Togainperspectivesfromnursingleaders on managing and supporting a diverse generational workforce in promoting compassionatecareinnursing
Togaininsightsfromnursingeducationon fostering compassionate care within the nursingworkforce.
To foster resilience within the nursing workforce in adapting to the current healthcareenvironment. egncc@acnhs.edu.my
Time Programme
730AM-800AM
800AM-810AM
810AM-815AM
815AM-915AM
915AM-1015AM
1015AM-1045AM
RegistrationandBreakfast
WelcomingRemarks
OpeningAddress
PrayerofBlessing
UnderstandingCompassionate Fatigue
CopingwithCompassionate FatigueinNursing
Break/Boothvisitation
1045AM-1145AM
1145AM-1245AM
1245PM-100PM
100PM-200PM
200PM-215PM
215PM-315PM
APathtoResilience: MentalHealthandWell-being forNurses
LeadershipApproachesto CultivateCompassionateWorkplaces
PhotoSession
Lunch/Boothvisitation
Boothvisitation
BuildingCompassionateCare: TheHeartofNursingPractice–NursingEducation
315PM-415PM
415PM-515PM
515PM-530PM
MsLimKeatHoon,RN,RMN,BN,MN,Chairperson, NursingClinicalInstructor,AdventistCollegeof NursingandHealthSciences
MrAlbinPhuaTuanHui,MBA ChiefExecutiveOfficerofPenangAdventistHospital/ ChiefExecutive,AdventistCollegeofNursingand HealthSciences
MsFlorenceLeeChewLing,RN,BN,MNur DeputyAcademicDeanI
DrLynneYong,AB(USA),MA(USA),PhD(USA) ConsultantClinicalPsychologist,PenangAdventistHospital
MsNgChingSee,RN,RMN,MBA, DirectorofNursingServices,SubangJayaMedicalCentre
MatronGusharanKaurMahinderSingh,RN,BN,MNUR ChiefMatron,PenangGeneralHospital
Questions&Answers
BuildingCompassionateCare: TheHeartofNursingPractice–Clinical ClosingRemarks
LightRefreshment
ProfDrKhatijahLimAbdullah@LimGeokKhim,RN,RMN, BSc(N),MSc(HealthServiceManagement),Doctoratein ClinicalPractice ProfessorandHeadofDepartment(Nursing)
MsMangalaeswariA/PNSubramanian,RN,BN,MEd (Psychology) NurseInstructor,PenangAdventistHospital
VilmaMadin,RN,BSN(Hons) ViceChairperson NurseTutor,AdventistCollegeofNursingand HealthSciences
Ms.FlorenceLee ChewLing
NurseTutor, AdventistCollegeofNursing andHealthSciences RN,BN,MNurs, CertifiedHRDFTrainer
Matron GursharanKaur MahinderSingh
ChiefMatron,Penang GeneralHospital RN,BN,MNUR
ConsultantClinicalPsychologist, PenangAdventistHospital AB(USA),MA(USA),PhD(USA)
ProfDr.Khatijah bintiAbdullah@ LimGeokKhim
ProfessorandHeadofDepartment (Nursing) RN,RMN,BSc(Nursing), MSc(HealthServiceManagement), DoctorateinClinicalPractice
DirectorofNursingServices, SubangJayaMedicalCentre RN,RMN,MBA,Certified HRDFTrainer
Ms.Mangalaesvari A/PN. Subramanian
NurseInstructor,Penang AdventistHospital RN,BN,MEd(Psychology), CertifiedHRDFTrainer
https://forms.gle/K7LFpyRbzeQc9oiZA
NurseTutor,AdventistCollegeofNursingandHealthSciences
RN,BN,MNurs,CertifiedHRDFTrainer
FlorenceLeeChewLinggraduatedfromtheAdventistCollegeofNursingandHealth Sciencesin2000andcompletedaPostRegistrationBachelorsinNursingfromMonashUniversityin2003.Subsequently completedaMaster’sdegreeinNursingfromAvondaleCollege,Australiain2017.ShealsoholdsanAdvanced TeachingMethodologyfromUniversityMalayawhichshereceivedin2006.
Florence Lee has almost 20 years of experience as a nurse and over 10 years’ experience in teaching and college administration.Shebelievesthatitisimportanttostaypassionateaboutwhatshedoesasanurseandteacherbyallowing herselftostaycurious.Thereisalwayssomethingnewtolearn.Currently,FlorenceservesastheDeputyAcademicDeanIatthe AdventistCollegeofNursingandHealthSciences.Sheservesasateacheraswellasclinicalinstructorwhentheoccasionarises.
ConsultantClinicalPsychologist,PenangAdventistHospital AB(USA),MA(USA),PhD(USA)
Dr.LynneYongisahighlyexperiencedandlicensedClinicalPsychologist,currentlyservingasaConsultantClinical atPenangAdventistHospitalsince2008.WithclinicallicensureinbothMalaysiaandthestateofConnecticut, specializesinpsychotherapyandpsychodiagnosticsforadultsandchildren.Herintegrativetherapeuticorientationisprimarily grounded in Cognitive Behavioral Therapy (CBT), complemented by expertise in neuropsychological, cognitive, and developmentalassessments.Sheisalsodeeplyengagedinpublicmentalhealtheducation,havingconductednumeroustalks andtrainingsessionsonstress,trauma,andbehaviorchangeformedicalprofessionals,NGOs,andcorporateclients.
SheholdsaPh.D.andanM.A.inClinicalPsychologyfromtheUniversityofRhodeIsland,andcompletedapost-doctoral fellowshipattheUniversityofConnecticutHealthCenter.Heracademicworkhasfocusedontrauma,resilience,andmental healthoutcomesinvulnerablepopulations,includingex-refugeesanddisastersurvivors.HerresearchcontributionsincludecoinvestigatingeatingdisordersinMalaysianyouthandparticipatinginNIH-andADA-fundedprojectsondiabetes,stress,and mental health in the U.S. She is a frequent collaborator with international humanitarian organizations, contributing psychologicalexpertisetopost-disasterinterventionsinSriLanka,thePhilippines,andLaos.
Beyondherclinicalandresearchpursuits,sheplaysaninfluentialroleinmentalhealtheducationandpolicydevelopment.She hasservedasaclinicalsupervisor,adjunctlecturer,andmemberofnationalpsychologyeducationstandardspanels.Asa formerPresidentoftheMalaysianSocietyofClinicalPsychologyandexecutivecommitteememberofregionalassociations,she continuestoadvocatefortheadvancementofmentalhealthservicesandeducationinMalaysia.Herdedicationtoexcellenceis underscoredbymultipleacademichonors,includingPhiBetaKappaandSigmaXimemberships.
Ms.NgChingSee
DirectorofNursingServices,SubangJayaMedicalCentre RN,RMN,MBA,CertifiedHRDFTrainer
NgChingSeeisanaccomplishednursingleaderwithoveradecadeofexperienceinclinical,operational,andstrategic healthcareleadership.AsDirectorofNursingServicesatSubangJayaMedicalCentre,sheiscommittedtoadvancingnursing excellence,patientsafety,andhealthcareinnovation.
