Obstacles to compassion-giving among nursing and midwifery managers: an international study.

AIM: To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. BACKGROUND: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. METHODS: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. RESULTS: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. CONCLUSIONS: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.

The experiences of postnatal patients regarding postnatal care in Mopani District, Limpopo Province, South Africa

This paper describes the experiences of postnatal patients regarding postnatal care; with the intention of making recommendations to improve the quality of care during the postnatal period. The participants receive care from midwives for the first six hours after delivery and are discharged home. On discharge; the participants receive health advice from midwives on how to take care of themselves and newborn infants at home during the postnatal period. At home they receive care and advice from traditional birth attendants. Different pieces of advice confuse the participants because they interfere with decision-making skills. A qualitative; exploratory; descriptive and contextual research method was used in this study. A semi-structured interview guide was also used to conduct focus group interviews. Data were collected until saturation was reached during the second focus group interview. Participants revealed the following challenges: lack of openness and transparency between the midwives and the traditional birth attendants; exclusion of participants' relatives when giving health advice on discharge; conflicting postnatal care advice; lack of postnatal care supervision and follow up; postnatal patients under direct care of traditional birth attendants only; and feeling of insecurity by the participants. The participants suggested that there should be incorporation of indigenous postnatal care practices into the midwifery healthcare system in order to enhance teamwork between the midwives and the traditional birth attendants. Follow up should be conducted by the midwives to ensure safety; support; supervision and continuity of care to the participants during the postnatal period