theory, which attracted mainstream social cognition scientists. Perceptual cognitivism treats people as perceivers of incoming perceptual information processed in different ways (Edwards & Potter, 1992). Most of the depictions in Social Representation Theory are regarded as cognitive constructions or grids that make sense of data, especially about unfamiliar social objects. Diskursive Psychology rejects perceptual-cognitivism in favor of a systematic reformulation of cognition as a feature of the practices of respondents, where it is built, defined and directed as individuals conduct tasks. Thus, cognition is shifted from an explanatory resource to a research subject. This promotes the study of procedures and prevents a series of confusions resulting from the cognitive assessment of speech and texts (Edwards, 1997; Potter, 1998a). To paraphrase it, click the Quill It button on the right.

5. Construction

Characterizing both the theory of social representation and discursive psychology as constructionist is now widespread. Social representations are not merely handled as instruments for individuals to interpret (or misunderstand) their social worlds–they are building the nature and value of those worlds. Where social representation theory and discursive psychology vary significantly, however, is in this construction’s nature and breadth. While it is mainly a perceptual-cognitive method in Social Representation Theory (involving the anchoring and objectification processes), building in Diskursive Psychology is performed in speech and texts are created and rhetorically undermined as particular versions of the globe. Therefore, in Diskursive Psychology, building is more analytically tractable because a set of components can be used to study how representations are built, developed and undermined. Write down anything you want. To paraphrase it, click the Quill It button on the right.

6. Epistemology

The theory of social representation was created as a theory of understanding, including a consideration of distinctions between the consensual and reified universes (about common sense versus science understanding). Diskursive Psychology has not created a theory of understanding as such; rather, it has created a relativistic and reflective attitude to understanding where what counts, as knowledge in distinct social and cultural environments is part of what is at stake in discourse activities. The broad range of latest and not so latest work in the sociology of science understanding, which makes the difference between the reified and consensual universe problematic (e.g. Ashmore, 1989; Knorr Cetina, 1998; Latour, 1987), is particularly striking here. On another level, while discursive psychologists have been concerned with the reflective relationship between their own categories, claims and textual forms, and those of their participants (Ashmore, et al. 1995; Edwards, 1997; Mulkay, 1985), theorists of social representations have not been concerned with the status of their own representational practices. Problems resulting from this inattention were identified in a number of Social Representation Theory Discursive Psychology Discussions (e.g. Potter, 1996 ; McKinlay, et al., 1993).

7. Method

Research on social representation theory has used a variety of distinct techniques of social science, including surveys, interviews, tests, and ethnography. The main point of conflict with Diskursive Psychology, however, is not the choice of a specific technique, but the inability in Social Representation Theory to conceptualize the actions being performed and oriented to when respondents develop depictions in their speech or texts in any of these techniques. In attempting to use social scientific techniques to achieve hypothetical underlying, yet shared, cognitive depictions, the action orientation of accounts, descriptions and versions is systematically ignored. This may be the reason why scientists in Social Representation Theory have shied away from critical job on methodology in sociology and anthropology, which challenges the use and representation of English (e.g. Atkinson, 1990; Cicourel, 1974). Most importantly, in it’s theorizing, the theory of social representation is overwhelmingly perceptual-cognitive; while it’s analytical components are overwhelmingly discursive.

These points are connected together around the perceptual-cognitivism of social representation theory with its sense-making account of depictions, which provide a code for communication and build mental versions of the globe, and can be investigated using a variety of techniques of social science. For the above reasons, the option of Diskursive Psychology requires a systematically contrastive stance. The reasons mentioned above can be fleshed out by considering the article on various concepts of insanity in Indian discourse by Wagner et al. (1999).

It’s not just the word itself, communication. When characterizing Social Representation Theory, Moscovici relies on the entire anthropology of communication terminology. Consider the following, where Moscovici offers reasons to look beyond’ linguistic forms’: the richness and originality of meanings, this is what we are actually trying to transmit to each other. But linguistic forms in this communication are not enough to clarify how to receive and then understand the transmitted message. Why? Because before transmitting it or receiving it, we conduct many more practical activities on it…. Too often a message’s communication does not coincide with correctly talking language communication. (1994: 164-5) This is illustrated by the difficulty in offering a clear definition of even the seemingly simple concept of’ conversational subject’ (Jefferson, 1993).

Recent commentators on the theory of social representation have suggested that the powerful constructionism and relativism of discursive psychology is self-refuting and does not allow for political engagement (Wagner, 1998; Moscovici & Markova, 1998). There is no room for these points to be addressed in complete here. It’s enough to say that we consider both of these allegations to be wrong. In our perspective, weak constructionism is less consistent with its islands of epistemic privilege; and political engagement is no more evident from realism or weak constructionism than powerful constructionism. See: Edwards et al. 1995; Potter, 1998b for advanced arguments to this impact.

Discursive psychologists do not criticize techniques of studies because they involve experimentation, manipulation or some other method. The critique is specifically directed against the (largely inexplicit) theory of discourse that is used in many research and analytic methods. For further discussion of this point, see Edwards, 1997; Potter, 1997.

Conclusion

Compassion is influenced here by Buddhism’s exercise of compassion. His definition is also significantly distinct in the sense that one may have heard compassion. This is due to the concept of ability that ignores the normative characteristics of good and evil. Instead, skill encourages individuals to look holistically at decision-making. Looking at an action alone as an individual action is inadequate.

The act of compassion is an attempt to create and incorporate the models of the world and the other people into mental processes. This is designed to assist one minimize the cost of thinking. One would need to get into the other people’s heads without compassion or modeling, an act that is only feasible for a psychic. Skillful compassion involves coordination of different systems: the brain’s organs need to be well aligned, the culture needs to promote open-minded and sympathetic thinking, and individuals need to be intelligent in order to prevent pitfalls that would make them unskilled.

Recently, Moscovici replied to Social Representation Theory’s Discursive Psychology criticisms by proposing that asking’ whether language or representation is the best model can have no more psychological significance than asking the question:’ Does a person walk with the assistance of his left arm or correct arm? (1998, 246). One would agree that making a language-representation opposition is misleading. The research of representation (either in speech or cognition) needs attention to located methods of discourse. Research on social representation theory continues to fail to do this, and as a result it continues to be faulty.

