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Primary care blog: We must never forget patient dignity

Patient dignity should be at the forefront of everything nurses do, says NT primary care blogger Lynn Young

Being nursed can be a pretty humiliating business, and always has been.

Contrary to popular belief, there was no golden nursing time and many of our most vulnerable members of society – the elderly, mentally ill, those with learning disabilities and children without loving parents – have suffered at the hands of unkind and incompetent nurses.

Nursing in 2008 talks much and often about political influence, leadership, health promotion, public health and the prevention of disease. We need to talk more about the nursing care that takes place at the bedside, and for patients who are so ill that they are incapable of carrying out their most intimate of daily living activities.

Not many of us relish visiting the toilet in public view, and having help with being kept clean and fragrant are tasks that all human beings want to do for themselves.

How shocking it must be for a previously fit and hearty person to suffer a catastrophic stroke and lose all personal independence overnight.

What do people feel when, for the first time in their lives, they are dependent on strangers to perform the most basic of bodily functions in a private and sensitive way? And how truly horrible it must to be looked after by nurses who are dismissive, brusque and totally insensitive to the appalling embarrassment often felt by patients.

In May 2007, the RCN began to develop its all-embracing, patient- and nurse-centred dynamic dignity campaign. If patients are to receive dignified care at their most challenging and difficult times of life, dignity has to be at the heart of all that nurses do and think.

We must not be complacent and we must concentrate all our efforts in helping to ensure health organisations have a zero tolerance policy in terms of ending all interaction between staff and patients that endangers the dignity of patients.

One problem is that, after a while, nurses can become hardened to the discomfort and suffering of others. We cease to be shocked and the shocking becomes normal. In other words, it is common for people to become dehumanised and insensitive to the suffering of others.

So nurses need the preparation, inspiration, support and encouragement required to help them only provide care which can be described as dignified. Any less must be beyond comprehension to all nurses, regardless of where they work and who they work with.

We need to boldly accept feedback from patients, and their friends and families, with good grace and a determination to adapt our behaviour according to other peoples’ experiences.

While this can be tough, nurses need to also be aware from the beginning of their training that patients are the greatest teachers, and we need to listen to them when they say that the care they received in their darkest moment made them feel less then dignified.

The RCN dignity campaign is a splendid affair and seeks to make a genuine impact on the quality of care received by patients who, regardless of how long they depend on nurses for, are assured that dignity lies at the heart of that care.

Readers' comments (3)

  • I fully agree with these sentiments. I am afraid with the increasing focus on targets and risk, that the person at the receiving end of what we do gets forgotten

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  • I'm sure all caring nurses agree with these sentiments entirely too. How different it is on the frontline though when the expectations of what staff can achieve with limited numbers is totally unrealistic. We are in an age of nursing care where the bats have got into the ivory towers, where all standards appear to be lip service because it is all about paper and not patients. It's all about looking good, and not doing good. Coping is not the same as caring. Someone, somewhere, please give us the tools to do the job and stop spouting on about ideals that are unachievable without the workforce, it only lowers staff morale to be told what they should be doing, when they want to be doing it but can't because they are told to do other things first as a priority to tick target boxes. We all know what the probelms are, at least those on the coal face do, so lets stop burying our heads in the sand and actually make a difference, by giving us some action on what's needed, enough talk, lets see some action.

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  • I agree with the sentiments expressed by the author and posters. While some providers do exploit the manipulative and control value of patient humiliation, there are also many, often nurses, who understand the empowerment present when there is genuine respect for dignity and autonomy. Bravo to those making the extra effort. I was treated and rehabed from a stroke in Westchester, NY facilities and the attention given to dignity made alll the difference in the world.

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