Academic journal article Online Journal of Issues in Nursing

Compassion Practice by Ugandan Nurses Who Provide HIV Care

Academic journal article Online Journal of Issues in Nursing

Compassion Practice by Ugandan Nurses Who Provide HIV Care

Article excerpt


Compassion is fundamental to ethical nursing practice; it represents a commitment to acknowledge and respond to the suffering of the patient. Many structural, economic, and sociopolitical challenges confront Ugandan nurses in their efforts to incorporate compassion into their care of persons with HIV illness. After reviewing the literature related to compassion fatigue, the author describes nursing in sub-Saharan Africa and presents a qualitative study exploring the impact of education on 24 nurses' lives, including their capacity to avoid or mitigate the development of compassion fatigue. Data were collected through interviews, observation, and focus group discussions. Findings illustrate the barriers participants faced in providing competent care and the liberating effects of new knowledge and skills. Engaging in meaningful relationships, maintaining hopeful attitudes, and advocating for the profession were found to transform and affirm the nurses' approach toward their work and enhance their experiences of compassion satisfaction. The author discusses the unique aspects of the experience of compassion among Ugandan nurses caring for persons with HIV illness.

Citation: Harrowing, J., (Jan 31, 2011) "Compassion Practice by Ugandan Nurses Who Provide HIV Care" OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 5.

DOI: 10.3912/OJIN.Vol16No01Man05

Key words: compassion; compassion fatigue; HIV illness; Uganda nurses; critical qualitative methodology

Compassion is commonly viewed as intrinsically linked to the caring work and values of the nursing profession. It is defined as the acknowledgement of another's suffering and is accompanied by the expression of a desire to ease or end that suffering (van der Cingel, 2009). The role of a nurse is to be present and offer care to those who experience the consequences and distress of health problems. Because of this obligation to humanity, the concept of compassion is extremely relevant to nursing practice. Engaging in compassion practice requires the willingness and ability to be in relationship with another person. Such a commitment may be difficult and debilitating for the nurse, or it may be a fulfilling and energizing experience.

Compassion fatigue is a term that describes the weariness and stress felt by some nurses as they struggle to sustain the ability to witness and respond to profound suffering in their patients. Compassion satisfaction, on the other hand, refers to the inspiration and revitalization experienced by the nurse who shares in and contributes to the relief of such suffering. The purpose of this article is to explore the concept and consequences of compassion practice as revealed during an ethnographic study involving nurses and nurse-midwives who provided care to HIV-infected and -affected people in Uganda.

Literature Review

Considerable ambiguity and multiple perspectives characterize the discourse around the phenomenon of compassion fatigue in the healthcare literature. Introduced initially by Joinson (1992) to describe a symptom of burnout among emergency room nurses, the term has since been discussed in association with secondary, indirect, or vicarious traumatization (Meadors, Lamson, Swanson, White, & Sira, 2009; Sabo, 2006; Simon, Pryce, Roff, & Klemmack, 2005; Sinclair & Hamill, 2007), nurses' stress (McGibbon, Peter, & Gallop, 2010), and the moral stress or distress experienced across a range of healthcare disciplines (Aycock & Boyle, 2009; Forster, 2009). Coetzee and Klopper (2010), in a concept analysis examining the phenomenon of compassion fatigue within nursing practice, described compassion fatigue as the terminal outcome of a progressive, cumulative, and intense process that manifests with physical, emotional, social, spiritual, and intellectual effects. Despite a lack of consensus about its definition, most authors agree that healthcare providers and their workplaces bear a certain cost related to compassion fatigue. …

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