REFERENCES

1. Bohannam, L. (1966). Shakespeare in the bush. Natural History, Retrieved from https://law.ubalt.edu/downloads/law_downloads/IRC_Shakespeare_in_the_Bush.pdf
2. Carter, N. L., & Weber, J. M. (2010). Not pollyannas: Higher generalized trust predicts lie detection ability. Social Psychological and Personality Science, 1(3), 274-279. doi:10.1177/1948550609360261
3. Doidge, N. (2007). The Brain the Changes Itself: Stories Of Personal Triumph From The Frontiers Of Brain Science. Toronto: Penguin Group (Canada).
4. Garos, S., Beggan, J. K., Kluck, A., & Easton, A. (2004). Sexism and pornography use: Toward explaining past (null) results. Journal of Psychology & Human Sexuality, 16(1), 69-96.
5. Langer, E. (1989). Mindfulness. Boston: Addison-Wesley Pub. Co.
6. Mendez, F. M., Chen, A. K., Shapira, J. S., & Miller, B. L. (2005). Acquired sociopathy and frontotemporal dementia. Dement Geriatric Cognition Disorders, 20, 99-104. doi:10.1159/000086474
7. Morf, C. C., & Rhodewalt, F. (2001). Unraveling the paradoxes of narcissism: A dynamic self-regulatory processing model. Psychological Inquiry, 12(4), 177-196. doi: 10.1207/S15327965PLI1204_1
8. Neff, K. D., & Lamb, L. M. (2009). Self-compassion. In S. Lopez (Ed.), Encyclopedia of Positive Psychology (pp. 864-867). Chichester, United Kingdoms: Wiley-Blackwell.
9. Nemedi, D. (1995). Collective Consciousness, Morphology, and Collective Representations: Durkheim’s Sociology of Knowledge, 1894–1900. Sociological Perspectives, 38(1), 41-56.
10. Pemment, J. (2013). Psychopathy versus sociopathy: Why the distinction has become crucial. Aggression and Violent Behavior, 18(5), 458-461. doi: http://dx.doi.org/10.1016/j.avb.2013.07.001
11. Shannon, C. E. (1948). A mathematical theory of communication. Bell System Technical Journal, 27, 1-55. Retrieved from http://cm.bell-labs.com/cm/ms/what/shannonday/paper.html
12. Ashmore, M. (1989). The reflexive thesis: Wrighting sociology of scientific knowledge. Chicago: University of Chicago Press.
13. Ashmore, M., Myers, G., & Potter, J. (1994). Discourse, rhetoric and reflexivity: Seven days in the library. In S. Jasanoff, G. Markle, T. Pinch & J. Petersen (Eds.), Handbook of science, technology and society (pp. 321-342). London: Sage.
14. Atkinson, P. (1990). The ethnographic imagination: Textual constructions of reality. London: Routledge.
15. Billig, M. (1988). Social representations, objectification and anchoring: A rhetorical analysis. Social Behaviour, 3, 1-16.
16. Billig, M. (1993). Studying the thinking society: Social representations, rhetoric and attitudes. In G. Breakwell & D. Cantor (Eds.), Empirical approaches to social representations (pp. 39-62). Oxford: Oxford University Press.
17. Cicourel, A.V. (1974). Theory and method in a study of argentine fertility. New York: Wiley.
18. Edwards, D. (1997). Discourse and cognition. London and Beverly Hills, CA: Sage.
19. Edwards, D. & Potter, J. (1992). Discursive psychology. London: Sage.
20. Edwards, D., Ashmore, M. and Potter, J., (1995) Death and furniture: The rhetoric, politics and theology of bottom line arguments against relativism, History of the Human Sciences, 8, 25-49.
21. Flick, U. (1998) Introduction: social representations in knowledge and language as approaches to a psychology of the social. In U. Flick (Ed.). The psychology of the social (pp. 1-14). Cambridge: Cambridge University Press.
22. Heritage, J.C. & Greatbatch, D.L. (1991). On the institutional character of institutional talk: The case of news interviews. In D. Boden & D.H. Zimmerman (Eds.), Talk and social structure: Studies in ethnomethodology and conversation analysis (pp. 93-137). Oxford: Polity.
23. Hutchby, I., & Wooffitt, R. (1998). Conversation analysis: Principles, practices and applications. Cambridge: Polity.
24. Jefferson, G. (1993). Caveat speaker: Preliminary notes on recipient topic-shift implicature. Research on Language and Social Interaction, 26, 1-30.
25. Knorr Cetina, K.D. (1998). Epistemic cultures: How scientists make sense. Chicago: Indiana University Press.
26. Latour, B. (1987). Science in action. Milton Keynes: Open University Press.
27. Litton, I., & ner, W., Duveen, G., Thermel, M., & Verma, J. (1999). The modernization of tradition: Thinking about madness in Patna, India. Culture & Psychology, 5, 413-445.

Throughout medical school, we develop and gain new skills based on the experiences we come across and learn from, building up our development of compassion and teamwork which is essential for our futures as doctors. Here we will be exploring the ideas of compassion and teamwork, what would happen with an imbalance of them and how they are specifically important to us and our futures.

What does it mean to be compassionate? Compassion is a feeling that is evoked in the prescence of someone that is suffering, whereby you want to act and relieve the suffering the individual is experiencing (Medical Dictionary, n.d). When admitted to hospital, patients come in with illnesses as well as being distilled with confusion and fear. In response to the multitude of distresses, compassion is needed to be conveyed by the doctor in order to relieve the individual’s problems (Department of health, 2013). Compassion is a way of being able to integrate our own morals and instinct into the situation, rather than just focusing on the science, solving one problem and moving on. Personally, especially through placement and SGTs do we get to explore the concept of compassion, understanding more about the integration of compassion into both our daily lives and in a working environment. This also involves the idea that compassion is a human instinct that can also be developed throughout medical school, be it through communication, teamwork or listening (Keltner, 2004). We are given difficult scenarios and students work to explore the ways of being able to provide support for patients, learning how compassion comes with consistent communication and interaction whether it be verbal or non-verbal such as pauses or touch. For example, my mother had been rushed to hospital and I was in a state of distress and shock. Upon explaining to a friend, we saw eachother the next day and discussed the situation and there would be times where she would hug me or hold my hand. To me this was her letting me know that she was there to support me in my situation, emphasised by small interactions that I still to this day, really appreciate. She was patient and listened to me giving small gestures of support when I really needed it, linking back to the idea that compassion is not only effective communication.

Especially in the future is this relevant to be able to provide the best quality of care for patients as these skills are directly transferrable, but rather exploring the ideas, compassion contributes to the treatment of patients.

Through compassion, it is more likely that a patient can freely express their thoughts and worries, which is needed for the doctor to be able to diagnose a patient. Likewise, it is shown that doctors are less likely to make errors in providing their treatment when being more compassionate, as their focus is on a patient and so there is a less likely chance of malpractice (Developing compassion and empathy as a medical student, 2014). A case study was taken, looking at the differences in responses of bereaving individuals to doctors who showed compassion or lack of (Crowther, Wilson, Horton Lloyd-Williams, 2013). The study showed that those who were shown compassion, gave more positive responses in that they were being supported by the doctors whereas, for example when a nurse spoke ill of a patient, where the family could hear (demonstration of a lack of compassion) there was lack of trust between patient and medical team, which became detrimental towards the patients’ health.

There are aspects in compassion whereby emotional involvement is necessary, however too much emotion may take over a doctor’s judgement which results to a multitude of symptoms that degrade the doctor’s health. In the UK, mental health issues and stress alone contribute to being one of the “biggest problems in occupational health” (Coleking, 2015) and if the doctor is neither mentally nor physically fit, then the patients’ health is put at risk as a result of compassion fatigue. Therefore, it is a doctor’s responsibility to be able to find balance between clinical outcomes and compassion to bring about maximum patient satisfaction. Doctors also must be aware that every patient is different, meaning the levels of compassion patients require will be different amongst individuals as there are also instances whereby the patient has prioritised facts and outcomes rather than compassion (Cole, 2016).

Compassion is the ability to show empathy, love, and concern for other people with a desire to help reduce their suffering. It is often confused with empathy, and although the two share similar qualities, empathy refers to our ability to feel the emotions another person is feeling and to see their perspective, while compassion has an added desire to help. A person showing empathy simply sees the perspective of another person, while a compassionate person must become an active participant in the suffering of another. Many people are able to feel compassion for others, but have trouble feeling compassion for themselves because they think it is selfish or self indulgent.

