From the exploration of many investigations and vast amounts of research, it has been discovered that nurses can deliver compassionate care in innumerable ways. Compassionate care is a top priority in the nursing profession (Dewer, 2012). Compassionate care is “witnessing another person’s suffering and experiencing a subsequent desire to help” (Goetz, Keltner and Simon-Thomas, 2010). There are many facilitators that enable nurses to deliver compassionate care in the most caring and respectful way, but before we can deliver compassionate care effectively we must first understand what compassion is and explore the many ways of delivering this care. The deliverance of compassionate care is facilitated by the learning and understanding of the meaning of compassion, the teaching of ways to care compassionately, the enhancement of vital skills and crucial knowledge and the necessary experience gained from oneself or learned from the observation of others. Unfortunately compassionate care is not always a priority due to the many challenges nurses face such as compassion fatigue and the unfavourable circumstances in which they strive to work successfully in.According to Schantz(2007), compassion is “nursing’s most precious asset”, but before a nurse can usethis significant asset in her profession, she must first understand what themeaning of compassion is and how can she deliver it in her care of patients. Youngson(2008, p2) describes compassion as “the humane quality of understandingsuffering in others and wanting to do something about it”. Compassionate care isrevealed through the smallest acts of kindness. It needs no permission andrequires no resources other than our individual willingness to be kind,understanding, respectful and considerate, to listen and to respond tosuffering. “When we bring these attributes to our daily practice, we influenceothers around us. Compassion is contagious.” (Robin Youngson, 2014). Evidence suggests that fundamental elements ofcompassion such as empathy, Kindness, understanding, attention to pain,consideration given to basic needs and attention to dignity, are imperative toalleviating pain, stimulating a faster recovery from injury or illness andrelieving stress and anxiety. Evidence of physiological benefits of compassionhave also been found in studies which show that small acts of kindness andtouch can alter the heart rhythm and brain function in both the person receivingthe care and the nurse providing it (Fogarty et al. 1999; Shaltout et al. 2012:Science Daily 2012). A UK Department of Health Report (2009), states that inproviding compassionate care “we respond with humanity and kindness to eachperson’s pain, distress, anxiety or need. We search for the things we can do,however small, to give comfort and relieve suffering, we find time for those weserve and work alongside. We do not wait to be asked, because we care”. A nursemust think only of the patients comfort, not of herself, and that she should beconscientious and diligent, seen and unseen. Nightingale believed a nurseshould be intelligent in her comfort to her patients, giving it honestly fromher heart with her strength and mind, and not pretending to care. CatherineWoods (1878) “gentleness of the heart will teach gentleness of the hands and tothe manners. I can give your no better rule than to put yourself in yourpatients’ place”. “The nurse must always be kind, but never emotional. Thepatient must find a real, not forced, or ‘put on’, centre of calmness in thenurse”, (Nightingael 1882:1038-1049). “The nearness of another human beinghelps tremendously. A nurse by kindly little attentions, such as gentlyadjusting the bedclothes and pillows, moving a shaded light, altering thepatient’s position in his bed or chair, provided that these alterations areperformed with a genuine interest in him, will all help” (Pearce 1969:39).Providingcompassionate care however is not as straightforward as it seems (Theodosius, 2013).Recognising that each patient has individual preferences and personalities andputting them at the heart of nursing care is essential (Todres et al, 2009;Borbasi et al, 2012; Hemingway et al, 2012), but many competing priorities canintervene to prevent the provision of compassionate care leading todisengagement among nurses and could be compromising professional practice. There is a growing awareness and evidence that identifies that thedelivery of compassionate care by a nurse is of eminent importance and ishighly valued by patients and their loved ones. The way in which a nursedelivers the care a patient requires is of equal importance as the care itself(Firth-cozens and Cornwell 2009: Pearcy 2010: Dewer 2013). A nurse possesses theskills and knowledge needed to provide medical care for patients througheducation, experience and learning from other nurses. Compassionate care isoften more difficult to articulate and there is much debate as to ifcompassionate care can be taught (Bradshaw 2009: Shea and Lionis 2010). Somepeople believe that compassion is a trait a person is born with and that itcannot be taught (Barker 2013) while other people believe it is a virtue to becultivated (Bradshaw 2009).  