ARegisteredNurseandMidwifewithanMBAandHealthcareManagementcertification,shehasledmajorhospitalinitiatives, includingaMedicationSafetyProgramrecognizedwithanExcellentAwardattheHealthcareManagementAsiaConference 2018.SheisalsoaCertifiedHRDFTrainer,developingfuturenursingleadersthroughcontinuouseducationprograms.
Herexpertisespansqualityandclinicalgovernance,leadershipdevelopment,healthcareprocessimprovement,andnursing talentengagement,makingherapassionateadvocateforsustainableexcellenceinpatientcare.
ChiefMatron,PenangGeneralHospital
RN,BN,MNUR
MatronGusharanisadistinguishednursingleaderwithover25yearsofclinical,managerial,andpolicy-level in perioperativeandhospitalnursing.HoldingaMaster’sinNursingfromMAHSAUniversityandaBachelor’sdegreefrom MonashUniversity,shehassteadilyadvancedthroughMalaysia’shealthcaresystemtobecometheHospitalChiefNursing DirectoratHospitalPulauPinangandActingStateChiefNursingDirector.
Sheiswidelyrecognizedforherexpertiseinperioperativecare,nursinginnovation,andhealthcarequalityassurance.Matron Gusharanhasdevelopedstateandnational-levelclinicaltools,includingvitalsignobservationchartsandI/Omonitoring protocols,andhasbeeninstrumentalinshapingnursingpracticesduringcrisessuchastheCOVID-19pandemic.
Arespectedvoiceinnursingeducationandpolicy,shehaspresentedatnumerousnationalandinternationalconferences, servedasaspeakerandtrainer,andledkeyinitiativesundertheMalaysianNursesAssociation,whereshealsoservedas ChairmanofthePenangBranch.HeraccoladesincludemultipleOutstandingPublicServiceAwardsandthePingatJasa Kebaktian(PJK)fromtheGovernorofPenang.
Herlifelongcommitmenttotheprofessionisfurtherdemonstratedthroughhercontributionstonursingguidelines,audits, andorientationtools,aswellasheractiverolesinvariousprofessionalorganizations,includingtheMalaysianNurses Association(MNA)andtheAmericanOperatingRoomNurses(AORN).
ProfDr.KhatijahbintiAbdullah@LimGeokKhim
ProfessorandHeadofDepartment(Nursing)
RN,RMN,BSc(Nursing),MSc(HealthServiceManagement),DoctorateinClinicalPractice
ProfessorKhatijahisadistinguishedacademicandnursingleaderwithoverthreedecadesofexperienceinclinicalpractice, education,andhealthcaremanagement.ShecurrentlyservesasaProfessorintheDepartmentofNursingatSunway University,Malaysia.
WithaDoctorateinClinicalPracticefromtheUniversityofSouthamptonandadvanceddegreesinNursingandHealthService ManagementfromtheUniversityofManchester,ProfessorKhatijahhasheldsenioracademicrolesatbothUniversitiMalaya andSunwayUniversity.ShealsobringsextensiveinternationalclinicalexperiencefromleadinghospitalsintheUK. Herresearchportfolioincludesover100publicationswithastrongcitationrecord,reflectingherimpactfulcontributionsto women'sandchildren'shealth,nursingeducation,andhealthcareleadership.
Ms.MangalaesvariA/PN.Subramanian NurseInstructor,PenangAdventistHospital
RN,BN,M.Ed.(Psychology),CertifiedHRDFTrainer
Ms.MangalaesvariA/PN.SubramanianholdsaMaster’sdegreeinEducation(Psychology)fromUSMPenang degreeinNursingfromMonashUniversity,Australia.ShecompletedherbasicnursingeducationatTun SchoolofNursing,AssuntaHospital,PetalingJaya,andfurtheredherexpertiseinTeachingMethodologyatthe MedicalUniversity(IMU)inBukitJalil.In2025,sheearnedcertificationasanAccreditedHRDFTrainer.
Ms.Mangalaesvari’sprofessionalnursingexperiencebeganatAssuntaHospital,wheresheworkedasaregisterednursefrom 1999to2001intheSurgicalandPaediatricwards.ShethenmovedtoPenangAdventistHospital,wheresheservedinthe Surgical1wardfrom2001to2009.
In2009,shetransitionedintonursingeducationasaClinicalInstructoratSURYACollegeButterworth'sNursingSchool,before becomingaLectureratSEGICollegePenangfrom2010to2014.From2014to2017,shewasappointedasNursingEducation ExecutiveatIslandHospital.
WithextensiveexperienceinbothClinicalNursingandNursingEducation,Ms.Mangalaesvaricurrentlyholdsthepositionof NursingInstructoratPenangAdventistHospital,whereshecontributestoNursingStaffDevelopment.
By the end of this session, participants will be able to:
1. Define compassion fatigue.
2. Identify common causes of compassion fatigue.
3. Recognize key characteristics of compassion fatigue.
4. Differentiate between compassion fatigue and burnout.
5. Describe the consequences of compassion fatigue.
6. Develop a personalized self-care toolkit to maintain wellbeing.
Compassion fatigue is defined as the physical, psychological, and emotional exhaustion people experience from caring for others or from witnessing and absorbing others’ traumas.
First coined by Dr. Charles R. Figley, 1980’s
Psychologist and Pioneer in trauma research
- Nursing
- Social work
- Counseling
- Mental health professionals
- Emergency services
Watching a patient’s health rapidly deteriorate, informing a loved one of a patient’s passing, and being exposed to people in life-threatening situations can all contribute to moral distress and worsen compassion fatigue.
“The nurses have been giving and giving compassion to the patients without receiving any of that compassion in return.”
Physical Symptoms: Headache, digestive issues, difficulty sleeping, dizziness, and nausea.
Emotional Changes:
- Reduced Empathy or Compassion ‘Numb’
- Feelings of Hopelessness or Helplessness
- Anxiety
Burnout is a “process” in which a previously committed professional disengages from his or her work in response to stress and strain on the job. Burnout occurs because of excessive and prolonged levels of job stress (Cherniss, 1980).
Compassion fatigue, by contrast, “can emerge suddenly with little warning” (Figley, 1995).
Burnout typically stems from a combination of too much work and too many responsibilities, compassion fatigue is feeling like you just have nothing left to give.
(impact of helping others)
“Doing okay, but watch your energy”
“Need a refill soon”
“Running on fumes”
“Pretty good”
“Energized and ready!”
Ongoing compassion fatigue might also result in:
- Chronic health conditions for nurses. (e.g.: obesity, cardiovascular disease, and diabetes)
- Vulnerable mental health conditions. (e.g.: depression, eating disorders, personality disorders, and hypochondria)
- Higher nurse turnover rates.
- Increased nurse shortages.
- Decreased patient satisfaction and safety.
1. Write one self-care commitment on a sticky note.
“I will take a 10 minute walk daily.”
2. Post it on the Self-Care Wall or board.
3. Sample Affirmations:
• "I deserve rest."