Self compassion is showing caring and kindness towards oneself, especially when faced with failure, rather than being harshly self critical. It is acknowledging one’s setbacks and learning and improving from one’s mistakes. It also involves mindfulness, the recognition of emotions, without suppressing or exaggerating these feelings, allowing one to see themselves and the situation more clearly. It is important to differentiate self compassion from narcissism. Narcissistic people feel superior to others and constantly seek approval and appreciation from others. Their feelings about themselves is entirely based on what other people think of them. In contrast, self compassion is not based on positive judgments or evaluation, it is a way of relating to ourselves. With self compassion, one does not have to feel better than others to feel good about themselves. Self compassion is extremely important because accepting oneself relieves insecurities and prevents self harm, such as eating disorders. (Neff)

Eating disorders, stemmed from a distorted body image, are a serious and fatal disease with mental and physical consequences that can affect people of all ages, gender, race, and body weight. Eating disorders are a self-soothing mechanism people use to cope with overwhelming feelings and painful emotions by controlling the intake of food. There is genetic predisposition, however other elements such as sociocultural ideals, family life, and environment are other contributing factors that can lead to the development of an eating disorder. The idea of an ideal body, cultivated through media puts so much pressure on appearance and perpetuates unrealistic body standards. Pressure from the media makes people, specifically girls feel like they have to be as skinny as the photoshopped models they see on instagram and magazines and creates unrealistic expectations.

The environment a person is in greatly impacts a person’s self esteem and their relationship with their body as well. For example, in ballet there is so much pressure to be thin. Dancers in the company of a recent production of The Four Temperaments were anonymously interviewed. One ballerina admitted that “weight gain could get them fired, while thinness can help them advance” (Kelly). Dancers spend hours in a leotard and tights staring at themselves in a mirror comparing themselves to others. It is no surprise that fifty percent of dancers have eating disorders, and despite demands for change from dancers who have experienced problems and psychologists specializing in eating disorders, the stereotype that a dancer must be elegant and lean persists. “In shape for us is being hungry,” she said later on. “Eat nothing and see how far you can go” (Kelly). The ballet culture is competitive and demanding and companies only casting thin girls promotes eating disorders from very early ages.

Family life is also a factor that can lead to the development of an eating disorder. If someone has an extremely controlling or over involved parent they may feel like they have no independence or control over their life, so they turn to restricting food to have control over at least one aspect of their life, as a mechanism for feeling better. All these factors can lead to low self esteem and negative thoughts about oneself, which is what fuels an eating disorder. The opposite of low self esteem is self compassion. Self compassion is crucial for maintaining good mental health and exemplified during eating disorder recovery.

While recovery is extremely difficult, it is achievable through the development of self compassion. Self compassion is a foreign concept to people with an eating disorder or to people in the early stages of recovery because their self concept is filled with self loathing, critical and judgmental thoughts, and self harming behavior. Sarah, opened up about her eating disorder when she said, “I consider myself a very loving, caring person and would never inflict harm on anyone. But I was certainly capable of inflicting harm on myself” (Rzemieniak). People who struggle with an eating disorder constantly have negative thoughts about their looks, behavior, thoughts, and feelings, which depletes the body of positive encouragement and causes their self esteem to diminish. She said that self compassion was crucial in her recovery because, “once I started relating to myself with more compassion rather than ridicule and disgust, the part of me holding onto old behaviours felt safer in exploring the idea of why, and how, to begin giving them up and looking for new alternatives to feel safe” (Rzemieniak). Self compassion suppresses these feelings of self doubt and worthlessness and allows individuals to recognize that they are suffering and change their self loathing to self love. Self compassion has been associated with intuitive eating, fewer body image concerns, less guilt about eating, and a lower drive for thinness. Self compassion is essential during eating disorder recovery, however it can be extremely frightening and challenging for many patients who feel that they are unworthy of receiving compassion. In order for one to recover they must be open to receiving compassion not just from themselves, but from others as well.

Compassion is the ability to show empathy towards someone who is suffering and the desire to help another or oneself. Eating disorder recovery is extremely difficult, but achievable through the development of self compassion. As a dancer, I have seen friends suffer with eating disorders. Seeing people I care about starve themselves to the point where their body is struggling to function is hard for me to watch, knowing there isn’t much I can do, but be a supportive and compassionate friend. Initially, I was frustrated because I didn’t understand why someone would engage in self harming behavior, but understanding that their eating disorder overrides their self control, allowed me to feel compassion towards them. I know that they are not choosing to have an eating disorder and that being compassionate is extremely helpful in fueling their recover. When we see someone refusing to eat it’s easy to criticize and judge them, but criticism is the last thing a person with an eating disorder needs. Someone with an eating disorder needs all the love and support they can get because they feel so much self loathing and if other people are able to show compassion towards them it will help them to show compassion towards themselves. It provides the person with love and support, when they can’t find love and support for themselves. Having had friends who have struggled with eating disorders, I am well aware of the physical and mental consequences eating disorders promote and this knowledge has fueled me to make sure I don’t develop one. It has also made me more aware of eating disorders and what fuels them, so if I notice a friend restricting food, hopefully I can help prevent their development of an eating disorder.

Work Cited

1. Biasetti , Ann. “The Use of Self-Compassion in Eating Disorder Recovery.” CMSC, 6 Dec. 2018, centerformsc.org/the-use-of-self-compassion-in-eating-disorder-recovery/.
2. “Eating Disorders.” National Institute of Mental Health, U.S. Department of Health and Human Services, Feb. 2016, www.nimh.nih.gov/health/topics/eating-disorders/index.shtml.
3. Enegel, Beverly. “What Is Compassion and How Can It Improve My Life?” Psychology Today, Sussex Publishers, 29 Apr. 2008, www.psychologytoday.com/us/blog/the-compassion-chronicles/200804/what-is-compassion-and-how-can-it-improve-my-life.
4. Gleissner , Greta. “Self-Compassion in Eating Disorder Recovery.” Psychology Today, Sussex Publishers, 12 Sept. 2016, www.psychologytoday.com/us/blog/bottoms/201609/self-compassion-in-eating-disorder-recovery.
5. Kelly, Deirdre. “The Cult of Thin.” Dance Magazine, Dance Magazine, 16 Sept. 2019, www.dancemagazine.com/the-cult-of-thin-2307026233.html.
6. Team, GoodTherapy Editor. “Self-Compassion.” Self–Compassion, GoodTherapy, 17 June 2019, www.goodtherapy.org/learn-about-therapy/issues/self-compassion.
7. https://centerformsc.org/the-use-of-self-compassion-in-eating-disorder-recovery/
8. https://www.psychologytoday.com/us/blog/bottoms/201609/self-compassion-in-eating-disorder-recovery
9. https://www.goodtherapy.org/learn-about-therapy/issues/self-compassion
10. https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
11. https://www.dancemagazine.com/the-cult-of-thin-2307026233.html

There has been an increasing focus on the professional role of the doctor in the interest of their critical participation in the Covid-19 pandemic. Considering their occupation, physicians have a greater ‘duty of care’ to ‘Apply [their] knowledge and skills when needed’ (AMA, 2002, p. 145) despite potential risks, as and when expected by the public (AMA, 1955). This does not imply such duties are absolute but suggests, particularly in view of a pandemic, a general responsibility for doctors to utilise expertise as well as critical soft skills. Namely, compassion and teamwork greatly contribute to quality patient care.

Compassion can be defined as ‘sympathetic pity and concern for the sufferings of others’ (oxford dictionary, no date). It is intelligent kindness (NHS), that is linked with but ‘extends beyond empathy’ (the lancet, 2020) due to the added motivation to help alleviate suffering in others. Compassion does not involve ‘feeling with the other’ (Tania singer, Olga M. Klimecki 2014) but instead feeling concern for and desire to better their wellbeing. It is what motivates us to take action, a vital skill in doctors, being that they possess ‘the wisdom to know what is required’ and how to implement it (Harriet Harris, Marti Balaam, 2020).

