By continuing to use the site you agree to our Privacy & Cookies policy

MARK RADCLIFFE

'If we care enough, we can teach people how to be compassionate'

So I’m chatting to this nice young man, all youthful energy and floppy hair - him not me - and he’s telling me about his life because I am the only person left in the swimming pool changing rooms and putting his pants on in silence might have been a bit too challenging.

I’m nodding as he tells me about his stepmother, favourite shirt, preferred cheese and PIN number, when he tells me he works in learning disabilities. I nod more encouragingly and he takes the social cue to move from cheese to learning disabilities seamlessly.

“Do you know the hardest thing about working in learning disabilities?”

“Yes,” I say, aware of the fact that he didn’t know until that point that (a) I could speak and (b) I was English.

“I’ll tell you,” he says. “Manual handling.”

“Patience?” I offer quietly.

“Well yeah, you’ve got to be patient. But manual handling is the big thing.”

“Isn’t it easier to get a hoist than to help someone learn not to become impatient?” I offer, momentarily aware that I sound pompous like Yoda and also that I am only wearing a T-shirt and one sock.

And he says sagely, “Yeah but you can’t teach patience; you’ve either got it or you haven’t.”

And I distract myself by looking for my other sock because I want to say, “Why can’t you teach patience? How come you can teach someone to use a hoist, to pilot a space shuttle, make soufflé, tango, understand Kant, draw a face, do algebra, counsel, lie, juggle or perform mime but you can’t teach patience?”

Instead I settle for: “Can’t you?” And he says: “No, it comes from within.” And I think: “Surely that’s wind?”

Of course he is part of the body that is of the consensus - the widely assumed, rarely discussed assertion - that human qualities like patience or compassion, kindness or sensitivity happen to exist in some people and not others, and cannot be engendered, sculpted, developed or protected. As far as I can tell there is no evidence for this belief, it has not been the subject of enquiry and if you ever ask anyone to expand that view they never get beyond: “it just is”.

The subject of investing in education geared towards the development of human qualities is unthinkable because it is caught in some sort of ideological pincer movement. On the one hand, we follow right-wing economics that creates a health service based on austerity and cost rather than need; on the other, we have a distaste for education and a preference for training that defies logic and gets a bit medieval by claiming (too clever to care) that being able to think somehow pushes any ability to feel from the body - implying that only stupid people can be kind. Personally, I think right-wing economics benefits from undermining education because it enables politicians to both pay and teach nurses less but hey, maybe I’m just a one-socked conspiracy theorist.

However, regardless of my paranoia, we do know that at the heart of Mid Staffs and recent Care Quality Commission reports is a crisis of compassion - the struggle for many of us to hold on to the best of ourselves in difficult circumstances. Surely the most important challenge for nurse education is to develop ways of helping nurses protect, grow, sustain and develop their human qualities? Not just because patients need it and not just because nursing needs to collectively reclaim those characteristics, but because nurses, as individuals, deserve to be protected from the erosion to self that the loss of patience, compassion or softness amounts to.

Mark Radcliffe is senior lecturer, and author of Gabriel’s Angel

Readers' comments (16)

  • I am in the middle of writing my personal statement for University and was looking for some inspiration and came across this.... Brilliant article!!!!

    Unsuitable or offensive?

  • I agree with anonymous above! Great article.

    Unsuitable or offensive?

  • Oh so right mark . How do we do it tho ? Return to ward sisters who taught by example ? Well mine certainly did... I can remember their words to this day. We need to reengage with our inner selves , to think of the kindnesses that we would like to receive and stop running like headless chickens chasing targets.

    Unsuitable or offensive?

  • In preparation for the discussion that I'm hosting on Sat 20th at the Battle of Ideas 'A crisis of Compassion: who cares? 'http://www.battleofideas.org.uk/index.php/2012/session_detail/6776
    I've been trying to get to grips with Martha Nussbaum's 'Compassion and Terror'. She suggests that compassionate judgement necessitates that we understand our world as one in which bad things happen to people, and human beings are both dignified and needy. This complex interaction, and our own ability to recognise our personal encounters with future tragedies, is what inspires compassion. Food for thought....

    Unsuitable or offensive?

  • I think it's possible to teach these qualities if the person you are teaching is willing to learn. I believe there are some people in care work (who really shouldn't be) who unfortunately would not be interested in developing such qualities. I am thinking of some of the thugs /bullies who worked at Winterbourne View for example. Yes I know there was poor leadership etc.. etc.. but it doesn't take a genius to work out that you don't treat people like that.

    Unsuitable or offensive?