• "Taking care of me helps me care for others.“
• “My well-being matters.”
• “I choose peace over pressure.”
“I will take a 10 minute walk daily.”
“I will set aside time for my hobbies.”
I deserve rest “I need to reward myself with ……..”
Keep your tank full – for your sake, your patients’, and everyone you care for.
• Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion Fatigue–Short Scale [Measurement instrument]. American Psychological Association. https://doi.org/10.1037/t30396-000
• “Compassion Fatigue: Symptoms to Look For.” WebMD. https://www.webmd.com/mental-health/signs-compassion-fatigue. Accessed June 29, 2025.
• Figley, C. R. (1995). Compassion Fatigue- Toward a New Understanding of the Costs of Caring.
• Lord, Zara. “Compassion Fatigue in Nurses.” uPaged, June 26, 2024. https://upaged.com/blog/compassion-fatigue-in-nurses/. Accessed June 29, 2025.
• Prevent compassion fatigue through self compassion. https://www.myamericannurse.com/prevent-compassion-fatigue-throughself…. Accessed July 30, 2025.
• “Self-Care for Nurses.” NurseJournal.org. https://nursejournal.org/resources/self-carefor-nurses/. Accessed October 29, 2024.
Dr. Lynne Yong Ee Lin, PhD.
Consultant Clinical Psychologist
Penang Adventist Hospital
• Definition: “A state of exhaustion and dysfunction – biologically, psychologically, and socially –as a result of prolonged exposure to compassion stress.
• What you see:
• Emotional exhaustion, numbness, cynicism, detachment.
• Reduced empathy & effectiveness in patient care.
• Increased errors, absenteeism, turnover.
• Physical symptoms like headaches, GI issues, sleep problems.
• Moral distress and secondary traumatic stress
Figley, C. R. (1995, 2002).
High Acuity
Staffing shortages
Administrative burdens
Ethical dilemmas
Pandemic aftermath
Workplace violence
Lack of management support and understanding
Burnout: General work-related exhaustion, depersonalization, reduced accomplishment. *
Compassion Fatigue: Specific to caregiving, involves secondary trauma & loss of compassion.**
Compassion Satisfaction: The positive aspect –fulfillment from helping, feeling effective. ***
ProQOL Scale: Nurses can exist anywhere on this spectrum simultaneously.
* Maslach & Leiter, 2016: Workload, Lack of Control.
** Figley, 2002; Stamm, 2010: Empathic Engagement with Suffering.
*** Stamm, 2010: Meaningful Work, Positive Connections.
Reduced patient satisfaction and trust * 01 Decreased quality of care and safety ** 02 Less effective communication & therapeutic relationships 03
* Vahey et. Al., 2004. ** Melnikov et al., 2019.
* Hunsaker et al., 2015
** Mason et al., 2014
High turnover costs and recruitment challenges
Reduced morale and team cohesion.
Increased liability risk.
• Self-Awareness & Recognition
• Regular self-check-in to recognize early warning signs
• Use tools like ProQOL
• Physiological Basics:*
• Adequate Sleep
• Nutrition
• Hydration
• Regular Physical Activity
• Sleep deprivation significantly exacerbates compassion fatigue.
• Melnyk et al. (2021) – Found that nurses with better physical health habits reported significantly lower burnout and higher well-being.
* Bakibinga et al., 2016
• Do daily mindfulness practice (even 5 – 10 minutes), *
• Deep breathing exercises,
• Yoga,
• Progressive muscle relaxation
• 2023 meta-analysis confirmed that mindfulness-based interventions significantly reduce emotional exhaustion and depersonalization while improving personal accomplishment among nurses.**
* Guillaumie et al. (2017) & Gauthier et al. (2015)
** Chiesa, A., et al. (2023)
• Structured debriefing after difficult shifts/events*
• Journaling about emotional responses
• Clinical supervision focusing on emotional processing
• 2023 study found that reflective practice is crucial for processing vicarious trauma, preventing emotional numbing, and restoring perspective.**
* Lombardo & Eyre. (2011)
** Russo, A. (2023)
• Learn to say “NO” to non-essential tasks*
• Disconnect from work communications off duty
• Clearly separate professional and personal life
• 2020 study showed that boundary-setting skills are key predictor of lower compassion fatigue and higher compassion satisfaction.**
Duarte, J., & Pinto-Gouveia, J. (2016)* (2020)**.
Professional therapists (EAPs)
Spiritual advisors
* Nurses with strong peer-support networks report significantly lower levels of secondary traumatic stress.
*Kim, Y., et al. (2022).
• Utilize EAPs
• Seek therapy
• Consider medication if indicated
• The American Nurses Association strongly advocates for destigmatizing mental health care access, recognizing therapy as essential for nurses experiencing compassion fatigue.
* American Nurses Association. (2023).
• Intentionally recall positive patient outcome,
• Moments of connection
• Value of your work
• Engage in activities that reinforce purpose
• 2020 study found that actively focusing on positive aspects of care and perceived meaning in work was a protective factor against compassion fatigue.*
* Ruiz-Fernández, M. D., et al. (2020).
• Treat yourself to the same kindness, understanding, and non-judgment you offer your patients.
• Recent study linked higher self-compassion to lower compassion fatigue in ICU nurses.*
* Peters, E. (2024).
• Demand –
• Adequate staffing
• Manageable workloads
• Access to respite spaces
• Trauma-informed debriefing protocols, e.g. RISE – Resilience in Stressful Events
• Wellness programs
• Leadership support
• American Association of Critical-Care Nurses linked staffing, meaningful recognition, and authentic leadership to mitigating compassion fatigue.
• Brief walks in nature (even a hospital garden)
• Listening to calming music
• Brief social connection
• Mindful moments (focusing on your senses for 60 seconds)
• “Microbreaks” – very short, intentional pauses can reduce acute stress accumulation during shifts.*
* Zacher, H., et al. (2021).
• Leadership commitment –
• Visible prioritization of staff well-being as core to patient safety & quality *
• Adequate Staffing & resources -
• Important to reduce overwhelming workloads **
• Psychological safety –
• Create environment where nurses feel safe to speak up about challenges, errors, or distress without distress or fear of blame ***
• Meaningful recognition –
• Regular, specific appreciation for contributions and compassionate acts ****
• Ethical clarity & support –
• Clear policies, accessible ethics committees, support navigating moral dilemmas *****
• Fostering connection –
• Team building, mentorship programs, celebrating successes
* Aiken et al. (2012). *** Edmondson (1999) ***** Rushton et al. (2015)
** Melnyk et al. (2018) **** Laschinger et al. (2009).
Definition:
• The process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress (APA).
Building Key Components –
• Self-Efficacy
• Belief in one’s ability to manage challenges. Enhanced through mastery experiences & positive feedback.
• Optimism & Hope
• Realistic positive outlook focusing on solutions
• Cognitive Flexibility
• Ability to reframe situations, find meaning in adversity.