Displays of compassion can vary. ‘Proximal compassion’ involves alleviating current suffering, whilst ‘distal compassion’ refers to the avoidance of future suffering. It is important doctors can identify how to help in the now, whilst also educating patients and implementing necessary measures to aid in their future (Paul Ekman, no date). During placement, I observed a patient who had been prescribed medication to tackle his diabetes but had also, worked with his doctor to make the necessary lifestyle changes, mainly dietary, to manage his health condition in the future. Such discussion builds trust between doctor and patient as well as allowing the patient to feel secure in managing aspects of their care. Showing compassion and building a rapport allows patients to feel heard, thus preventing ‘hasty, undiscerning attempts’ to subdue affliction (Dr kitty whether 2020). This is of particular importance due to Covid-19, which has resulted in an influx of patients, and the inability to physically consult many individuals with unrelated conditions. As such many consultations have occurred over the phone and through the use of photographs. Upon GP observation, I saw a greater emphasis on communication and the ability to explicitly convey information between doctor and patient. Compassion also allowed inference of a patient’s state, allowing GP’s to reassure them of uncertainties surrounding their health and access to care in light of the pandemic. (Tania singer, Olga M. Klimecki 2014).

The nature of compassion continues to be debated with/alongside various studies indicating both an innate and learned origin. Neuroscience has demonstrated neural networks in the brain that ‘are hard-wired to share the experiences of others’ (Beth A. Lown, 2015). Alternate studies, namely Antoine Lutz et al propose compassion can also be learnt suggesting that ‘mental expertise to cultivate positive emotion alters the activation of circuitries’ (Antoine Lutz et al., 2008). We are born with the capacity for compassion which can be developed through our interactions giving rise to use of compassion training (Beth Lown, 2015). Particularly in medical students, compassion can be built upon through training and shadowing of doctors demonstrating such skills. This cultivates a better ability to cope with stress and adapt emotions and responses to individual patients.

Compassion also relates to the self and can have varying physical and mental effects on healthcare professionals. Self-compassion involves ‘taking an understanding, non-judgmental attitude toward one’s inadequacies and failures’ (Neff, 2003). Self-compassion drives reflection and studies have shown it ‘attenuates peoples’ reaction to negative events’ (Mark R Leary et al., 2006) leading to improved psychological well-being and ability to cope when exposed to stressful situations. Compassion for the self and others can reduce stress (Allen & Leary, 2010) and improve wellbeing. Particularly in the time of Covid-19, it also highlights a ‘common shared humanity’. Awareness of a mutual struggle can help us recognise that we aren’t isolated in our suffering (Kristen Neff, no date).

As a doctor, negative implications can include compassion fatigue (CF) which is a condition that arises from secondary stress and ‘unboundaried empathy’, individuals wish to relieve suffering but may lack the capacity to do so (Nolte et al, 2017). It is a ‘state of exhaustion’ (Figley, 1995), irritability, and diminished ability to empathise which can impair a professional’s ability to effectively care for patients (Fiona Cocker, Nerida Joss, 2016). Particularly in context of the pandemic, Doctors and nurses may have insufficient resources or feel perceived inability to help upon witnessing death and distress in many Covid-19 patients in intensive care. Their increased risk of exposure to infection adds to concern and can create an unwillingness to associate with friends or family, for fear of transmitting infection. (Wallace et al., 2020). CF can jeopardise the health of an individual and compromise quality of care for others, it ‘also signals a need to feel more supported’ (Dr. Kitty Wheater, 2020) which highlights the significance of teamwork in the workplace and support in the wider community.

The NHS states that teamwork involves people ‘working through collective endeavours towards a common goal. Teams are an intrinsic component of the healthcare system where common goal primarily refers to the delivery of quality patient care. Teamwork is a ‘cooperative process’ (Scarnati, 2001, p.5), that incorporates a range of knowledge and invaluable skills to deliver better results than could be obtained by isolated individuals (Francis & young, 1979).

According to the GMC, such collaboration involves respecting and encouraging ‘skills and contributions’ of colleagues as well as actively listening to any concerns raised. Diversity of knowledge within teams allows for recognition of errors or alternative routes that may not have been identified by a single individual. Additionally, Lencioni acknowledges ‘fear of commitment’ which involves placing ’artificial harmony’ over ‘constructive criticism’ as one of his five key dysfunctions of a team. In theatre, I observed the importance of contributions in a team, when problems arose concerning insertion of a catheter during surgery, another surgeon debated alternative routes to the current method and upon discussion, they were able to advance successfully. The rapid decision making among the team, and ability to adapt clinical knowledge in quite a stressful situation stood out to me. In addition, open communication is also critical between ‘vertical divisions of hierarchy’ with reviews suggesting that poor response of supervisory teams to medical errors provides limited opportunity for reflection and improvement (Richard N. Keers et al, 2013). This reflects an interdependence in teamwork whereby, there is a reliance on feedback and contributions from all members. As such, team members must be comfortable in sharing their knowledge but also in providing constructive criticism to each other (Harris & Harris 1996) to reflect on errors and progress, building synergy within teams.

Teamwork can ‘offer greater adaptability, productivity, and creativity’ to patients’ care (Salas et al., 2000) given that effective skills are implemented within the team. Clinical care involves transitions of care between specialists and units forming multi-disciplinary teams ‘who must constantly interrelate’ (Sutcliffe et al, 2004), and accurately share crucial information to coordinate care. Research by Sutcliffe et al. reported 91% of medical mishaps related to communication failures, citing it as the main factor contributing to preventable patient harm. Good communication within and between teams creates an environment of trust, allows for individual reflection, and significantly reduces the risk of patient harm.

Team composition is crucial to effective patient care. Members must be clear on their specific roles and be ‘accountable for their contribution’ (Pina Tarricone, Joe Luca, 2002). Upon delegation of roles, it should be ensured individuals have the appropriate knowledge and training necessary. Accountability of the roles you have taken on is equally important, for example, doctors who chose to ‘opt-out’ of frontline work risked placing burdens of workload on their colleagues who were already experiencing the unprecedented stress of the pandemic (Stephanie B Johnson, Frances Butcher, 2020). Whereas recent retirees and senior medical students who volunteered in response to COVID-19 acted to relieve workload and support the other teams by collectively sharing responsibility. Prevalence of such team spirit and engagement particularly in current times can avoid burnout and stress which could compromise patient safety and the general wellbeing of practitioners.

Skills of compassion and teamwork are fundamental for success in a medical career. As a medical student, I should practice such attributes to the same level of professionalism through interactions with fellow students, professionals, and patients. Constant reflection on my experience will aid me in my duties as a doctor to provide quality patient care and procure a high level of trust from my patients and colleagues.

Introduction

Compassion is a profound human emotion that prompts individuals to extend understanding, kindness, and support to those in need. In American society, where diversity and complexity shape everyday interactions, it fosters community, understanding, and mutual respect. This essay explores the multifaceted nature of compassion within the United States, examining its significance in various spheres, including social, educational, healthcare, and interpersonal relationships.

In a country marked by a rich tapestry of cultures, beliefs, and backgrounds, compassion unifies, bridging gaps and promoting harmony. It encourages people to look beyond their differences, recognizing the common humanity that binds everyone together. It fosters an inclusive and supportive environment in educational settings, essential for effective learning and personal growth. Teachers who embody compassion create classrooms where students feel valued and understood, paving the way for more profound and meaningful educational experiences.

In healthcare, compassion is critical. It goes beyond mere treatment; it involves understanding patients’ experiences and providing care that acknowledges their unique circumstances. This human-centered approach in healthcare improves patient outcomes and enhances the overall quality of care.

On a personal level, it enriches relationships, building stronger, more empathetic connections between individuals. It encourages a deeper understanding of others’ perspectives and experiences, fostering a sense of community and belonging.

Throughout this exploration of compassion in the United States, the essay focuses on practical applications and real-world examples, ensuring that every sentence adds value to the reader’s understanding.