  • Love this piece, Mark! And want to add Critical Thinking and intuition to the ideals I have heard nurses say they cannot teach, and I have seen that they can be. Critical Thinking is mostly a matter of having the facts and being able to recall them in a timely manner. Intuition is having the observational skills to notice a change from baseline and remark upon it.

    Unsuitable or offensive?

  • Yes But

    Interesting, Mark.

    But whether people can become more caring (or more patient) isn't exactly the same question, as can they be 'taught' those qualities, I think ?

    I'm different in my 50s, than I was in my late teens, in many ways - but I think these changes are largely down to long-experience of life, and I doubt that they could have been 'quickly instructed into me' (as 'teaching' normally works).

    After all, most training is an attempt to short-cut the acquisition of experience: even so, almost invariably people who then have the real-life experience tend to say 'unless you have actually been there ....'.

    Unsuitable or offensive?

  • Fab article Mark. Our work at HSMC (Sawbridge and Hewison 2011. Time to Care?) also considers how we need to create a system which looks to support nurses and recharge their emotional bank account -which is often overdrawn. We are working with 3 hospitals to test the feasibility of introducing a model of support, and will share our findings when we have some! This is an important dialogue to illustrate the complexities of caring and help us all to find ways to get it right for patients and, as you say, for individual nurses, most of whom want to do a good job.

    Unsuitable or offensive?

  • The overriding theme I have noticed in recent years is,
    'the less people are cared for, the less they care',
    and guess what nurses are people too.

    Unsuitable or offensive?

  • Yvonne S: That's exciting. I really look forward to hearing about that. I am trying to do some work in that area myself currently.
    Alice P: Completely agree. Indeed for what its worth I think critical thinking is a cornerstone of any progressive educational process.
    Judy: I think we need to radicalise what we think education and supervision is personally.
    Anonymous at the top: Good luck.
    Yes but:Two things; firstly I believe training is different to education. Secondly if people cannot become more patient, or kinder or more generous doesn't that mean growing up or old is just a decline into misanthropic bitterness? I don't think you or I believe that do we? I think our challenge is to find effective and workable ways to help people hold on to or grow the best of themselves - because our patients benefit from those qualities.

    Unsuitable or offensive?

  • Over many years I noticed that my "patience" was gradually eroded by an increasing number of Patients (and relatives) who are convinced of their entitlements !

    I became intolerant of people who fail to accept any responsibly for their own health and well being.

    I became even more intolerant of individuals who avoid any involvement in their own care /treatment, much preferring to blame care givers for poor outcomes !

    I have become very good at explaining that people have responsibilities as well as rights !

    An anecdote !

    X burnt his arm as a result of using petrol as an aid to lighting a barbecue !

    He sustained a deep dermal non-circumferential burn to his forearm.

    The burn was appropriately treated and a tet tox booster given. Instructions were given to the patient including the need to maintain elevation of the arm and to ensure the dressing was kept dry. He was also asked to return to A&E the following day for re-evaluation of the burn.

    This patient chose not to re-attend as requested and reappeared 10 days later accompanied by his wife.

    The burn by this time was grossly infected and smeared with some form of "ointment".
    The patients wife ( a rude, offensive
    woman with a very colourful vocabulary) made it very clear that she blamed us for failing to provide "proper" treatment and that "they" would be "suing"
    When asked what she would regard as "proper" treatment she told us that "any fool" knows that Germoline was the proper treatment for burns. We responded by saying that in our opinion the wound now required daily cleaning and that a course of antibiotics was needed to combat the established soft tissue infection. This suggested treatment was refused and a few days later a letter was received from a firm of "No Win No Fee" solicitors which alleged "negligence".

    The allegation was robustly denied but this nonsense was pursued for three years before finally being ended by a wise Judge who found the patient was 100% liable for his own misfortune.

    Patience ----- I have lost mine !

    Unsuitable or offensive?

  • I have to agree with Anonymous | 22-Oct-2012 5:34 am.

    Unfortunately people become very complacent about their own behaviour. We see so many no win no fee adverts on TV that we assume it is the norm.

    Patience is a virtue so the saying goes, but I believe that is something we should learn in the growing up process. We are not born with it, which is why a baby or child will throw a tantrum to gain attention, in much the same way an adult behaves as they do.

    Patience I had loads when I was younger, but as more people treat me with disrespect it’s very hard to keep.

    Training and education works if they are susceptible to understanding the outcome of their actions if they don’t have that patience that things take time and are not instantaneous.

    As the waiting times are longer and the general public are unaware of the stress medical staff are under, because they only see their own blinkered view.



    Unsuitable or offensive?

  • I have to agree with Anonymous | 22-Oct-2012 5:34 am.

    Unfortunately people become very complacent about their own behaviour. We see so many no win no fee adverts on TV that we assume it is the norm.