• Strong Social Support
• High quality connections with colleagues, friends, and family
• Purpose & Meaning
• Connecting work to personal values and a greater purpose
Resilience training programs
• Teach coping skills, cognitive restructuring, mindfulness*
• Formalized programs like RISE (Resilience In Stressful Events), where trained peers provide confidential support after critical incidents** Robust peer support
Trauma-informed leadership
“Emotional PPE”
• Leaders trained to recognize and respond supportively to signs of trauma/distress in staff
• Providing dedicated, paid time for emotional recovery after traumatic events, like physical PPE***
• Identifying and supporting staff members who promote well-being initiatives. Wellness Champions
Addressing workplace violence
• Zero-tolerance policies, effective incident reporting, de-escalation training, security measures.
* Maben et al., (2018); Mealer et al., (2014)
** Everly et al., (2011)
*** Shanafelt et al., (2022)
• It’s a Continuum, Not a Destination:
• Requires ongoing effort at individual, team, and organizational levels.
• Compassion for Self is Foundation:
• Nurses cannot sustainably give compassion without practicing it towards themselves.
• Resilience Enables Compassion:
• Resilience provides the strength to stay engaged and compassionate despite challenges.
• Systems Shaped Behavior:
• Organizational culture, policies, and leadership actions are the most powerful determinants of nurse well-being and capacity for compassionate care*
* Aiken et al., (2012)
1. Prioritize:
• Make nurse well-being a strategic imperative, measured alongside patient outcome.
2. Assess:
• Regularly measure compassion fatigue, burnout, and compassion satisfaction (e.g., ProQOL, MBI).
3. Invest:
• Dedicate resources to evidence-based interventions: Staffing, resilience training, EAPs, peer support.
4. Empower:
• Give nurses agency over their practice and schedules where possible.
5. Lead with Compassion:
• Model self-care, vulnerability, and supportive leadership.
6. Create Community:
• Foster psychological safety and authentic connection among teams.
AACN. (2023). AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence (3rd ed.).*
Aiken, L. H., et al. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. *BMJ, 344*, e1717.
American Nurses Association. (2023). Healthy Nurse, Healthy Nation™ Year 5 Highlights Report.
Bakibinga, P., et al. (2016). The role of mindfulness in reducing compassion fatigue among nurses: A systematic review. *Journal of Clinical Nursing, 25*(15-16), 2106-2119.
Chiesa, A., et al. (2023). Mindfulness-Based Interventions for Reducing Burnout and Enhancing Well-Being in Healthcare Professionals: An Updated Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 12(3), 1124.*
Duarte, J., & Pinto-Gouveia, J. (2016). Effectiveness of a Mindfulness-Based Intervention on Oncology Nurses’ Burnout and Compassion Fatigue Symptoms: A Pilot Study. *Journal of Nursing Management, 24*(8), E190-E199.
Duarte, J., & Pinto-Gouveia, J. (2020). The Role of Psychological Inflexibility and Cognitive Fusion in the Burnout and Compassion Fatigue of Oncology Nurses. Journal of Contextual Behavioral Science, 18, 94-103.*
Figley, C. R. (Ed.). (1995). *Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized*. Brunner/Mazel.
Figley, C. R. (2002). Compassion fatigue: Psychotherapists' chronic lack of self care. *Journal of Clinical Psychology, 58*(11), 14331441.
Gauthier, T., et al. (2015). The role of coping strategies in predicting compassion satisfaction, burnout, and compassion fatigue among nurses. *Journal of Nursing Management, 23*(5), 620-627.
Guillaumie, L., et al. (2017). A mixed methods systematic review of the effects of mindfulness on nurses. *Journal of Advanced Nursing, 73*(5), 1017-1034.
Hunsaker, S., et al. (2015). Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. *Journal of Nursing Scholarship, 47*(2), 186-194.
Kim, Y., et al. (2022). The Impact of Peer Support on Compassion Fatigue, Burnout, and Compassion Satisfaction Among Pediatric Nurses. Journal of Pediatric Nursing, 65, e31-e37.*
Laschinger, H. K. S., et al. (2009). Workplace empowerment, incivility, and burnout: Impact on staff nurse recruitment and retention outcomes. *Journal of Nursing Management, 17*(3), 302-311.
Maben, J., et al. (2018). 'You can't walk through water without getting wet' UK nurses' distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study. *International Journal of Nursing Studies, 131*, 104242. (Highlights need for support).
Maslach, C., & Leiter, M. P. (2016). *Burnout*. In G. Fink (Ed.), *Stress: Concepts, Cognition, Emotion, and Behavior* (pp. 351357). Academic Press.
Mason, V. M., et al. (2014). Compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States *Oncology Nursing Forum, 41*(3), E241-E249.
Mealer, M., et al. (2014). The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: Results of a national survey. *International Journal of Nursing Studies, 51*(3), 410-418.
Melnyk, B. M., et al. (2018). A national study links nurses' physical and mental health to medical errors and perceived worksite wellness. *Journal of Occupational and Environmental Medicine, 60*(2), 126-131.
Melnyk, B. M., et al. (2021). A National Study of Nurse Leaders' and Clinical Nurses' Physical and Mental Health, Healthy Lifestyle Beliefs, and Organizational Culture. Worldviews on Evidence-Based Nursing, 18(2), 108-117.*
Melnikov, S., et al. (2019). The association between nurse burnout, patient safety, and quality of care in acute care hospitals: A crosssectional study. *International Journal of Nursing Studies, 95*, 7-15.
Peters, E. (2024). Self-Compassion as a Buffer Against Compassion Fatigue in Intensive Care Unit Nurses. Nursing in Critical Care, 29(1), 45-52.*
Rushton, C. H., et al. (2015). Moral distress: A catalyst in building moral resilience. *American Journal of Nursing, 115*(7), 58-62.
Russo, A. (2023). Reflective Practice as an Antidote to Compassion Fatigue in Emergency Nursing: A Scoping Review. International Emergency Nursing, 68, 101274.*
Ruiz-Fernández, M. D., et al. (2020). Professional Quality of Life, Self-Compassion, Resilience, and Compassion Satisfaction Among Healthcare Professionals During the COVID-19 Health Crisis in Spain. Journal of Clinical Nursing, 29(21-22), 4321-4330.*
Shanafelt, T. D., et al. (2022). Emotional PPE for Health Care Workers. *Mayo Clinic Proceedings, 97*(3), 479-487.
Stamm, B. H. (2010). *The Concise ProQOL Manual* (2nd ed.). ProQOL.org
Vahey, D. C., et al. (2004). Nurse burnout and patient satisfaction. *Medical Care, 42*(2 Suppl), II57-II66.
Zacher, H., et al. (2021). Employee Microbreaks: A Review and Future Research Agenda. Journal of Occupational Health Psychology, 26(3), 231–245.*
Zander, M., et al. (2013). Individual and organizational resilience in healthcare: A review and integration. *Health Care Management Review, 38*(4), 293-303.
THANK YOU
Nurses – You cannot pour from an empty cup. You need to take care of yourself first.
Ng Ching See 20 September 2025
Reflection 2. The Crisis
3. Resilience
4. Combatting Challenges
5. Practical Toolkit For Nurses
6. Conclusion
• How are you?
