Are you compassionate, or too busy to care?

23 April, 2010 | By Victoria Thompson

Overdue or over-egged? Beyond the Bedpan puts compassion tests to the test

You can’t see us, but Beyond the Bedpan is gazing lovingly at you as you read this. We’re plumping your pillows and gently brushing that stray hair from your face. We’ve made you a cup of tea and - can you smell that? It’s the scent of freshly cut flowers placed gently on your bedside in a vase we bought for you. What’s that? No, we’re not in love with you! We’re being compassionate obviously. Can’t you tell?

Well, if you supervise placements in Wales you’re going to have to get pretty good at knowing compassion when you see it.

The news this week that nursing students are to be tested on how compassionate they are seems to have, as usual, split opinion on nursingtimes.net. But at least you’re an articulate lot.

“This article makes me want to vomit,” says the first commenter, “but not as much as the apparent fascination with a concept that defies the laws of logic and common sense.”

And it seems that many of you agree that it won’t be easy to measure compassion. After all, as one reader adds: “A person might ACT compassionate but not BE compassionate - Dr Shipman was universally considered to be a very compassionate man. We now know he was not.”

Indeed.

But some people think that the idea is long overdue: “I am amazed that it’s taken management so long to take this vital subject seriously.”

Another adds “Anyone can administer treatment but to do it with compassion is the essence of nursing. Time pressures and stresses are ever increasing but remember each patient could be a member of your family and should be treated as a person not a disease.”

So how do you go about testing for compassion?

On placements, supervisors will be asked to rate students on a scale from one to seven on how they meet a range of standards, including: “Is always polite”, “Happy to accept constructive criticism” and “Shows a caring disposition towards others”.

But forget that, it sounds like a lot of work. Instead we’ve come up with the perfect one question test for nursing students.

How do you feel about your patients?

a) I wish they’d all leave me alone and stop pestering me. I’m busy, I want to chat to the nice doctor in the staff room and then nip out for a fag.

b) I want to give them the best care possible, ensuring that they are comfortable and have everything they need.

There, that should sort the wheat from the chaff.

Readers' comments (32)

mike | 24-Apr-2010 0:16 am
Haha, I like that one question test!

What a complete joke this is, compassion, altruism and empathy are very subjective and therefore almost impossible to measure accurately in this context. It can be assumed I think that the overwhelming majority of us have these traits as part of our innate personality, which is why we are drawn to a career in Nursing, but how do you measure that? How do you ensure or enforce it? You can't. None of us are compassionate and empathic 100% of the time. We get tired, we have personal issues that affect us, etc etc etc. A week off and we might be as compassionate again, or in the meantime we may simply ACT in a compassionate way whilst privately thinking 'all I want to do is get into my bed and sleep for a year!' Is it professional to do this? Absolutely. Is it compassionate? Who is to say? It is too subjective!

Compassion fatigue, or secondary traumatic stress disorder to be more technical, however is a pretty important consideration, and it is the causes of THIS that need to be adressed. NOT wether Nurses are compassionate or not in the first place.
Unsuitable or offensive?
Anonymous | 24-Apr-2010 10:47 am
As I'm not a nursing student in Wales I can hold my head up high, and yell with my mightiest voice "I pick A"!!!
Unsuitable or offensive?
Anonymous | 24-Apr-2010 10:48 am
Flo was a statistician, gathered information, analyzed and implemented appropriate action. I sure there was compassion, but not sure that was the driving force, I think she was trying to stop people dying for no reason. Do we get tested on our ability to asses, analyze, plan and implement as well?
Unsuitable or offensive?
Anonymous | 24-Apr-2010 2:32 pm
Hi I think the question approach is great. Having worked in a number of private nursing homes I have noticed most of the nurses and carers who smoke opperate the first question response... I don't think it requires a verbal answer AS ACTIONS SPEAK LOUDER THAN WORDS... oops sorry to shout but sometimes those smokers take so many breaks us non smokers are left to do our own jobs and those of our smoker colleagues that we become stressed and worn out and then unfortunately we non smokers can succumb also to what appears lack of compassion... MAYBE THE SMOKERS AMONGST YOU COULD BEAR THIS IN MIND WHEN YOU DISAPPEAR EVERY 5 MINUTES FOR YOUR 15 MINUTE SMOKE BREAK DRESSED UP IN JUST A QUICK PUFF statement... Thanks
Unsuitable or offensive?
Anonymous | 24-Apr-2010 3:33 pm
Or.... perhaps it is that some of us smokers do not actually take our full allotted breaks because we prefer to take 5-15 minute "quick puffs" as you so inacurrately describe it! Do we slope off on a night shift to sleep as you non smokers no doubt do. The answer is..... a resounding NO, and l find your accusation highly offensive from a personal perspective.
Unsuitable or offensive?
Gana Davis | 24-Apr-2010 3:53 pm
Please can we ignore the above comments and assume that the department in question is evidently badly managed and ppl there extremely stressed.

