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Are nurses born or made?

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7 January, 2013

Everyone has an opinion on what makes a good nurse. Words such as kind, caring, empathetic, patient, efficient, compassionate, organised, giving and thoughtful trip off the tongue – and then there are the thorny question of cleverness and vocation.

Funny thing is, whatever words are used to describe a good nurse we all know one when we meet them.

In my experience good nurses are good people.

This was brought home to me when a friend died on Boxing Day after a long illness. She was a nurse and loved her job. I never worked with her but in her life she portrayed the all the characteristics of a good nurse. She had an endless capacity to give of herself and her time, she was always there when people in her community needed help, visiting the sick and recently bereaved. She motivated people to get involved and helped to raise huge amounts of money for charities and good causes.

Most of all, my friend cared about people. She noticed when those around her looked sad, discouraged or unwell. She touched everyone with her kindness.

So I am left wondering, are nurses born or can they be taught to be caring and compassionate? What makes a good nurse?

No one should be in any doubt that nurses need a high level of education and training, but they also need to come to the job with qualities that help them translate this education meaningfully into practice.

You can teach the elements of nursing but I am not convinced you can teach the compassion, empathy, kindness and care required to deliver good care. And there lies the challenge. We all know people who would make great nurses but don’t have the qualification to get in, and others who could easily pass the theoretical part of a course but lack qualities that a nurse should have.

In 2013, nursing is facing probably its most difficult time in decades. Publication of the Francis report on care at Mid Staffordshire will focus again on nurses’ failings and I suspect we will be engulfed in another debate about degrees and who is “too posh to wash”.

Although the report is likely to make for painful reading, the profession can ensure that it has a positive effect by using it to rebuild nursing. Perhaps the first step is to ensure our recruits to nursing have the right qualities and values and the NHS is prepared to support them to use these in practice.

Readers' comments (21)

  • I love this blog and it raises so many points - I agree good nurses are generally good people. I believe that compassion is a human trait that we all have but to give compassionate care we do need the rights skills, the right environment and the right support. Compassion needs to be nurtured and cherished in order for it to grow and flourish. The start of 2013 will be challenging for nursing but if we support each other and look forward we can use the Francis report positively as you have described to ensure that a culture of compassionate care is apparent in every organisation and that each and every patient receives the care they need.

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  • how do you switch off all the porno attached to key words in this article? Is it associated with NT? It looks as if they are being paid to advertise on their site which does not reflect professional nursing values or a good image of the profession.

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  • sorry was preoccupied with all these ads that keep popping up and somebody who said they are a virus. It is very strange, irritating and of concern.

    Excellent article and I agree with every point and can't find much else to say at the moment other than to further emphasise the importance of recruiting the most suitable candidates which may not always be the easiest task to get it right every time but at least the best possible means of assessment should be sought. It also begs the question of whether some nurses start with all the right qualities and some how lose some of them during the course of their job which may merit further study to enable those with difficulties to continue in their chosen career and give their very best.

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  • David Foord

    Great article very well written. I agree with most of what is said, but do think that empathy can be 'taught' or at least, the potential to act in an empathetic manner can be developed in people. Much work outside of the healthcare industry in this area in more general customer service and some good examples and evidence of this from Jamie Lywood: http://www.empathy.co.uk/home

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  • i will have to ask my mummy if I came out with a frilly hat on and a fob watch attached to my belly button.

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  • tinkerbell

    perhaps we're barking up the wrong tree. Maybe we should be researching psychopaths and whether you can be born without empathy or compassion or did you become that way. Let's see if they can be made to fake it until they make it.

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  • Anonymous | 9-Jan-2013 6:59 pm

    There is a higher incidence of BPD and Narcissistic PD reported in the caring professions than there is psychopathy.

    According to the website below psychopaths don't tend to choose the caring professions as a career.

    From Barking up the Wrong Tree

    http://www.bakadesuyo.com/2012/11/professions-most-fewest-psychopaths/

    Which professions have the most psychopaths? The fewest?
    By Eric Barker


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  • I think there is truth in not being able to teach empathy. I think a lot of people went to university/college with other student nurses and wondered why and how they were doing nursing....

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  • you probably cannot teach empathy to somebody suffering from alexithymia but then they most probably would not choose nursing in the first place. I would imagine that those who are not compassionate or do not understand empathy and have no desire to help others would not choose nursing as a career. surely you can't have a wish to help others if you do not have these qualities and this would suggest that they somehow get lost on the way.

    there seems to be confusion between compassion and empathy in some posts. maybe you cannot teach compassion but if you have it you can possibly develop empathy through good interpersonal skills, many of which have to be learned. cf the teachings of Carl Rogers

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  • Nursing is like any other profession. If anyone choose nursing as a profession, one should be committed to it and have all the necessary requiments for the job. Learning on the other hand helps to enhance your job. A good nurse has to have both. Owing to our socity today, nursing has attracted the wrong people who choose nursing because it is another profession to earn a living.