• Who has felt emotionally drained after a shift this week?
• Who has ever had trouble switching off from work when you get home?
• Who believes their well-being is crucial for providing the best patient care?
• Global Shortage (WHO, 2020): The World Health Organization (WHO) projects a global shortfall of 10 million health workers by 2030, with nurses and midwives constituting the largest segment.
• Malaysian Shortage (MOH, 2022): Malaysia faces a critical shortage with a nurse-to-population ratio of approximately 1:400, still striving towards the WHO recommended ratio of 1:200.
• Private hospital turnover rates up to 18% annually (HMA, 2023).
• Projection (WHO, 2020): The demand for nurses in private healthcare is projected to grow by 15-20% in the next 5 years due to an ageing population and increased healthcare needs. Without retention, this gap widens.
• Approximately 49.3% of Malaysian nurses experiencing significant levels of work-related stress (Permarupan et al., 2020)
• 24.4% or 1 in 4 nurses experienced burnout. Younger, single and childless nurses had higher prevalence of burnout. Nurses on shift work were 1.6 times more likely to develop burnout,nurses who performed > 6-night shift per month were 1.5 times more susceptible to burnout (Zakaria et al., 2022).
• Nurses on shift work experienced higher burnout (27.1%) compared to regular shift nurses (22.4%) (Lee et al., 2024).
• Experiencing traumatic events at work led to 4.2 times higher risk of burnout, post trauma debriefing is crucial in reducing risk of burnout (Zakaria et al., 2022).
• A 2022 study in a Malaysian public hospital found that over 40% of nurses reported high levels of emotional exhaustion, a key dimension of burnout (Roslan et al., 2022).
• Private hospital nurses often face additional stressors: higher patient expectations, commercial pressures, and managing more complex cases.
• High burnout directly leads to high turnover, which increases the workload on those who stay, creating a vicious cycle. (High turnover – changing workplace or out of nursing profession)
1. Nursing shortage
• leading to heavy workloads / workload and staffing issues due to constant strain, lead to burnout (characterized by emotional exhaustion, depersonalization, reduced sense of personal accomplishment
2. Workplace environment and bureaucracy
• Bureaucratic constraints – inefficientprocesses and admin burdens, non-clinical tasks which diverts attention from direct patient care
• Lack of support – insufficientorganizational support, inherent emotional demands of nursing, insufficient support from peers and superior – increases stress that led to feelings of helplessness.
3. High emotional and physical demands
• High expectations – high organizational and emotional expectations from patient, adding to stress level.
• Stressful conditions – exposure to traumatic events at work and general high-stress environment of healthcare. Multiple patient care, administrative tasks and responding to emergencies – all within limited timeframes.
4. Demographic and social factors
• Sociodemographic vulnerabilities – gender/age/marital status can influence mental health status, with younger and single nurses facing higher incidences of stress.
• Work-life balance challenges – juggling the demands of nursing with personal responsibilities, further impacts nurses’ well-being. Shift work does contribute to burnout.
• Resilience - Professional Shock Absorber
• Resilience is NOT:
Never feeling stressed or tired.
Suffering in silence ("tahan lasak" to the point of breaking).
A fixed trait you're either born with or not.
• Resilience IS:
A skill that can be learned and strengthened.
The ability to adapt, bounce back, and grow from challenges.
Knowing when to rest and recharge your batteries.
Time and encounter– key factors for resilience.
• Resilience is the capacity to recover from difficulty, and recovery inherentlyrequires time to heal, adapt, and grow stronger.
• One cannot build resilience withoutfirst encounteringadversity, challenge, or stress. You can't learn to get back up if you are never knocked down. The "encounter" is the necessary stimulus that forces resilience to develop.
• Hence, we build resilience through the dual process of encounteringadversity and having the time to integrate and learn from it.
• Resilience is directly tied to retention. Hospital that invest in resilience reduce turnover by 15-20% (ICN, 2022).
• For nurses: Better mental & physical health, happier life outside work, career longevity,and job satisfaction.
• For patients:Improved patient safety, higher quality of compassionatecare, better outcomes.
• For Team & Hospital:Lower turnover,stronger team morale, reduced recruitmentcosts, and a positive reputation.
1. Nursing Shortage
• Effective recruitment
• Retention through engagement program
2. Workplace environment and bureaucracy
• Induction program
• Effective mentor-mentee program
• Onboarding program
• Nursing competency program
• Robust CNE
• Speak up program
3. High emotional and physical demands
• Organizational support –
segregation of clinical/non-clinical task
Monitoring of work hours – promote effectiveness and minimize redundancy
Training on inclusive management - recognize the signs of burnout and stress that may manifest differently across ages, genders, and personal circumstances.
• Emotional support
Proper debriefing: after critical incidents
Promote a culture of appreciation and respect – thank you card
Peers support – through specific groups
Regular sharing/meeting
Access to leadership
Access to confidential mental health resources
4. Demographic and social factors
• career ladders and professional developmentopportunities for younger nurses to engage them and provide a sense of purpose and progression.
• Flexible shift/ working hours
• Flexible employmentterms
1. Self-care assessment - signs and symptoms of burnout & compassion fatigue.
• Physical: Constant fatigue, headaches, sleep disturbances.
• Emotional: Irritability, anxiety, cynicism, feeling numb, loss of enjoyment.
• Professional: Dreading work, decreased productivity, making errors, feeling unappreciated.
2. Develop a self-care plan
• Emergency plan
A list of actions for crisis – calling a specific friend, specific activity such as specific mindfulness exercise
• Maintenance plan
Regular activities for ongoing well-being – gym session, coffee time with friends, shopping day, me time …..
3. Practice micro-mindfulness and boundary setting
• Breathing exercise
• Mindful handwashing
• Circle of control – mentally categorize stressors into within control and beyond control, consciously release the energy spent on beyond control factor. Set boundaries: How to be compassionate without owning the patient's pain.
4. Prioritize physical foundation
• Acknowledge direct link between physical health and mental resilience
• Prep and train our body to handle physical and mental demands
• Sleep hygiene - Protect your sleep like you protect your patients.
5. Normalize help-seeking
• Seeking help is self awareness and sign of strength
• Know Your Resources: Speak up program, access to mental health resources
• Trusted peer or mentor
• Calm in the Chaos: 60-Second Resets
• You don't need hours. You need moments.
• Techniques:
The 1-Minute Breath: Inhale for 4 counts, hold for 4, exhale for 6.
Mindful Handwashing: Focus on the sensation of the water, the smell of the soap.
The 3-Breath Pause: Before entering a room or after a difficult task, take three conscious breaths.
Mental health crisis in nursing cannot be solved by yoga apps and resilience workshops alone. It requires a concerted, collective effort:
• For Nurses: Commit to your self-care plan. Adopt suitable tools and courageously utilize the resources available to you.
• For Nurse Leaders: Champion your staff's well-being. Advocate for them at the executive level, model vulnerable leadership, and create a culture of support and safety.
• For Hospital Management: Invest in systemic change. View expenditures on staff well-being, safe staffing ratios, and mental health resources not as costs, but as a critical investment in retention, patient safety, and the long-term viability of organization.