I find it difficult to be compassionate now, at first I could have cried every time I saw a pressure ulcer on Mrs B or the fact that every patient is left to stare at the wall all day in their 'recovery time'.

Staffing pressures, workload (that of a HCA and a mini-medic it seems) and unattainable government targets have a way of stripping good people of emotions!

Also...3 years of constantly being assessed, never feeling good enough, staff bossing you around/ being consistently called 'the student', and uni work on top of it all takes its toll- to the point where I ask myself why I even entered the 'caring' profession after all?!

I absolutely LOVE my patients, but after qualifying am actually considering an alternative career..I feel I need to do a job that I can actually exercise my compassion not one I have to act it whilst walking on egg-shells.
Unsuitable or offensive?
Anonymous | 24-Apr-2010 4:50 pm
Regarding the comment about the smokers going off for a quick cigarette. I found a solution you may consider as it worked for me a treat. Being a non-smoker myself it bugged me that smokers were forever going off for a fag. Nobody to complain to as the ward manager was herself a 'Quick Fag Breaker'. So I decided I had had enough. Whenever my colleagues went for a quick fag break, when they returned, I went for a quick tea break. I can tell you it caused a great big stink, but I stuck it out, and the practice was seriously curtailed particularly when I was on duty.
Unsuitable or offensive?
Anonymous | 24-Apr-2010 7:41 pm
Again, regarding the comments about smokers and their 'quick-puffs'. I'm a smoker, I work through my entire 12 and a half hour shift without going out for a cigarette. I take exactly the same breaks as my non-smoking colleagues... You simply shouldn't be smoking whilst at work. Besides, patients don't want their nurses to smell like stale fags!
Unsuitable or offensive?
mike | 25-Apr-2010 9:18 am
I completely agree with Gana Davis here. Like I said before I think it can be assumed that the vast majority of us enter the profession as caring people. It is the profession itself, and the culture of this so called 'caring' profession, that literally kicks the compassion out of a lot of people.
Unsuitable or offensive?
halfanurse1987 | 25-Apr-2010 2:06 pm
Good for you Anonymous | 24-Apr-2010 7:41 pm.

As a non-smoker and working with people who nip outside for a smoke, even though NHS Lothian is supposedly "non smoking" on all of their grounds, it is not nice having your workmates reaking of stale smoke. I can only imagine what patients think. Not professional in my opinion. We are told not to wear perfume as it can make patients feel sick. I think I would rather have my nurse smell of perfume than smoke.
Unsuitable or offensive?
Anonymous | 25-Apr-2010 9:15 pm
Having been critically ill in intensive care 7 years ago i remeber the smell of smoke on the uniforms of some nurses when i was moved to the medical ward and it made me feel sick, it was those same nurses who ignored my call bell!!! some of the comments above make me feel ashamed to call myself a nursing student.
Unsuitable or offensive?
Anonymous | 26-Apr-2010 3:08 pm
Nurses who smoke?!

Would that be a sign of our profession not being really all that professional. Is that the 'working class' girl in nursing?

I digress. can nursing really be regarded as a profession if it is a career of the working classes. I think not.

I know a few Dr's who smoke (but not many).. I know lots of nurses who smoke.