100 Words Essay on Compassion

Compassion in the USA embodies understanding and kindness amidst diversity. It’s the heart of communities, guiding people to support and empathize with others regardless of their background. This virtue fosters unity, especially in challenging times, by encouraging individuals to extend a helping hand. In schools, workplaces, and neighborhoods, it builds bridges, breaking down barriers of indifference. It’s a catalyst for positive change, inspiring actions that transform lives. American stories of compassion, from everyday acts to large-scale initiatives, reflect a nation committed to uplifting and caring for one another, truly embodying the spirit of togetherness. This ethos underscores American society’s core values, promoting a culture of care and mutual respect.

250 Words Essay on Compassion

Compassion, a cornerstone of the American ethos, represents more than just a feeling; it is a committed action to understand, empathize, and aid those around us. In the melting pot of the USA, it becomes a bridge across diverse cultures and communities, fostering unity and respect. This essential virtue is evident in various aspects of American life, from community services to national policies.

In educational settings, it shapes the future. Teachers who practice compassion create nurturing environments vital for students from all walks of life. This approach builds resilience, empathy, and a sense of belonging, preparing learners for a diverse world. Compassion in education is not just about academic success; it’s about shaping socially conscious individuals.

Healthcare in America, often a subject of debate, sees compassion as central to patient care. It transcends clinical treatment, involving understanding the patient’s story, fears, and hopes. Compassionate healthcare professionals make a significant difference in patient outcomes, turning a medical facility into a place of healing in its truest sense.

Small acts of compassion weave a fabric of community strength in daily interactions, whether in bustling cities or quiet towns. It could be as simple as smiling at a stranger, volunteering at local shelters, or supporting a neighbor in need. These acts, though small, create ripples of positive impact.

At the national level, policies reflecting compassion, like support for the underprivileged and disaster relief, echo America’s commitment to its foundational values. American history is rich with examples of compassion driving significant social changes, proving that it is an emotion and a powerful force for good.

It is not merely a part of the American narrative; it is its heartbeat, vital in creating a more inclusive, understanding, and unified nation.

400 Words Essay on Compassion

Compassion, a virtue deeply ingrained in the American ethos, manifests in various forms nationwide. It is reaching out with empathy and understanding, a critical element in nurturing a society that values each individual’s dignity and worth. In the United States, compassion takes on a unique significance, given the country’s diverse tapestry of cultures, beliefs, and experiences. It is a unifying force, fostering community and shared humanity.

In the realm of education, it is a vital component. American educators who embrace compassion create environments where students feel valued and understood, regardless of their background. This approach is not just about imparting knowledge; it’s about cultivating empathy, resilience, and a sense of global citizenship among young learners. When students are taught with compassion, they learn to extend it to others, shaping a more understanding and inclusive future generation.

Healthcare, a critical sector in American society, is significantly enhanced by the practice of compassion. In hospitals and clinics nationwide, healthcare professionals who exhibit it greatly improve patient outcomes. This goes beyond medical treatment; it’s about understanding the patient’s journey and providing care that respects their individuality and needs. Compassionate healthcare is more effective and humane, embodying the true spirit of healing and care.

In everyday life, from bustling cities to small communities, acts of compassion are evident. Americans volunteer in numerous ways, from feeding the homeless to supporting disaster relief efforts. These actions, though they may seem small, contribute significantly to building stronger, more supportive communities. Compassion in daily life fosters a culture of kindness and understanding, essential in a society as diverse as the United States.

Furthermore, compassion in America transcends individual actions, reflecting in national policies and initiatives to support the vulnerable and disadvantaged. Programs that provide healthcare, education, and welfare to those in need demonstrate a national commitment to compassion. These policies are not just about offering assistance; they are about upholding the dignity and rights of every citizen, a principle deeply rooted in American values.

American history is replete with examples where compassion has driven significant social changes. Movements for civil rights, gender equality, and social justice have all been fueled by compassion, showcasing its power to bring about positive change. In essence, compassion in the USA is more than an emotion or an act; it is a guiding principle that shapes the nation’s character and its approach to domestic and global issues.

In conclusion, it is integral to the American identity. It enriches education, healthcare, daily interactions, and national policies, creating a more empathetic, inclusive, and united society. As the nation faces various challenges, compassion will continue to drive positive change and foster a shared humanity.

500 Words Essay on Compassion

In the multifaceted society of the United States, it emerges as a fundamental value, influencing various facets of life. This essay delves into the essence of compassion in America, exploring its impact on education, healthcare, daily life, and national policies while emphasizing its role in fostering a united and empathetic community.

Compassion in American Education:

The education system in the United States, marked by its diversity, is profoundly influenced by the practice of compassion. Educators who embrace this virtue create a nurturing environment crucial for the holistic development of students from varied backgrounds. Compassionate teaching goes beyond academic instruction; it involves understanding and addressing students’ emotional and social needs. This approach enhances learning outcomes and instills empathy and social consciousness, preparing students to be compassionate citizens.

Healthcare and Compassion:

In the realm of healthcare, the application of compassion is pivotal. American healthcare professionals who integrate it into their practice significantly improve patient experiences and outcomes. This involves more than just medical treatment; it encompasses understanding each patient’s unique story and catering to their specific needs. Compassionate care in healthcare settings elevates the quality of service, reflecting the true essence of healthcare – healing and support.

Compassion in Daily American Life:

Everyday acts of compassion are a testament to the empathetic spirit of the American people. From volunteering at local shelters to helping a neighbor in need, these acts of kindness strengthen community bonds. Compassion in daily life fosters a culture of mutual support and understanding, which is crucial in a nation as diverse as the United States. Such actions demonstrate that it is not just a concept but a lived practice, integral to the American way of life.

National Policies and Compassion:

Compassion in the United States is also evident in national policies and initiatives aimed at supporting the vulnerable and marginalized. Programs providing healthcare, education, and social welfare reflect the country’s commitment to upholding the dignity and well-being of all its citizens. These policies highlight the nation’s understanding that it is a key component of a just and equitable society.

The Role of Compassion in American Social Movements:

Historically, it has been a driving force in various American social movements. Campaigns for civil rights, gender equality, and environmental conservation have all been fueled by a sense of compassion towards fellow beings and the planet. These movements showcase the power of it to inspire change and address societal issues, reinforcing its significance in shaping the nation’s history and future.

In conclusion, it is a multifaceted virtue that influences education, healthcare, daily interactions, and national policies. It is a unifying force in a diverse society, promoting understanding, empathy, and a sense of community. As America continues to navigate through various challenges, its people’s actions and the empathy-driven policies of its leaders will steer the nation towards a more inclusive and harmonious future. This pervasive sense of compassion not only defines the American character but also shapes its position as a leader on the global stage, advocating for humanity and kindness.

According to the NHS, the 6C’s of nursing are the guiding principles for anyone working within the healthcare sector (NHS England, 2012) In March 2016, a 3-year study named “Compassion in Practise” was concluded, and a framework of recommendations and best practice called “Leading Change, Adding Value” was created to guide healthcare staff with the work they do. The 6Cs have been listed as care, compassion, competence, communication, courage and commitment.

Whilst it has been emphasised that all these traits should work in unison to create a successful healthcare environment, for this essay I specifically chosen to reflect and explore the importance and meaning of “Compassion” within nursing. Compassion is typically associated with sympathy; Oxford University Press (2019) has defined compassion as condolence and pity towards others’ when they experience hardship.

However, it appears that analysts have unique opinions on what compassion means with relation to nursing. Compassion in nursing does not appear to simply be feelings of sympathy for others. Several researchers have argued that what compassion really includes within the nursing profession is complex and they have put forward differing ideas of what compassion involves.