Let’s begin to shift the culture from silent enduranceto sustained support,assist nurses to not only survive their careers but to thrivewithin them.
American PsychologicalAssociation.(2012).Buildingyour resilience. https://www.apa.org/topics/resilience
HospitalManagementAsia (HMA).(2023).Private HospitalNursingShortageReport.
InternationalCouncil of Nurses (ICN). (2022).NursingWorkforce Report.
Lee KY, Zakaria N, Zakaria N. Examiningthe Impact of Burnout on HospitalNurses Engagedin Shift Work: InsightsFrom a NationwideCross-Sectional Study in Malaysia.SAGE Open Nurs. 2024Apr 5;10:23779608241245212.doi:10.1177/23779608241245212.PMID:38585337;PMCID:PMC10998483.
Ministryof Health Malaysia(MOH).(2022).HealthFacts 2022.https://www.moh.gov.my/index.php/database_stores/attach_download/337/1753
Permarupan,P. Y., Al Mamun, A.,Samy, N.K., Saufi, R. A., & Hayat.N. (2020).Predictingnurses’ burnout throughquality of work lifeand psychological empowerment:A studytowardssustainablehealthcare services in Malaysia.Sustainability,12(1),388.
Roslan,N. S., Yusoff,M. S. B., Morgan, K., & Ab Razak, A. (2022).*Burnout Prevalenceand Its AssociatedFactors among MalaysianHealthcareWorkers during COVID-19Pandemic:An EmbeddedMixed-Method Study.*Healthcare, 10(5),901.https://doi.org/10.3390/healthcare10050901
The Circle of Control. Adaptedfrom thework of StephenR. Covey.
World HealthOrganization(WHO). (2020).State of theWorld's Nursing 2020:Investing in education,jobs and leadership.Geneva:World Health Organization.https://www.who.int/publications/i/item/9789240003279
Zakaria N, Zakaria NH, Abdul RassipMNA, LeeKY. Burnout and coping strategiesamong nurses in Malaysia:a national-levelcross-sectionalstudy.BMJ Open.2022Oct 10;12(10):e064687. doi:10.1136/bmjopen-2022-064687.PMID:36216421;PMCID:PMC9557773.
To all lovely angels, thank you for the vital work you do every single day.
'LEADERSHIP APPROACHES TO CULTIVATE
GURSHARAN KAUR CHIEF NURSING OFFICER PENANG HOSPITAL
MNA PENANG BRANCH, CHAIRMAN
Leadership Style Leadership Respect Leadership- Autocratic/ Democratic.
• Voice Framework -Match your energymessage
• Ownership (Use I for accountability)
• Intention- Lead with your purpose
• Clarity- One clear tought at a time
• Empathy- Connect before you direct
Blocking in being rationale Blocking to negotiate
Blocking to communicate Blocking to care
Blocking to under stand Blocking to understand
Updating Connecting Scrolling How Social Media impak your routine
TRAINING WHAT ACTIVITIES ELABORATION OF EXAMPLES
Social Activities
• What activities
• How appreciation is given
• After a good job done
• Monthly
• 6 monthly
• Yearly
• Never
• Get it done
• Be together in doing it
THANK YOU
SUNWAY UNIVERSITY
University
Established in 2004 as Sunway University College. Upgraded to full university status in 2011
School of Arts
School of Business
School of Engineering and Technology
School of Mathematical Science
Faculty of Medical and Life Sciences
School of Hospitality and Service Management
School of Interdisciplinary Studies
School of Psychology
Department of Biological Sciences
Sunway Microbiome Centre
School of Nursing
School of Medical Sciences
Sunway Biofunctional Molecules Discovery Centre
Department of Medical Education
Ageing Health and Well-Being Research Centre
The material provided is a summary and should not be considered complete.
All content in this presentation has been carefully sourced and acknowledged.
References and credits have been provided for all external materials used.
• Defining compassion is difficult, with everyone forming their own personal definition of the word
• Compassionate care is defined as having a deep concern for a person's suffering, coupled with a desire to act and alleviate that suffering.
Theoretical foundations
• Jean Watson’s Theory of Human Caring
• Kristen Swanson’s Theory of Caring
• Ethical foundations: respect, dignity, humanism
• Compassion is a multidimensional concept that refers to the capacity to recognize the suffering of others and to empathize with their suffering, along with a genuine desire to alleviate that suffering (Hernandez NC et al (2022) Building culturally competent compassion in nurses caring for vulnerable populations. J Holist Nurs. 2022;40(4):359–69.
• Lee and Seomun define compassion competence as “an individual’s skill or ability to understand and alleviate the suffering of others and to emotionally connect with patients through insight and sensitivity.”
LeeY, Seomun G. (2016). Role of compassion competence among clinical nurses in professional quality of life. Int Nurs Rev. 2016;63(3):381–7. September 23, 2025
• Puan Salmah teaches a group of first-year nursing students in a clinical skills lab.
• Many students are feeling overwhelmed by the workload, and a few are struggling with confidence.
• One student, Aisha, is particularly concerned about performing her first patient assessment. anxious
• She expresses fear of making mistakes and feels that she may not be cut out for nursing.
Think of a teacher who made you feel safe and supported.
• Puan Salmah notices Aisha’s distress during lab practice.
• Instead of simply correcting her errors, he pauses the session to check in.
• Recognizing that anxiety is a barrier to learning, he models compassionate education.
So what is compassionate education?
• How can nursing curricula better prepare students to balance clinical competence with compassionate care?
• What barriers make compassionate care challenging in practice?
• How can nurse educators model compassionate behaviors for students?
• What strategies help students internalize compassionate care as a core value?
In the curriculum of nursing traiming, there are no specific courses for compassion practices.
UK coverage of ‘compassionate care’ from 2007-2017.
Compassionate care: not easy, not free, not only nurses
Roberta Bivins et al. BMJ Qual Saf 2017;26:1023-1026
• Compassionate care is defined as having a deep concern for a person's suffering, coupled with a desire to act and alleviate that suffering. It involves:
• Empathy: Recognizing and feeling another person's concerns, distress, pain, or suffering.
• Action: Taking concrete steps to address and ameliorate those states.
• Respect: Treating patients with dignity and kindness.
• Holistic Approach: Addressing not just the physical, but also the emotional and spiritual needs of a patient.
• Malaysia does not have a single "Code for Compassion Care" but rather integrates compassion through religious principles and regulatory frameworks like Private Healthcare Facilities and Services Act 1998 (Act 586):
• This law sets standards for private healthcare facilities to ensure patient safety and quality of care, which indirectly requires a compassionate approach to patient treatment.
MADANI Framework:
• The Malaysian government's MADANI Framework highlights "Care and Compassion" (Ihsan) as one of its six core pillars. The framework seeks to promote compassionate in all aspects of life, including healthcare, by fostering kindness and caring
The Malaysian Nursing Board's Code of Professional Conduct is clear and specific about the requirement for compassionate care.
• Core value: The preamble of the code establishes nursing as a "caring profession where compassion is their core value".