Smoking is mainly a habit of the lower social classes. Nursing is predominantly staffed by folk of working class (or lower social status) background. Therefore smoking is to be expected amongst nurses. . . .therefore 'fag' breaks will be needed as smoking is addictive.
Unsuitable or offensive?
Anonymous | 26-Apr-2010 5:39 pm
Disagree. I would argue you are able to evaluate someone's compassion. Measure it in minute detail probably not but then the job doesn't require that does it. enforce or command it, don't think so, don't think that's how it emerges. empathic 100% of the time, not unless you happen to be jesus on his second coming...and maybe not even then.
As for smokers, I think it is unwise to underestimate addictions and those who are addicted. Assumptions always leave you with egg on your face.
Unsuitable or offensive?
Anonymous | 26-Apr-2010 8:17 pm
OMG Was Anon 26/4 5:39 really serious or is it because my working class background missed some attempt at humour. I consider those remarks to be totally inaccurate not to mention arrogant. I once knew a doctor who was a smoker and a drug addict (but surely not - he was a professional and from an upper class family)! I thought there was no class system anymore!
Unsuitable or offensive?
Anonymous | 26-Apr-2010 8:22 pm
Sorry 5:39, my comments about the class system were meant for Anon 26/4 3:08.
Unsuitable or offensive?
Anonymous | 27-Apr-2010 9:18 pm
I think that you do measure compassion,not in the form of a tick box exercise, but when you are actually doing the job. I'm not even sure if it is a question of compassion as it is, sympathy or empathy. You have distance yourself or you would end up in the hospital as well.
(incidentally on the class thing, there are some real terrors of nurses,Doctors and HCW who believe themselves "having been touched by the hand of God himself" and rest of us, patently we're poor white trash-don't smoke though.
There are of course, some stupid folk that fail to see the irony in telling ill people how to look after themselves when they smoke, eat rubbish and drink like maniacs themselves)
Unsuitable or offensive?
Anonymous | 27-Apr-2010 9:20 pm
was going add up all my "non smoking breaks" and take a fortnight off in July
Unsuitable or offensive?
Anonymous | 28-Apr-2010 9:47 am
Anon 26/4/10 8.17pm.

I am serious. Nothing is inaccurate in what i put.

Smoking is predominantly a habit of the lower social classes. FACT

Nursing is predominantly staffed by people of lower social classes. FACT

There is definately still a class system in the UK. FACT

Am i arrogant? YES.

Am i correct YES.

Sorry if you don't like it but it's the truth.
Unsuitable or offensive?
vanessa stapleton | 28-Apr-2010 10:18 am
and here was me reading that nursing will be an all degree profession soon!!!!!!!!!

Compassion will go out the window then for sure..along with the fags!!!!!!!!!!!
Unsuitable or offensive?
Martin Gray | 29-Apr-2010 9:04 am
Don't know why thew comments about smoking have been brought in to the fore on this thread when it is supposed to be about the question of the existence of compassion. It's an entirely different issue.

As many have already stated, there are several reasons why compassion seems to be missing today; most of them are also due to other human traits - anger, frustration, overwork, stress, etc. To show compassion surely you must have it to begin with? Or are we all as guilty as Gordon Brown of being somewhat 2 faced?

There are, unfortunately, people in the caring industry(not the profession) that show little patience or compassion for the people in their care. This may be for a number of reasons but one which I think is of a higher incidence is that of poor pay for long hours - mainly in the private residential/nursing home sector. Caring can be a very physical job, having to do frequent patient turns, lifting without the proper equipment, etc. Such physical work, on top of having to look after a family, leads to chronic fatigue which, in itself, is very debilitating and strains the emotions.

As for nursing being staffed by people from lower classes; when nursing first started out most of the nurses were from upper class families! I find it rather insulting to make such statements; what does class matter? Working class people are supposedly unintelligent, yet we are now embarking on a period where all nurses must be eduicated to degree level. Surely working class people are not capable of attaining this standard

Sorry I digressed yet again from the main topic, but I couldn;t let that point go without comment.
Unsuitable or offensive?