Be a Real Nurse: Compassion is the Key

In this article, the author discusses the importance of true compassion in nursing. She invites the reader to share their own experiences.


Be a Real Nurse: Compassion is the Key

The three siblings stood woodenly to the side in the ICU room, trying to stay out of the way while they waited for the doctor to make her early morning rounds, and fighting the tears that kept creeping into their eyes making it so that they couldn't see clearly, and somehow even affecting their ability to hear and understand. The tears filled their throats, silencing all the questions that had no answers. Just twenty four hours prior, their dad had been active and able, always serving and busy doing good for others. Now he lay comatose and on a vent, his brain overwhelmed by a massive bleed.

The shift nurse came in and made a point of setting them at ease by introducing herself and going over to the whiteboard to jot down her name. Then she explained that she would be doing her daily assessment. She moved smoothly about, a gentle expression on her face as she familiarized herself with the patient. When she finished, she took just a moment to ask if they had any questions and to learn their names and relationships. Her manner suggested patience and compassion and the three relaxed just a bit, their shoulders less tense. They answered "yes" when she offered to bring another chair and then followed through.

The nurse, if asked, would say she didn't do anything particularly special. But she did. Her attitude, her bearing and her words communicated that she saw them in their pain and that she not only felt for them but also would do what she could to put action behind her feelings.

The definition of compassion given by some is: "a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering." So it starts with a feeling but the nebulous emotion is then joined by action. Together, competent action and caring make up the twin bases of excellence in nursing beyond providing basic care.

How does true compassion differ from pity and sympathy? If words are kin to one another, then compassion and empathy are cousins who walk around in each other's shoes helping one another out, while pity and sympathy feel bad and sit side-by-side and don't do much.

Can you think of a time when you received compassion from a medical professional? What did it mean to you? I remember meeting the nurse in the ER after our son had a bike wreck with a possible head injury. He was in the CT scanner, and I was panicked. She put her hand on my shoulder and make eye contact with me and said something reasonable like, "We are taking care of him right now, and we will let you see him as soon as he gets back." The combination of the human touch and the calm tone of her voice, brought me down from my desperate perch just a notch of two, but enough so that I could take a breath and hold myself together. A few days later, he was fine (save some teeth he lost on the bike trail!), but I never forgot the compassionate touch of the nurse's hand and the even, calm tone of her voice.

Compassion manifested through physical touch is key to effective nursing practice. Everyone needs physical contact, but people who are ill are especially vulnerable to its absence, as are their close family members. Along with touch, people note the tone of our voices, the words we chose and even the body language we employ as we communicate. Together, these components merge to further define how our patients see us. Is compassion easy? Never.

So here is the tricky question: do these nurses that practice caring and compassion burn out faster than those that stay detached and keep a distance from their patients? I am not sure there is a scientific answer to this question (how to you quantify compassion?) but we can all decipher plainly the results of living out of loving compassion and pulling back into our protective shell of doing the job technically well without getting too attached. We all know the glowing satisfaction of working hard, and doing good. However, notice here that being appreciated or recognized doesn't come into this equation. True compassion in nursing often means offering ourselves in a caring relationship even when the other party doesn't deserve or appreciate it. It's nice when they do, but that is not what feeds compassion.

Compassion is an interior state of the heart; an overflow of the Good that resides within. Compassion is not easy, but living and working without it, is not being fully alive to all that we can be as nurses and has human beings.

Being a fairly new grandmother, I am reading children's books all over again and loving the experience. One of the ones that I never "got" as a kid was The Velveteen Rabbit. How does getting all banged up and pulled apart, make you "real?" The concept was beyond me as a child, but now it makes me weep. Because the truth is, unless we give ourselves away, to be used up in loving one another, then we are never truly real. As nurses, compassion takes us to a new level, to the place where we become the best we can be-REAL nurses.


Joy has been a nurse for 35 years, practicing in a variety of settings. Currently, she is a Faith Community Nurse. She enjoys her grandchildren, cooking for crowds and taking long walks.

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Emergent, RN

2 Articles; 4,111 Posts

Specializes in ER. Has 30 years experience.

