End of life experts have reinforced the importance of values-based recruitment for student nurses to ensure they deliver care in a compassionate way, but claimed this quality can later be “destroyed” in the workplace.
As part of a Commons select committee on palliative and end-of-life care, the experts were asked by MPs how to ensure care was compassionate.
“We do need to recognise we are looking for the right person at the beginning [of a clinician’s career]”
The Public Administration and Constitutional Affairs Select Committee session followed publication of a recent report by the Parliamentary and Health Service Ombudsman about failures in end of life care.
Dr Jane Collins, chief executive of terminal illness support charity Marie Curie, said there were “well-developed” procedures for recruiting people into nurse training who were more likely to be compassionate.
“We do need to recognise we are looking for the right person at the beginning. Because otherwise you’ve got too much shaping to do you won’t necessarily have the outcome you want,” she told the MPs yesterday.
Dr Collins added that clinicians should then be encouraged to use that compassion in their jobs, but noted the strains of the workplace could see this quality “destroy[ed]”.
Sir Mike Richards, the Care Quality Commission’s chief inspector of hospitals, echoed her views and said registrants sometimes failed to use their compassionate skills during periods of staff shortages and heightened stress.
“There is recognition that what used to be the state enrolled nurse role perhaps is one of the missing parts of what’s required on wards and in the community”
He said the regulator found that when it ordered trusts to close bed spaces due to a lack of staff, patients then reported that nurses were more caring.
Professor Irene Higginson, director of the Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation at King’s College London, said clinicians could be taught some skills in how to make people feel they have been treated with compassion.
However, she said it was more difficult to tackle “attitudinal” determinants of compassion.
She said values-based recruitment should be used to select caring people, alongside strategies during training which addressed how students’ personal experiences affect their approach to end of life care.
Meanwhile, the experts were asked by Conservative MP for Hertsmere Oliver Dowden whether the move to degree training for nurses had reduced the compassionate element of nursing.
In response, Professor Higginson noted there was “very little” on palliative care included in nurse training and called for communication skills around end-of -life conversations to be made mandatory.
Dr Collins also noted there was a national shortage of nurses across the UK, hinting that there was scope to further develop some healthcare assistants roles – as recently suggested by others.
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She said if entry routes into nursing roles were widened for those who did not want to complete a degree then this would “bring in people with different skills that would undoubtedly be of benefit”.
“There is recognition that what used to be the state enrolled nurse – as opposed to the state registered nurse – role perhaps is one of the missing parts of what’s required on wards and in the community,” she said during an earlier part of the committee session.