Otheropinions suggest that compassion cannot be taught but help can be given tostudent nurses to develop the knowledge and skills they need to enable them tocare compassionately (McLean 2012). “In order to develop these skills we mustfirst discover what makes care compassionate, or not, and hearing about theexperiences of patients, carers and those who provide care can help to informthis” (Adamson and Smith 2014). Compassionate nursing is embedded within theundergraduate nursing curriculum and this is proving to facilitate in thesuccessful delivery of compassionate care to patients by nurses (NHS Lothian2012).  This curriculum should supportlearning about compassionate care and should integrate nurturing and furtherdevelop existing knowledge, skills and exposure to experiences of compassion.“Sharing and hearing individual narratives of what compassionate care lookslike, helps to stimulate and challenge how individual practitioners and teamsthink about and practically deliver this type of care” (Adamson and Smith2014), listening to experiences, responding to feedback and having caring conversations can keep thedelivery of compassionate care a priority for nurses.Compassionate fatigue can be a major barrier for nurses to providecompassionate care to their patients. Compassion fatigue is a combination ofphysical, emotional, and spiritual exhaustion associated with the care ofpatients with significant pain and physical distress (Lombardo & Eyre,2011). Compassionate fatigue is a condition of gradual lessening of compassionover time which is brought on by the exposure to trauma and by caring fortrauma victims. “The expectation that we can be immersed in suffering and lossdaily and not be touched by it is as unrealistic as expecting to walk on waterwithout getting wet. This sort of denial is no small matter.” (Remen, 1996). Thereare many personal and professional attributes that put a nurse at risk ofdeveloping compassionate fatigue.  Thosewho are overly meticulous, devoting and committed with high levels of stress intheir personal lives are more likely to develop compassionate fatigue. In theprofessional setting, it is found that the therapeutic relationship betweennurse and patient is a contributing factor to compassionate fatigue (Sabo 2011;Lombard and Eyre 2011).It is generally believed that nurses who are empatheticand caring are more prone to absorb the traumatic emotional stress of thosethey care for (Joinson 2010). A nurse’s capacity for empathy and ability toengage in a therapeutic relationship is considered central to providingcompassionate care, but those who display high levels of empathy are morevulnerable to experiencing compassionate fatigue. In 1995, Figley’sground-breaking observations revealed that nurses who listened to patientsfears, witnessed their pain and supported them through their suffering oftenfeel similar fears. Pain and suffering because they care. “Sometimes we feel weare losing our own sense of self to the patients we serve”. It is this “compassionatefatigue” that is said to hinder such nurses’ performance and make them prone toburnout.  Although a nurse may stillcarry out care as mandated by policy, their desire to help and their ability toshow empathy can be impacted significantly. Nurses experience a reducedcapacity for, or interest in being empathic towards patients and their families(Lombard and Eyre 2011). Compassionate fatigue may even reduce the quality ofcare for patients and relatives (Donchin Y, Seagull FJ 2002). Compassion is theinvisible work of nurses and is only noticed when it is absent (Dewar, 2012).In the absence of compassion, patients are left feeling frightened, stressed,confused, depressed and agitated and are often made feel like they are nothing“ more than just theappendectomy in room 207” (Corbin, 2008, p163). Compassionatefatigue causes professional and organisational implications. It is known tohave a major impact on nurses’ job satisfaction and their performance ability(Lombard and Eyre 2011). Inaccurate documentation, poor interpersonal skills,lack of record –keeping, medication errors, avoidance of intense patientsituations and insufficient