It has been suggested that numerous definitions of compassionate care exist that incorporate a range of other elements (Bivins and co-authors, 2017). These include:

• Considering other’s perspectives and thoughts
• Aiming to respond to others’ complaints and concerns
• Picturing oneself in the same situation as another to understand their emotions and concerns
• Ensuring charitable, unselfish behaviour is shown towards patients
• Recognising ways they can reduce, and not influence, any types of pain or distress

Furthermore, compassion has been closely associated with a positive, uplifting state of mind (Ling, 2018) A compassionate nurse is likely to sympathise with a patient’s situation, aim to put them at ease and give them the perception that they are “on their side” during the healing process. To do so, a positive mindset from a nurse is believed to be essential as it enables a patient to feel hopeful about their future by promoting a healthy mentality and helping to reduce their concerns and fears.

It has also been hypothesised that there is a direct link between compassionate behaviour and a nurse’s individual work ethic (Ozaras, 2016) A study discovered that patients trusted their nurses to a greater extent when nurses presented themselves as approachable characters who appeared to possess a strong work ethic.

If nurses present themselves as dedicated employees, it can be argued that this can be considered a form of compassion towards their patients and colleagues. A dedicated nurse is prepared to recognise the uniqueness and importance of every patient’s individual situation (as no two may be the same) and aim to improve it for them to their greatest ability. A hardworking nurse will can also be compassionate to their colleagues by working alongside them to ensure tasks are done safely and to the best standard possible.

It is important to consider the value of self-compassion within nursing. When one considers the meaning of compassion within the healthcare sector, they may automatically perceive it be associated with selflessness. Yet, self-compassion is a vital part of maintaining a healthy and positive mental state (Stephenson, 2017) If one fails to show compassion to themselves, they are likely to have a low self-esteem. Stephenson’s investigation recalled that a low perception of oneself is connected to mental health conditions including depression and anxiety and it has been predicted that self-compassion can help lower the risks of these mental health conditions. It is also believed that self-compassion plays a role in working to reduce a negative mindset and unrealistic thoughts.

Overall, there appears to be a recurring opinion from different analysts that compassion is something to be gained by experience, and that compassionate behaviour has many forms and types.

Nurses and other healthcare staff may lose compassion for their patients gradually over time. A term is now widely used to describe declining rates of compassion from nurses and other healthcare professionals towards their patients. This term is known as “compassion fatigue” (Dewey, 2017)

Some factors that are believed to contribute to compassion fatigue are exhaustion from long shifts and emotionally and physically challenging workdays and environments, resulting in a nurse feeling overworked. Ultimately, work related stress can lead to a nurse failing to provide compassion to others. Another contributing factor to compassion fatigue is frequent exposure to numerous incidents of subjection to suffering as this may lead one to feel desensitised to hardship. As nurses are frequently exposed to stressful working environments and suffering of others, every nurse is at risk of developing compassion fatigue.

It is estimated that compassion fatigue affects approximately two thirds of care professionals at some stage in their career (Jarrad, 2018) The article that compassion fatigue may not only be inflicted on patients; nurses and other healthcare staff can also lack compassion towards each other. Consequences of compassion fatigue on the nurses themselves includes less job satisfaction and productive behaviour while on the job. One may be unaware that that they have been affected by compassion fatigue, as nurses can lack self-awareness; compassion fatigue does not have to be deliberate.

It has been well documented within certain sections of the media that the NHS is under continuous economic pressure. For example, it has been reported that patient waiting times have increased in various areas of England, particularly disadvantaged areas, with immigration levels being a contributing factor to this (Guintella, 2015) As more people move into the country, the NHS is under pressure to tend to the needs of the increasing population. It has also been recorded that the NHS has an inadequate amount of staff employed to manage the demanding workload (Gyton, 2017) It has been recalled that the NHS is said to have required 5.9% more staff in practise than they currently have employed. Staff shortages affect areas throughout England, and the number of practise numbers has reduced since March 2016 by 1.4%.

With relation to compassion, as pressure on the NHS increases alongside the population and staffing levels decrease, it is reasonable to assume the remaining nurses are more likely to suffer from compassion fatigue than ever before. As more staff leave the profession there is less support and assistance available, resulting in a heavier workload experienced by the remaining nurses. Nurses who continue to stay in the profession will also have a larger number of patients to care for British population increases; the population of England has increased by 390,000 people since the middle of 2016 (Park, 2018)

There have been instances where compassion has failed to be present in healthcare settings, one of these being the Mid Staffordshire Hospital Scandal. The Francis Report (Francis 2013) summarised the scandal and described situations where patients were neglected during their hospital stay, resulting in psychological trauma, worsened conditions and deaths. Francis recalled that one of the main factors that contributed to the scandal was lack of compassion from staff, particularly nurses. His perception of lack of compassion was described to be a failure to provide necessities to patients in need such as the appropriate medications, nutrients, hygiene and assistance when required.

It has been suggested that Francis gave compassion a great deal of importance in nursing after the Francis Report drew the public’s attention. The report provided recognition to the victims of the Mid Staffordshire scandal and highlighted the consequences when nurses do not show compassion towards their patients (Chadwick, 2015) Francis emphasised his beliefs that compassion must be provided to patients during their hospital stay and that staff have the responsibility to be dedicated to their duty and provide service of a high quality.

Therefore, it is reasonable to conclude that compassion fatigue was a factor that allowed incidents such as the Mid Staffordshire scandal to occur. Many professionals are likely to defend the importance of compassion in nursing practise and recognise compassion fatigue as a danger to patients. When recognising the causes of compassion fatigue and ensuring these are tackled early on, potential scandals like Mid Staffordshire can be prevented from being repeated.

Compassion Cultivation Training (CCT) is a course designed to improve one’s mental state and develop their overall wellbeing, relationships with others and emotional strength (Scarlet, 2017) It has been discovered that Compassion Cultivation Training increases mindfulness in healthcare workers, particularly nurses. The programme enables healthcare workers to prevent “burnout” and compassion fatigue by promoting mental techniques to manage these situations. It has been reported that Compassion Cultivation Training increases job satisfaction and plays a role in reducing negative emotions such as anxiety, as well as improving one’s level of self-compassion. Thus, Compassion Cultivation Training and similar programmes are essential for nurses as they ensure they are emotionally healthy while preventing potential mistreatment of patients.

To conclude, there is no fixed definition on what compassion in nursing is perceived to mean as many authors and investigators hold their own opinions on what qualities and behaviour make a compassionate nurse. It should, however, not be underestimated in its importance towards effective patient care.

This assignment will evaluate the current literature to identify the impact of compassion and compassion fatigue on efficiency. Consideration will be given to the direction and impact of the dark side of leadership, as Schantz (2007) highlighted that for nurses (leaders) to powerfully impact the world; compassion is their most effective tool if they use it appropriately.

Reflections from the clinical workplace will be used to illustrate and inform the discussion. Compassion evokes deep feelings of sympathy, empathy, and the need to help someone in distress (Cambridge, no date). Compassion is one of the core values of the NHS Constitution (DoH, 2009); and is often referred to in the same context as good care to give a level of assurance, which it is argued dilutes its true significance and validity.