• Good standard of care: Nurses are expected to provide a good standard of nursing care by delivering "compassionate and competent nursing care to meet each patient's needs".
• Alleviating suffering: The code states that nursing contributes to society by "the alleviation of suffering in the care of individuals, families and communities"
23, 2025
The goal
of nursing education is to nurture students who develop caring behaviours and provide safe and high-quality patient care.
Nursing educators could play an important role in the development of professional attitudes and caring behaviours in nursing students
LiYS,Yu WP,Yang BH, Liu CF. A comparison of the caring behaviours of nursing students and registered nurses: implications for nursing education. J Clin Nurs. 2016;25(21–22):3317–25. September 23, 2025
• Compassionate nursing education moves beyond technical skills to cultivate empathy, self-compassion, and effective communication in future nurses.
• This human-centered approach benefits both patients and nurses by improving the quality of care and building resilience.
In a nutshell …
An approach to teaching that prioritizes empathy, kindness, and respect for students.
Recognizes students as whole individuals with unique challenges, strengths, and needs
Compassionate nursing education Compassionate nursing practice
Providing constructive feedback in a respectful manner
Direct patient-centered care based on empathy, respect, and dignity.
Supporting emotional as well as academic growth
Encouraging reflection, self-care, and resilience
Building trust between educators and students
Modeling compassionate behaviors for future nursing practice
Involves recognizing and responding to the emotional, psychological, and physical needs of patients.
Focused on alleviating suffering and promoting healing.
Builds therapeutic relationships between nurses and patients
Enhanced Nurse Motivation:
Core Professional Value:
• Compassion is a fundamental virtue in nursing, representing the human and moral aspect of healthcare.
Improved Patient Outcomes:
• Compassionate care is linked to better patient experiences and can shorten treatment times.
• It increases nurses' sense of value and their motivation to provide excellent care.
Foundation for Practice:
• Nursing education provides the crucial opportunity for students to learn and integrate compassionate values into their own behavior and self-concept during clinical practice.
For Nurses:
• Increases confidence, enhances reflective practice, and fosters a deeper connection to the profession.
For Patients:
• Leads to positive health outcomes and improved experiences during hospitalization.
For Organizations:
• Supports nurses and helps build an infrastructure that promotes compassionate care delivery at all levels.
The results of this study highlight the positive impact of compassion and self-compassion training on the academic formation of nursing students, underlining its relevance as an integral part of their personal and professional development.
Participating students reported significant improvements in their communication skills, greater self-confidence in facing challenging clinical situations, and a profound sense of purpose in their future careers as healthcare professionals
Andrés Gutiérrez-Carmona, et al (2025) Nursing students' experiences with compassion, self-compassion training in the academic setting, Teaching and Learning in Nursing, https://doi.org/10.1016/j.teln.2025.06.009.
Significant positive relationship between students’ compassion competence and caring behaviours
(r = 0.70, p < 0.001), compassion competence and professional commitment
(r = 0.41, p < 0.001) and between caring behaviours and professional commitment
(r = 0.48, p < 0.001).
Zarrinkolah, E., Ghafourifard, M. & Dehghannezhad, J. (2025) The relationship between compassion competence, caring behaviours, and professional commitment among nursing students: a cross-sectional study. BMC Med Educ https://doi.org/10.1186/s12909-025-07253-0
• Lee et al. showed that nurses’ compassion is significantly correlated with caring behaviours and the quality of nursing care, indicating that compassion competence is essential for improving the quality of nursing care through the development of caring behaviours.
Lee H, Seo K (2022) Mediating effect of compassion competence on the relationship between caring behaviors and quality of nursing services in South Korea. Healthcare: MDPI; 2022.
Duru et al. compassion is a key predictor of job performance and the quality of professional life for nurses. Nurses who demonstrate compassionate attitudes and behaviours tend to establish positive and high-quality relationships and professional practices, which enhance their professional commitments through increased job satisfaction. Duru P, Örsal Ö, Parlak L. (2022) Evaluation of the relationships between nurses’
forgiveness, compassion, and professional commitment. Perspect Psychiatr Care 58(2). September 23, 2025
Studies consistently show that embedding compassion in nursing education yields positive results for both students and patients:
• Improved patient outcomes and satisfaction: When nurses and students build trusting, collaborative relationships with patients, it leads to better adherence to treatment plans, fewer complications, and higher patient satisfaction.
• Enhanced student resilience: Compassion and self-compassion training help students manage their emotions, cope with stressful situations, and develop greater psychological well-being. This, in turn, helps prevent burnout and compassion fatigue.
Despite these efforts, several challenges can inhibit the development of compassionate care among nursing students:
• Workload and organizational issues: Heavy clinical workloads and a focus on procedural routines over patient needs often make it difficult for students to provide compassionate care.
• Lack of role models: Negative experiences, including witnessing bullying or receiving insufficient support from instructors and staff, can lead to student cynicism and disillusionment.
• Fear of compassion: Some students may develop a "fear of compassion can impede their ability to empathize and alleviate suffering.
• Clinical environment stressors: Working conditions, advanced technology, and patient situations can contribute to the dehumanization of care and erode compassionate behavior.
Communication barriers:
• Factors such as language differences, mistrust from patients and families, and negative media portrayals of nurses can create obstacles to compassionate communication.
Curricular limitations:
• The variability and lack of consensus on effective, sustainable pedagogical approaches to teach compassion can hinder consistent implementation across nursing programs
• Teaching compassion in
• Role modeling by faculty and mentors
• Reflective practice and journaling
• Simulation training for empathy and communication
• Assessment of compassion in students
• Creating supportive cultures
Educational Programs:
• Specific programs are designed to enhance nurses' ability to engage in compassionate care.
Clinical Practice:
• Experiencing compassion in real-life situations and clinical settings helps students develop these skills.
• Developing emotional intelligence is crucial for confident and empathic communication.
Reflective Practice:
• Educational programs help students develop reflective practice skills, enabling them to deal with difficult clinical challenges with greater confidence.
• The role of interprofessional education (IPE) in enhancing compassion competence has also been highlighted by Balay-odao et al. (2024) in a study on nursing students.
• They found that working in the collaborative learning environments significantly increased compassion and the emergence of caring behaviours among nursing students.
• Stronger communication skills: Educational interventions focused on empathy improve students' communication, active listening, and selfawareness, allowing them to better understand patients' emotional needs. Balay-odao EM, et al.(2024) Caring behavior and compassion competence and their association with readiness for interprofessional education among student nurses. Health Professions Educ. 2024;10(2):3.
• Clinical supervision of nursing students through preceptorship or mentorship programs in practical environments
• Simulation-based training using standard or virtual patients is an effective educational approach for developing the caring behaviours of students in nursing schools.
• Role modeling - Positive role modeling demonstrates to students how to appropriately manage situations that may arise during patient care
Inocian EP, t al (20220 Factors in the clinical learning environment that influence caring behaviors of undergraduate nursing students: an integrative review. Nurse Educ Pract. 63:103391.