patient information being communicated are onlysome examples of the professional consequences of compassionate fatigue.Organisational negative impacts include reduced productivity, absenteeism,unwillingness, tardiness which all have a direct effect on the hospital teamand definitively the patients (Showalter 2010). In this assignment ithas beenexplored how a nurse can deliver compassionate care. While acknowledging thenumerous facilitators to compassionate care, the focus was primarily on themost simple but yet most important attribute to being competent in deliveringcompassionate care; learning and understanding what it means to havecompassion, strengthening skills and knowledge which aid the deliverance ofcompassionate care, exploring the different ways of providing compassionatecare and how learning from one’s own experience and from observing thecompassionate work of others can teach a nurse how to care compassionately “themost important practical lesson that can be given to a nurse is to teach themwhat to observe” (Florence Nightingale).The meaning of compassionate fatigue and the causes of it were investigatedin this assignment to understand how it is a major barrier in the deliveranceof compassionate care and what can be done to prevent it. But after exploringthe facilitators and barriers to compassionate care it is not either that havethe most predominate effect on how a nurse can deliver compassionate care withsuch prestige but it is the continuous learning and understanding of compassionthat makes the care possible. “Let us never consider ourselves finished nurse..We must be learning all of our lives” (Florence Nightingale).Refernces:12. Donchin Y, Seagull FJ (2002) The hostile environment of the intensive care unit Review. Curr Opin Crit Care 8: 316–320. Youngson, Time to Care: How to Love Your Patients and Your Job. 2012, Raglan: Rebelheart Publishers Department of Health UK. (2009). The NHS constitution: The NHS belongs to us all. (online).Fogarty, L.A., Curbow, B.A.,Wingard, J.R., McDonnell, K., Somerfield, M.R. (1999). Can 40nseconds of compassion reduce patient anxiety? Journal of Clinical Oncology 17(1):371.Science Daily. www.sciencedaily.com/releases/2012/12/121203145952.htmShaltout, H.A., Tooze, J.A., Rosenberger, M.S., Kemper, K.J. (2012). Time, touch and compassion: effects on autonomic nervouse system and well-being. Explore 8:177-184.Woods, C.J. (1878) A Handbook of Nursing for the Home and the Hospital London: Cassell.Nightingale, F. (1882) Nurses, Training of; Nursing the Sick In Quain, R. (ed.) A Dictionary of Medicine 1st edn. London: Longmans, Green, abd Co. pp. 1038-1049 (part II).Pearce, E.C. (1969) Nurse and Patient: Human Relations in Nursing Lomdon: Faber and FaberFigley , C. (1995) Compassion Fatigue: Coping with SecondaryTramatic Stress Disorder in Those who Treat the Traumatized. New York: Brunner-Routledge.Lombard, B., Eyre, C. (2011). Compassion Fatigue: a nurse’s primer The Online Journal of Issues in Nursing 16(1), Manuscript 3  Sabo, B. (2011). Reflecting on the concept of compassion fatigue The Online Journal of Issues in Nursing 16(1), Manuscript 1Remen, .R. (1996) Kitchen Table Wisdom: Stories That Heal. New York: Riverhead Books.Barker, K. (2013) Can care and compassion be taught? British Journal of Midwifey 21(2), 82.Bradshaw, A. (2009) Measuring compassion: The McDonaldised nurse? Journal of Medical Ethics 35(8), 465-8.Firth-Cozens, J., Cornwell, J. (2009) The Point of Care: Enabling Compassionate Care in Acute Hospital Settings. London: The Kings Fund.McLean, C. (2012) The yellow brick road: A values based curriculum model Nurse Education in Practice 12, 159-63.Shea, S., Lionis, C. (2010) Restoring humanity in health care through the art of compassion: An issue for the teaching and research agenda in rural health care Rural and Remote Health Journal 10(4), 1679.  Pearcey, P. (2010) Caring? It’s the little things we are not supposed to do anymore International Journal of Nursing Practice 16(1), 51-6.Corbin, J. (2008) Is caring a lost art in nursing? International Journal of Nursing Studies. 45 (2) 163-165.Dewar, B.,  (2011) cited in Dewar, B ( 2013) Cultivating compassionate care Nursing Standard 27,34 48- 55.Dewar, B. (2012) Using creative methods in practice development to understand and develop compassionate care. International Practice Development Journal. 2(1) 1-11.Edinburgh University & NHS Lothian (2012) Leadership in Compassionate Care Programme. Final Report. Edinburgh University: ScotlandGet Help With Your AssignmentIf you need assistance with writing your assignment, our professional assignment writing service is here to help!Find out more