Recent change has seen compassion elevated to a subject of extensive consideration and debate in policy reform and strategy development (Sinclair et al., 2016). Dewar and Christley (2013) argue that the Compassion in Practice Strategy (DoH, 2012) isolates the fundamental aspect of care which is compassion, risking individual interpretations of implementation. Similarly, Crawford and Brown (2011) posit that the utilisation of a strategic compassionate approach, incorporating all six C’s to support the development of progress is more likely to achieve its goals of implementation. Dewar and Nolan (2013) welcome this view, as while there remains ambiguity around how to measure compassion, it will continue to be a political ruse to reassure the public that poor standards of care are being addressed. In conflict with this approach, Watson (2006 and 2009) demonstrates that the tools and outcomes of a metrics based approach do not go far enough to evidence the intricate layering required to fully represent what is needed to realise real compassion. It is asserted that this compromises its use as a foundation for transformation and should be used with informed caution. Crawford and Brown (2011) introduce the concept of ‘fastcare’, warning that there is too much focus on what people have been unable to deliver and not enough on what has facilitated the outcome. When this is considered in the context of the NHS becoming more business focussed (Lister, 2008), it is possible that a culture of threat will develop (Crawford et al., 2011), which Rothschild (2006) sanctions, can lead to compassion fatigue. Crawford et al. (2011) warn that this fatigue can cultivate a production line mentality, which is task and not patient focussed. Sadly, this is in direct conflict with Darzi’s (2008) plea for greater patient safety and dignity. Frustratingly, healthcare and social care workers experiencing feelings of stress, guilt, and exposure to bureaucracy, job instability and micromanagement are at high risk of becoming defensive, which in turn can prevent them from being compassionate (Gilbert, 2009). Adding to the picture, Cooper (2012) identifies that every day NHS leaders are faced with the fear of failure, amplified by the threat of external scrutiny which their organisations are unable to affect or control; the impact of these dictates a defensive mindset.A reflection recalled a patient in her last hour of life (‘Mary’); Mary was brought to the ward unannounced by a senior manager and a Matron as she was about to breach a 12 hour A&E target. They placed Mary in the day room as there were no beds available on any ward. Assertively challenging their action and reasoning, I was advised not to worry, as Mary didn’t have any family, positively noting that their action prevented a system breach. Continuing to challenge, I was shouted down and advised that I wasn’t senior enough to understand that this was a ‘good call’.

The learning from this situation identified that the lack of compassion demonstrated by the senior leaders was due to fear of a target breach and external scrutiny, which overrode their compassion threshold, making a normally unthinkable idea an acceptable solution.

It shouldn’t be assumed that ineffective leaders mean there is no leadership, advises Ashforth (1994) supported by Einarsen et al. (2007), whose model of destructive and constructive leadership behaviours, identifies the traits of the darker side of leadership behaviours. Benson and Hogan (2008) go on to caution that the darker side characteristics are present in all leaders. This is further exacerbated when leaders with narcissistic personalities do not receive targeted development as they will leave chaos in their wake argue Higgs (2009) and Maccoby (2000). These assertions have a considerable impact, when thinking of senior leadership; however it must be realised that there are leaders at all levels remark Goffee and Jones (2000), therefore it is considered reasonable to argue that the impact will be felt at all levels, moving up and down through service delivery processes in every team. It’s a fine line, posits Maccoby (2000), as narcissists are often skilled strategists who are able to clearly articulate a vision and inspire others, but if a person is perceived as blocking their progression they are likely to be perceived as an adversary.

Schein (1987) advises that human culture and socialisation determines whether a person will feel positive or react negatively, to the interpretation data gathered by an individual feeling and sensing and interpretation of risk. Therefore the skill of reading the room, or more appropriately, emotional intelligence is often attributed to women remarks Fletcher (1999), adding that this makes it inherently undervalued.

‘Nice’, ‘helpful’ and ‘thoughtful’ are not found on many lists of leadership characteristics.’ (Fletcher, 1999, p115)

The importance of emotional intelligence cannot be underestimated contends Goleman (1994), identifying those leaders as being distinguished, and step ahead of the others. Linking relational practice to emotional intelligence, Holmes and Marra (2004) present relational practice as the practical element of emotional intelligence; valuing the corridor conversations, welfare check-ins with a colleague delivered with congruence and trust. Surprisingly and in spite of this, Holmes and Marra (2004) found that in some organisations a culture of aggressive competition can craft strong teams and leaders, noting that for some people there will be a psychological disadvantage. It is strongly challenged and argued that the teams described by Holmes and Marra (2004) are pseudo, not real teams as defined by West and Lyubovnikova (2013), the variance in which are considerably better outcomes and experience for patients and staff for those cared for and working in real teams.

Fletcher (1999) refers those people that are disadvantaged as the ‘disappeared’; notably women, working within an organisation where they are not heard and as such are blocked from progression as they are perceived as under-achievers or not noticed at all.

A personal reflection highlighted the overt use of gender stereotypes in personality profiling within an organisation. Having completed a Myer-Briggs (1962) assessment profile, posters distributed contained images portraying women with children and books against the personality types linked to nurturing and teaching roles. Pictures of males in authoritative roles were aligned with the words ‘Inspector’ and ‘Fulfiller’. Individual concerns raised were noted and staff told they did not need to display them if they didn’t want to.

On reflection, I have realised that it was the informal corridor conversations which enabled a small group to share compassion with one another. This built their confidence and trust, enabling them to make a formal complaint about the posters. Many colleagues were oblivious to the stereotyping, hearing the concerns of others lent their support and encouragement to factor change and raise awareness.

The conclusion of the reflection was that although these corridor conversations reached a positive outcome, they can also be used negatively to marginalise and exclude a person or group, which is akin to the darker side of leadership (Benson and Hogan, 2008). This assignment has critically analysed the core arguments concluding that it is essential to balance compassion with effective and efficient service delivery.

The challenge remains how to effectively measure the presence of compassion without introducing meaningless metrics, which are evidenced as a causal factor of compassion fatigue. A reflection demonstrated the impact on compassion when the threshold of compassion was breached, leading to a quick-fix solution to Wicked Problems (Rittel and Webber, 1973) compromising individual and organisational values.

It is argued that congruent delivery of compassion improves patient outcomes and job satisfaction (Roze des Ordons et al., 2019), which inherently paves the ground for efficient real team working. It is maintained that compassion is an essential vehicle from which efficiency can be delivered; it is not a metric to demonstrate efficiency.

Compassion versus conscience, freedom versus slavery, and morality versus immortality are some of the numerous subjects which spur debate regarding Mark Twain’s novel, The Adventures of Huckleberry Finn. Twain’s novel is extremely controversial; however, this is not because of the story plot, but rather because of the language. Despite the novel focusing on Huckleberry Finn and his friend Jim escaping from civilization and slavery, many have taken offense stating that it is immoral because the word “nigger” is used. Although The Adventures of Huckleberry Finn has continuously faced criticism as an immoral novel, morality and integrity are seen through Huck’s willingness to do what is right by risking his reputation to save Jim from slavery; this illustrates the Biblical mandate of standing up for what is right, even if it requires going against a society.

Since its publication in 1885, Huckleberry Finn has been widely debated and called a derogatory and unethical novel. This is most often due to its frequent use of racial slurs; however, the novel was not intended to be taken this way. The novel was rather intended to demonstrate the injustice of slavery and prove that an individual’s community has a great influence on their opinions. Only a month after the publication of The Adventures of Huckleberry Finn, the Concord Library banned the novel and released a statement regarding why. This statement criticized the novel by saying that ‘all through its pages there is a systematic use of bad grammar and an employment of inelegant expressions,’ and that it was “absolutely immoral in its tone, “(The New York Herald 1885). However, the novel is only believed to be immoral because of the word “nigger.” While the word “nigger” is offensive, this was not what Twain hoped to teach his readers. On the contrary, The Adventures of Huckleberry Finn was intended to describe the injustice of slavery and emphasize the control society has on a person’s views and opinions. This is clearly seen through Huck as the public had raised him to believe that black people were “property.” Because of this, Huck struggled with the idea of helping free Jim from slavery as he did not want to steal another man’s property ( Twain 99). Trapped between two conflicting opinions about black people, Huck chooses to save Jim instead of returning him as many would have instructed.

