Compassionate Communities: Conceptual Evolution and Implications for Nursing Practice

Abstract

Background and Purpose: Compassion is a well-known nursing principle with a rich literature on concept development and clarification. Despite being central to care and at risk of being compromised due to increasingly challenging working conditions, compassion continues to be described as a predominantly individual attribute, with the responsibility to demonstrate compassion (and address lack of compassion) placed squarely on the shoulders of individual nurses. There is scant literature holding health care institutions accountable for implementing policies and practices that demonstrate, support, and sustain compassion. Acknowledging the encouraging recent literature on the potential for compassionate leadership, we look to other models based on compassion as embedded in practices and communities to better examine how it can shape nursing work environments. Methods: This paper examines the Compassionate Communities movement, first developed at the intersection of public health and palliative care. We trace its development, highlight ongoing methodological and conceptual tensions, and showcase its applicability as a conceptual framework for research and policy in health care beyond the palliative care context, specifically in nursing. Results: Literature on Compassionate Communities aligns with the priorities and concerns of nursing care, policy, and research. It also has the potential to transform health care institutions, creating compassionate spaces for patients, families, and nurses themselves. Implications for Practice: Proposed definitions and principles for using Compassionate Communities as a conceptual framework are offered; considerations on how health care organizations can become more compassionate, using reflections from our program of research examining nurses' psychological safety.

Keywords: compassion; compassionate communities; concept analysis; nursing; psychological safety.