Foundational curricular integration
• Rather than treating compassion as a standalone concept, future education should embed it throughout the curriculum as a core competency
Prioritizing self-compassion and resilience
• Compassion fatigue and burnout are significant risks for nurses, and future education must address the need for self-care and resilience
Innovative use of technology
• Technology can enhance compassion training by creating realistic learning environments and freeing up time for human connection
Fostering a systemic culture of compassion
• A compassionate educational environment is crucial for fostering compassionate nurses, and future efforts should address systemic barriers
• Explicit policy integration: Policies should explicitly prioritize patientcentered care and integrate compassionate care indicators into clinical learning experiences to guide curriculum development and clinical practice
Call to action for healthcare institutions
“Compassion is not optional—it is essential.” It must be practiced with patients, colleagues, and ourselves
Afew years ago, I cared for an elderly patient who was in great pain and fear after surgery.
Medically, everything had been done correctly his vitals were stable, the wound was healing but he seemed restless and withdrawn.
One evening, I pulled up a chair, held his hand, and simply listened as he spoke about his worries and his family. The next day, he told me, “Thank you, nurse.
Last night was the first time I felt like a person again, not just a patient in a bed.”
“Nurses are the heart of healthcare, and compassion is the heartbeat of Nursing”.
"In every act of care, we hold a human life in our hands. Compassion is the bridge that turns treatment into healing."
Treating a patient with dignity, honoring their values and included in decision making process.
Every patient regardless of their health condition deserve respect.
•Understanding and feeling what another person is going through
• It’s like putting yourself in their shoes.
•It is a foundation of compassionate care.
3.Advocacy
Nurse act as patient advocates.
Ensure patient voice is heard and receive the best care.
4. Integrity
Being honest, trustworthy, and doing the right thing even when no one is watching.
Builds confidence in the nurse-patient relationship.
Nurse showing warmth and gentle interaction.
Asmall act of kindness gives comfort and treats the patient as a human being, not just a task.
Being fully present and attentive to the patient needs.
Patients Outcome Nurse Satisfaction & Retention Organization benefits
• Patients who receive a high level of compassionate care often report greater satisfaction in surveys.
Strengthened patient-nurse relationship
• Pain relief comes not only from medication, but also from the compassionate presence and emotional support of the nurse.
• Patient openly shares concerns, and follows care advice more willingly.
Patient high score satisfaction:
• Builds a positive image of the hospital
• More patient choose this hospital.
Compassionate care is not just ‘soft skills.’It creates a system-wide impact: better care coordination, fewer re-admissions, cost savings and stronger patient trust in the hospital.
Hospitals that practice compassionate care gain stronger trust and reputation in the community.
Time Constraints
-Overloaded patient and time to deliver compassionate care will be crucial.
-Challenges to balance efficiency with emotional support
Staff shortages
• Patient high census
• Limit nurses to give compassionate care evenly to all patient
Emotional demand
Nurses handle patient and relative.
-Nurses need to provide equally care to all patient .
Lack of resources
-Limted resource make nurse struggle and delay in care
Cultural differences
Nurses find challenging due to cultural belief.
APatient CenteredApproach simply means putting the patient at the heart of everything we do:
Active listening – giving patients time to express concerns without interruption.
Respecting individual values – acknowledging cultural, spiritual, or personal preferences.
Shared decision-making – involving patients and families in planning treatment.
Holistic care – addressing emotional and social needs, not only clinical symptoms.
Effective communication is crucial for building compassionate and effective nurse-patient relationships.
It enhances rapport, conveys empathy, and can significantly impact a patient's comfort and trust.
Nurses can create a more supportive and healing environment, leading to better patient outcomes.
Peer support system where experienced nurse in mentor new graduate nurse can help cultivate a culture of compassion.
Involved in workshop on such as Communication Skill, Emotional Intelligent or Cultural Competence.
Teach nurses use affirming language:
“Your presence brings comfort”
“Your voice bring reassurance”
“Your touch bring healing”
“You matter every single day”
Emotional intelligence (EI) builds compassionate care by enhancing:
allowing caregivers to understand and validate patient feelings, build trust, and create a supportive environment ultimately leading to better health outcomes and patient satisfaction.
To create a compassionate hospital environment
grieving families and patients, provide quiet, private spaces for reflection and counselling
adjust environmental factors like lighting and noise to promote comfort
offer comforting personal items and soothing music, ensure access to supportive equipment
Staff should be trained to recognize and respond to emotional and spiritual needs, fostering a calm and confidential atmosphere.
Compassionate care begins with a calm and centered nurse:
• Deep breathing exercise
• Mindfulness
Sharing our struggles with someone we trust whether it’s a colleague, supervisor, mentor, or even a family member lightens the load.
Learn from role model
• nurses is an inspiring way to show how compassionate care can be lived out in daily practice
Appreciate staff who demonstrate compassion, reinforcing positive behaviours:
• Boosts morale and reduces burnout.
• Encourages compassionate behaviors to be repeated and spread.
• Builds stronger team spirit nurses support each other more.
Penang Adventist is proud that you have been commended by one of our patients (Mdm X). It has been noted that patient was happy that you were very caring and helpful during her treatment at PAH. Your compassion for the patients well being is appreciated by PAH administration. This is simple act of care and love is exemplary to all staff.
“Gibbs’model guides us to look back on our experiences step by step:
• what happened, how we felt, what went well, what could be improved and action plan.
• So we can learn and apply more compassionate strategies in future patient care.
“Patients may not remember every instruction we give, but they will always remember the compassion we showed.”
“Nursing begins with knowledge, but it truly heals with compassion. So, lets practise it in our daily clinical practise”
• Royal College of Nursing. (2023, September 21). RCN launches new definition of nursing. Royal College of Nursing. https://www.rcn.org.uk/magazines/News/UK-RCN-launches-new-definitionof-nursing-210923
• https://www.emerald.com/lhs/article/37/5/49/1233844/Health-care-leaders-and-professionalsexperiences
• https://www.researchgate.net/publication/380446116_Exploring_the_impact_of_compassion_and _leadership_on_patient_safety_and_quality_in_healthcare_systems_a_narrative_review
• https://b2b.healthgrades.com/insights/blog/hospital-leadership-solutions-to-cultivate-betterworkforce-trust
• https://www.sciencedirect.com/science/article/abs/pii
• https://www.researchgate.net/publication/380446116_Exploring_the_impact_of_compassion_and _leadership_on_patient_safety_and_quality_in_healthcare_systems_a_narrative_review
• https://www.uhcsolutions.com/patient-centered-care-a-key-component-of-effective-communityhealth-practice
• https://aimshealthcare.ae/compassionate-care-transform-healthcare.
• https://onlinelibrary.wiley.com/doi/10.1111/inr.12910
• https://www.myamericannurse.com/practice-mindful-nursing
• https://www.wmd2017.mcsprogram.org/virtual-library/
• Le Thi Thao Hien, & Aliswag, E. G. (2025). Quality of nursing care, compassionate care and patient satisfaction: A multiple regression in path analysis model. Journal of Nursing Science, 08(01). https://doi.org/10.
