Preventing care factor zero: improving patient outcomes and nursing satisfaction and retention through facilitation of compassionate person-centred care

Main Article Content

Allyson Waird


compassion, empathy, nursing practice, nursing satisfaction, nursing retention, patient outcomes


Aim: A discussion of empathy and compassion including patient and nursing perspectives, barriers and enablers, and the potential for development, teachability, and sustainability of empathy and compassion in nursing.

Background: Whilst compassion and empathy have long been recognised as prerequisites for the provision of effective nursing care, there are many interpretations of their meanings and the two are often transposed. The presence or absence of compassionate and empathetic nursing care has multiple positive and negative effects on nursing satisfaction and retention and on patients’ experiences and health outcomes.

Design: Discussion paper.

Data Sources: Embase, Emcare, Medline, ProQuest, and PubMed were searched from 1 January 2015 to 16 January 2023 for scholarly journals with full text articles in the English language.

Conclusion: Compassion and empathy are sine qua non in the provision of nursing care. Empathy is a core component of compassion. Compassion and empathy may be innate characteristics, but they can also be taught and fostered through education both pre- and post-graduation, which is based on experiential rather than didactic methods of teaching. Organisations have a pivotal role in supporting a compassionate environment through their leadership by developing policies and practices to ensure appropriate staffing levels, having consideration for skill mix and workload which will facilitate the provision of compassionate and empathetic nursing care leading to improved patient outcomes and satisfaction, and also increase nursing job satisfaction and retention.

Implications for research, policy, and practice: Pre- and post-graduate nurses in particular, should have access to targeted education and support from peers, senior nurses, and educators, especially positive role modelling. For all nurses to be able to provide compassionate care, it is important that organisations’ leadership and management recognises the time required to do so without pressure to complete clinical tasks. Indisputably, the prevailing clinical implication is that reducing staffing shortfalls and excessive workloads is essential to foster a compassionate environment.

What is already known about the topic?

  • Compassion is a prerequisite for the provision of effective, person-centred patient care.

  • Empathy and compassion are often used interchangeably and there is some confusion between the two.

  • Absence of compassion has a detrimental effect on patient experiences and outcomes together with nursing job satisfaction and retention rates.

What this paper adds

  • Whilst empathy is considered a separate concept from compassion, it has also been identified as a core component of compassion creating some perplexity.

  • It is possible to effectively teach empathy and compassion using non-didactic, experiential strategies both pre- and post-graduation.

  • Organisations play a pivotal role in supporting a compassionate environment which positively impacts on nursing satisfaction and retention rates thereby improving patients’ experiences and health outcomes.

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