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  • shan cheng | 10-Jan-2013 1:29 pm

    "Owing to our socity today, nursing has attracted the wrong people who choose nursing because it is another profession to earn a living."

    I don't know how it is in practice but your comment suggests to my that everybody should spend a considerable time working on the wards to see what they are letting themselves in for before going on to training. Alternatively they could be offered a pre-registration apprenticeship with some basic training and assessment. However, again it all boils down to cost.

    As far as earning a living, there are many far easier ways with higher returns than nursing but I believe many use it as an easy entry into university which should not be permitted if it is not going to attract candidates for the right motives but which may be difficult to assess.

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  • Spending sometime working in the wards before deciding whether nursing is for you or not is a good idea. Nursing these days require a certain qualifications, someone with caring attitudes might not have the qualifications to get into nursing. Therefore, there must be a balance inorder we have nurses that are doing their duties caring for the sick.

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  • From my observation of children today, caring for other people's feelings or for helping others, is NOT in evidence. Children seem to think they can do and say what they like. Other's feelings dont affect them, yet they are insisting on their "rights" without being taught respect and resposiblity to others. I think we can expect less empathy in nurses and all areas of life, in the future, regreatebly. And yes, having to have qualifications to "get in" can deter good, caring folk from applying, or from successful in applying

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  • sally carson | 10-Jan-2013 4:12 pm

    there is plenty of evidence of this when commenting on social and health issues in the newspapers. I wonder how much IT can be blamed for this when people seem to spend more time communicating with each other electronically and briefly than they do face to face. This may be especially significant during the developmental phase which presumably includes adolescence and even young adulthood. Maybe also spending time on the job staff spend much time on paper work and using IT for many of their tasks. Perhaps when writing up a patient's notes on a computer affects the way people think about others too, and possibly in a more impersonal and less empathic manner.

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  • A thoughtful blog which touched on key issues, I am however disappointed every time I see any reference to 'too posh to wash' - it presupposes that in 'our' day (pre degree profession) every nurse did everything as they should. From my recent study related to healthcare associate infection, we didn't! It's is derogatory toward degree nurses, most of whom are caring and compassionate - think about your current ward, or one you were in during your training - was every nurse someone you, or your family, would want to be nurse by?
    In relation to the question can you teach empathy - undoubtedly you can. A good mentor can introduce the idea of caring for other 'as if' it was you. Compassion is slightly different, you can act compassionately without actually feel compassion, you can teach the act of caring, but not the emotion of caring. The challenge we will face in 2013 is to demonstrate that the person, the patient, is at the centre of what we do - that will be a change in mindset for some (and they won't just be graduate nurses!).

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  • Derek Barron | 11-Jan-2013 9:55 pm

    there is nothing new about patient-centred care.

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  • Politicalnurse

    Dare I say that this is probably a rhetorical question? Most people are not born to be who they become although there may be some genetic personality traits, most people are shaped by and learn from their experiences of the world and the people in it? (Even psychopaths)

    If this is true then of course people can be taught to be good nurses who are compassionate, kind and caring. Unfortunately these words do not feature in nursing curriculum very often which is already decided by the professional bodies before it actually gets into the classroom - or the ward.

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  • a good nurse is one who thinks about their patients, is kind, thoughtless and hard-working.

    a bit like the staff who bought the baby reindeer in to see the children at christmas.

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  • I think you are 100% right. Many of the students I have come across in the past 10 years or so have come into nursing with the wrong mind-set about care and truly yes 'too posh to wash'. I think there is a fundamental failure from the recruitment of student nurses in the first place in that universities are more concerned about filling places, to generate income, rather than ensuring people with the right attitudes and qualities are recruited. Often one with excellent academical background may not necessarily be the best in caring, empathy, compassion etc. Over the years, I have seen so many non-clinically trained people who do far more than qualified nurses.

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  • Anonymous | 14-Jan-2013 8:06 pm

    I think what you say about the wrong mind-set is very true. For those who really want to nurse and care for others will put the best interests of their patients at the centre of their concerns whatever their needs are. Why would this not include washing those unable to do this for themselves? It is nonsense for nurses to put their own personal interests before that of their patients and be selective about which tasks they wish to carry out.

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