    Patience is a virtue so the saying goes, but I believe that is something we should learn in the growing up process. We are not born with it, which is why a baby or child will throw a tantrum to gain attention, in much the same way an adult behaves as they do.

    Patience I had loads when I was younger, but as more people treat me with disrespect it’s very hard to keep.

    Training and education works if they are susceptible to understanding the outcome of their actions if they don’t have that patience that things take time and are not instantaneous.

    As the waiting times are longer and the general public are unaware of the stress medical staff are under, because they only see their own blinkered view.



    Unsuitable or offensive?

  • Yes But

    mark radcliffe | 21-Oct-2012 9:53 pm

    Mark, I'm not saying that all of my 'naturally-developing' changes are for the worse: I think I have become more empathic, as I've grown older, to start with.

    And I agree with your objective - I'm just not sure that 'caring' can be trained into people, in a 'really deep {in-the-mind}' sense ?

    Could you 'train' caring into Osborne, for example ?

    Unsuitable or offensive?

  • michael stone

    Mark, this one is interesting – however, I might not answer the question you were asking, because I’m a little unsure about interpretations of ‘compassionate’ and ‘caring’. So I might have actually ‘moved your question’ – I’m not sure.

    When we first saw the videos of those fainting goats, my second thought (after ‘weird !’), and also my mate’s second thought, was ‘How could evolution, select for that ?’. I think, from what she wrote, that Tinkerbell’s first thought was ‘That’s cruel – why are people so cruel !’. My mate and I are not nurses, we both have chemistry doctorates - is there a connection, with how we think ?

    Generals spend a lot of time, working out how many men it is worth losing to take a strategic objective: sergeants, spend a lot of time trying to keep all of their men alive while achieving a tactical objective.

    Who would you want as your nurses ? The general and me, or the sergeant and Tinkerbell ?

    I think that some ‘aspects of how we feel/think’ are deeply ‘part of us’, and although they can alter, it is difficult to truly change them. And humans are social animals – we can tell, when someone is putting on a false smile.

    Now, this topic, I think, comes from the ‘nurses don’t care any more’ line – and I know, lots of nurses say ‘we do – but we don’t have the time to show it’.

    But, to modify the question, as I said I would, I suspect that what ‘nurses don’t seem to care’ really equates to, is “I want my nurses to feel WITH me – If I’m in pain, I would like to think that ‘the nurse also feels my pain’”. This is entirely unreasonable – the people who most feel other people’s pain, would be overwhelmed if they were nursing, unless they ‘hardened up’. But, I still think that is the basis of this ‘nurses no longer care’ thing.

    I don’t think I could have been a really good nurse – I don’t think I ‘get into other people’s feelings’ enough. I’m ‘analytical, not empathic’ if you only chose one or the other. I don’t believe, you can turn anybody into anything: but I can’t claim to have studied the evidence, one way or the other. Mind you, I’m very good at perplexing consultants, precisely because I am very analytical, and in respect of my current pre-occupation, that is much more useful than empathy would be.

    Unsuitable or offensive?

  • Hmmm…..teaching people to care?
    Personally, to fall back on an old saying, ‘You can lead a horse to water but you can't make it drink’
    Or.....you can waffle on and on to people about caring and how to care, and teaching compassion and empathy and positive human traits, but considering the fact that for at least the last thirty years we have been mentally pummelled by widespread rabid consumerism, financial scarcity, the growth of the fear based media, not to mention the effects on our lives of foreign and domestic political agenda’s like the war on terrorism, which lead to even more anxiety and caution about our fellow man.(especially if he has a large beard and prays facing East) Oh, and not forgetting the continued travesty of things like mental health stigma (which continues to be the prime role of psychiatrists besides supporting drug companies and maintaining the medical model)….I could go on, but in the end being a caring person in a role that would benefit others from such a caring attitude, is like being an artistic or a poet. Yes, people may love the idea of it, but really you’re still existing on the fringes of society. People may agree that in principle it’s the way things should be, but really its not as important as watching for own back and looking out for number one, because that’s the way things are.
    People’s priorities are not focused on such things, because there are so many other things that we are told are more important.
    The sad thing it that we don’t need all the things we think are important. What we need is a move away from the self and a step towards realising that we are all one. We’re are all the same, and caring for someone else is actually caring for yourself.
    In South Africa, its called Ubuntu.
    The best definition I heard of Ubuntu is, ‘I am because you are.’
    When we hopefully one day get a chance to even contemplate this concept, we won’t need to teach people to care, to be compassionate. It will once again be the natural thing to do.

    Unsuitable or offensive?

Have your say

You must sign in to make a comment.

newsletterpromo