I love your article. I, however, think detachment and compassion make a good combination, and are by no means mutually exclusive.


2 Articles; 133 Posts

I agree compassion is one of the qualities that elevates nursing to health CARE. And that care encourages healing and takes us past fear (and can think of many examples where this has been true for me).

I remember specifically before my first pap smear the nurse practitioner sympathetically touched my forearm. Somehow that human touch made it more possible to lay down and spread those legs into the indignity of the stirrups. I hope I can make people feel safe and cared for when I am a nurse, like she did for me.

Has 7 years experience.

Thank you for this article. One time I had to get a physical for a job and it was the fastest physical I've had (2 minutes literally). The interaction was cold like ice. The doctor asked a few questions and barely looked at me in the eyes. It was sad.

Specializes in ICU / Urgent Care. Has 7 years experience.

I'm a REAL nurse and no I don't "Give myself away". I clock in, do the best with what I have when I have it and clock out. From my experience your type of REAL nurses burn out quicker than others, but that's just anecdotal.


2 Posts

As an "old school" nurse I mourn the marked decrease in the appreciation of compassion which used to be one of the hallmark qualities of a nurse. These days it seems that compassionate interactions with patients and their families are not cost effective so, as one who continues to uphold that hallmark, I have to deal with management's opinion of this practice is a poor management of my time. As compassion is an intervention that really cannot be measured the health insurance business doesn't seem to value it since it is not billable. A very sad situation indeed...


3,726 Posts

I don't know. I'm not one of the called yet I've grown more satisfied with each passing year, in a field where there's a whole forum of exhausted nurses doing what I do.

I don't have the answers why one can grow more compassionate and feel purposeful while another feels used and battered. I'm sure much has to do with where one is in life, it certainly helps when you don't have to burn it at both ends and you have something left over at the end of the day.

I do know it didn't happen overnight for me, it's been a 30 year journey and I have kicked rocks and have had some big cries over the years.


1 Article; 508 Posts

To the OP: Very nice! Lovely article. The Velveteen Rabbit always made me cry too.


1 Article; 508 Posts

I'm a REAL nurse and no I don't "Give myself away". I clock in, do the best with what I have when I have it and clock out. From my experience your type of REAL nurses burn out quicker than others, but that's just anecdotal.

There has to be a balance somewhere between giving and giving yourself away. I haven't found it yet, but I'm working on it. Good point about burning out quicker. I'm trying to "recover" from that extreme right now. I'm twenty-five years in. Maybe I will find balance before I retire. I hope so.


12,646 Posts

Has 25 years experience.
There has to be a balance somewhere between giving and giving yourself away. I haven't found it yet, but I'm working on it. Good point about burning out quicker. I'm trying to "recover" from that extreme right now. I'm twenty-five years in. Maybe I will find balance before I retire. I hope so.



105 Posts

Specializes in Crit Care; EOL; Pain/Symptom; Gero. Has 36 years experience.

Dinosaur here, 37 years and counting. Your essay takes my breath away, particularly your characterizations of compassion and empathy as "doing", and pity and sympathy as "sitting and feeling bad".

There is an NLN video from the 1990s titled "Critical Thinking in Nursing. Lessons from Tuskegee". In this video, the nurse who represents Eunice Rivers tells of her nursing instructor, in the 1920s, saying "You give all you can, but you don't ever give any more than that. Need never ends".

When I've asked my students to interpret that statement, they eventually are able to drill down to the meaning of "giving of oneself in one's role as a nurse", but realizing that it is necessary, for our own emotional health, to hold back some reserve of compassion for ourselves - because "need never ends" - there always will be more and more individuals and families who require not only our nursing expertise, but also deserve that spirit and spark which define us as nurses.

Nursing is and should be more than impersonal performance of tasks carried out between clocking in and clocking out.

Specializes in Medical Surgical.

Nursing is mentally and emotionally the hardest thing I have ever done. I went from being a task oriented new nurse to a nurse that can emotionally and mentally be in the moment when people need me. I do have boundaries, though.