By risking his reputation and going against society’s standards to uphold what is right, Huck demonstrates great amounts of morality and integrity. In spite of what he had been taught, Huck notes that Jim is the same as a white man by making statements such as “…I do believe he cared just as much for his people as white folks does for their’n. It don’t seem natural, but I reckon it’s so,” (172), Because of this, Huck decides to abide by what he believes is right, although he knew of the possible repercussions. Laurel Bollinger, author of “Say it, Jim: The Morality of Connection in Adventures of Huckleberry Finn,” states that “In fact, Twain’s novel is often taught as the text that epitomizes this tradition, with Huck held up as its exemplar: a boy courageous enough to stand against the moral conventions of his society, to risk Hell itself rather than conform to the “sivilizing” process of communities he rejects,” (Bollinger 1). Ultimately, Huck determines that although acting upon what he believes means that he has to “go to hell” (237), it does not matter since he is saving his friend.

Because Huck upholds what is moral, he reflects the Biblical truth of standing up for what is right in the midst of difficult circumstances. Huck decides that it made no difference if people called him a “low down Ablitionist” (50) because he did what he felt was good. Clea Rees, author of “Reclaiming the Conscience of Huckleberry Finn,” states that “Although Huck fails to recognise them as such, he is, nonetheless, aware of crucial moral reasons to reject slavery,” (Rees 1). Huck’s actions parallel what the Bible teaches in Roman 12:2 which states, “Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will,” (New International Version, Rom. 12.2). By helping Jim escape, Huck is unknowingly upholding God’s standards of right and wrong. Huck does not “conform” to the ideas of the people but instead chooses to be “transformed” by following what is good and pleasing to God.

Although the presence of morality within The Adventures of Huckleberry Finn has often been debated, Huck demonstrates morality because he stands up for what he believes is right and is willing to suffer the consequences for his beliefs. Huck’s standard of doing what is virtuous parallels the Biblical truth of upholding what God desires, even if it means going against the norms of society. Twain’s novel is widely debated because many people focus on the racial slurs and miss his message against the injustice of slavery. Although Huck’s decision may not have been moral by the people’s standards, it did not matter because it was moral by God’s standards. The Adventures of Huckleberry Finn is a moral novel because it teaches two important lessons: first, that one lives to please God and not man, and second, that because society is not always right, it is imperative to come to a decision by one’s self and act upon it.

“Whether at home, on the streets or during the war, violence against women and girls is a human rights violation of pandemic proportions that takes place in public and private spaces.”

Gender equality and women’s rights are relevant to a successful nation’s growth. Securing these will secure the future of the country too. India is a country with a very low gender equality rating where a woman is murdered only because of her gender. Violence against women is a profound injustice prevailed enourmously in indian society. It is one of main hurdles to the fulfillment of women’s rights and to the achievement of the sustained development goals.

India has a high tolerance for crimes against women. Rape and dowry deaths are normalized. It is seen as a part of life for women, especially for those women from socially and economically destitute populations where levels of education and development are low. Crime against women has become a stain in the progressive efforts of India. The day by day increase of these crimes has increased to a disturbing level.

Different forms of violence that majorly prevailed all around the world are intimate partner violence, sexual violence, human trafficking, female genital mutilation and and child marriage. Intimate partner violence is the violence caused to the victim from her spouse, boyfriend or former partner. The se violence can be physical, mental or psychological. It is recognized that majority of violence that occurs towards women are intimate partner violence.

Majority of women experienc sexual violence at some point of their life all around the world. In under developed countries or developing countries their number is more when compared to developed countries. But most of the time they go unreported. These violence mostly occur from their partners or other relatives. This is just an assumption, the original rates are even higher due to the unreported crimes. Majority of the women murdered in India are killed by their close relatives or husband. they mainly happen in india as dowry death, honor killings, female infanticide and sex-selective abortion. Domestic violence is also a serious issue that causes many deaths every year.

Sexual violence is attempting a sexual act without the consent of other person. In cases when the other person cannot give consent like when the person is a child or unconscious, sexual violence may occur. A sexual violent act can take place in any situation and settings. Sexual harassment also includes non-contact forms, like commenting about a person’s body part, making sexually disturbing noises, asking for sexual favours, staring, exposing sexual organs etc. It also includes physical contact forms, like grabbing, pinching, slapping, or touching the other person in a sexual way.

Rape is having intercourse without the consent of other person or when the other person is unable to give consent if a child or unconscious person is victimised. This can be by persons known or unknown to the survivor, husband or boyfriend or other relatives, or during a conflict. India is considered as the most dangerous country in the world for rape. Rape is a very underrated and common crime in India. Also, marital rape is not considered a crime in India. India is one of many countries that does not recognize marital rape as a crime.

Human trafficking is the exploitation of people as a property rather than a living being. This may be by means of fraud, force or deception. In most of the cases they are women, girls or children. Millions of women and girls are exploited due to this crime worldwide. many of these women and girls are sexually exploited or forced into slavery. These women are mainly trafficked for sexual exploitation. They are used for forced prostitution. In India, forced prostitution is a serious issue that should be given special attention. Lakhs of women disappear from different parts of india every year. In some other cases they are brought in as workers or manipulated as brides but ultimately they end up as sexual tools or in brothels.

Female Genital Mutilation is intentionally alter or cause injury to the female genital organs for unethical reasons. These occur either part of punishment, or hatred. This crime creates extreme physical and mental pain to the victim. Beyond that, this practice also carries many health risks, including death. Child marriage is marrying off a girl way before she attains marital age suggested by the government. It puts an end to girl’s education and her right to make life choices. Child marriage is dangerous because girls who marry in childhood are at greater risk for intimate partner violence than girls of the same age who marry later. Acid throwing is an emerging crime prevailing amid youngsters. Often the victims will be due to rejecting love proposals.

violence against women occur throughout her lifespan from pre-birth, infancy, childhood, adolescence, adulthood and even in her old age. These violence occurs in different settings such as at home, workplace, hospitals, public places, and in the community. It occurs in all socioeconomic and cultural groups. One of the major concern is the increasing cases of domestic violence, sexual harassment at workplace, dowry-related violence, honor killings, acid attacks, and gang rapes.

The reason behind all of this is the many traditional patriarchal outlooks of Indian society. Gender-based inequality can be seen in all aspects of Indian society. Boys have more access to education whereas girls are only given basic education. In some cases that also is not acceptable. These inequalities start from home itself. Girls are given less food than boys. Less nutritious foods that their diet doesn’t include milk, butter, meat etc.

Violence against women in India is actually more present than it may appear at first glance, as many expressions of violence are not considered crimes, or may otherwise go unreported or undocumented. There are many facts to point out the reasons for this, such as: lower levels of education which perpetrate sexual violence or project the experience of sexual violence as a fault of the victim, a history of exposure to child maltreatment and witnessing family violence that causes execution of sexual violence as relief, antisocial personality disorder causes perpetration of sexual violence, harmful use of alcohol causes perpetration and experience of sexual violence, having multiple partners oradultry, arrogance of people that overlook violence, community norms that supports higher status to men and lower status to women and, low levels of women’s access to education and paid employment , marital discord and dissatisfaction, difficulties in communicating between partners, male controlling behaviors of patriarchal society towards their partners, beliefs in family honor and sexual purity, weak legal sanctions for sexual violence. Of all the above mentioned reasons, gender inequality and the acceptability of violence against women are the root cause of violence against women.

The novel Witness the night by kishwar Desai talks about the terrible situation of women in Indian households especially in Punjab. The novel tells the story of Durga a fourteen-year-old girl who was found tied in one hand raped was found surrounded by the corpses of her own family in a partially burned house. The novel won 2010 Costa First Novel Award. The novel explores the dark reality of female infanticide in India. It talks about how women are exploited in the names of culture, honour and status oin their own household.