The idea that university education erodes the compassion out of student nurses is ludicrous, argues Sarah Kendal
Apparently, nurses lack compassion. To address the problem, the chief nursing officer (CNO), has launched Compassion in Practice, a strategy to restore the nursing values of compassion, care, competence, communication, courage and commitment. She has been present in the media, tactfully responding to journalists who tell her that the root of the problem is nurses having a university education. She has rightly argued that while compassion is the current issue, nurses need real depth of knowledge to deliver care in a complex, rapidly changing environment.
Is it so shocking that a nurse should go to university?
“The everyday lunacies facing NHS staff can be like a surreal comedy”
I have always thought it a strange idea that university education might stop someone from being kind. In her blog, “Nurses need compassion, not a degree”, journalist Christina Odone scoffs at a previous CNO initiative focusing on nurses’ confidence. Odone argues:
“Who needs a ‘confident practitioner’ when they’re lying immobile on a hospital bed, dying (literally) of thirst because “a confident practitioner” is ignoring their calls for water? Who needs a “confident practitioner” when they’re soaked in their own urine because their pleas for fresh linen have gone unanswered?”
Of course, we need compassionate nurses. But haranguing the profession is hardly the answer. We know enough about human behaviour to understand that being supportive to a person helps them to be supportive to others. Kindness breeds kindness. And constant criticism is unlikely to generate compassion.
It is hard to deliver the high standards of care that a patient deserves, if resources of time, skill, equipment, opportunity, energy and so on are lacking. The everyday lunacies facing NHS staff can be like a surreal comedy. Purchasing decisions are made by people who do not understand what they are buying; space is organised by people who do not know how many patients will need to sit down at one time; expensive equipment is delivered to the wrong department, or abandoned in a holding area because no one knows it has arrived. Such situations are rarely created by clinical nurses and these nurses usually have very little influence over them.
Shorter inpatient stays mean constant admission and discharge, with few patients on a ward who are not acutely ill. Overcrowding and rapid throughput increases the risk of infection. Low morale contributes to sickness and staffing problems. Relying on agency nurses puts a greater onus on the permanent staff who are assigned to each shift. With regard to providing emotional comfort to patients, work is often organised so that the few qualified staff do the work that only they can do, and other work, such as personal care, falls to other staff (who are also under pressure).
How then can poor care be attributed to university education?
The idea that university education erodes the compassion out of student nurses is ludicrous. Across the UK, nursing curricula are designed, written, approved and studied by people who are passionate about the nursing values outlined in the CNO’s strategy.
Blaming nurses is easy, but unfair. What we do need to attend to is the context that nurses work in. Responsibility for this sits with the lines of management that can be traced from ward managers to the cabinet office. In a way, nurses are carrying a message about contemporary health politics. Please don’t shoot the messengers.
Sarah Kendal is lecturer in School of Nursing, Midwifery and Social Work, University of Manchester