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Compassion is no harder to measure than rain


I know her name but it might not be appropriate to write it. She is a charge nurse on a medical ward in the south of England.

Last week a patient on her ward arrested and died. The patient was in a four bed bay, she wasn’t that old and neither were the other three patients. In that sense it was somehow unexpected - at least by the patients.

They are variable little communities, those bays, aren’t they? Often they don’t settle into spoken relationships, sometimes there is conversation but it is light and superficial. But often there is a sense of each other gathered through observing habits or visitors’ visitors. Patients paint pictures of each others’ lives by the things they see and hear. If nothing else, it passes the time.

‘I am bored senseless by the misanthropy of political electioneering. Most people will vote for the leader who doesn’t annoy them as much as the others’

Anyway, long after the crash team had gone and the pretend normality brought by hospital routine had been re‑established and the night staff had taken over, the charge nurse was still there. Not doing the inevitable paperwork and not debriefing staff, but instead sitting with each of the patients in the bay, talking with them about how they experienced the arrest, about how they felt. About how they were. She took her time. She shared real emotions. She was sad and honest. She was doing her job. And doing it really well.

I mention this in part I suspect because I am bored senseless by the misanthropy of political electioneering. Most people will vote for the party they dislike the least, for the leader who doesn’t annoy them as much as the others, or for the party that may not do as much harm as the others.

And I can’t help thinking we ought to be able to hope for more. So, against a backdrop of relentless self promotion by needy and unconvincing politicians, I was warmed by the good nurse.

And then there is that old chestnut called “compassion” and the seemingly controversial idea reported by Nursing Times that compassion will be tested in Wales (news, page 2, 20 April).

“It’s immeasurable,” say some. “It’s irrelevant,” suggest others. One can only imagine such cynicism is born of tiredness or overwork. Compassion is no harder to measure than rain. Is there rain? Stand outside and you’ll know. Is there compassion? Be around it, you’ll know.

And irrelevant? Rarely. It’s the thing that stops nursing being simply a list of acts aimed at wellbeing. Ask patients what makes the difference and they always say something that looks like compassion.

Election times can be weird. They are crammed full of anger and distaste, name calling and smears. Meanwhile, nursing and the public sector are preparing for brutal cuts to services and jobs when the politicians emerge from the dust.

Maybe the new economic brutalism is shaping us already. Perhaps there will be no time for the human exchange so brilliantly exhibited by the charge nurse above and, perhaps, that is why we may be disdainful of such soft minded ideas as compassion.

But, personally, I still think nursing is better than that. And thank goodness there are nurses like that to prove it every day.


Readers' comments (15)

  • I don't think compassion or any of the 'personal skills' are irrelevant, however having nurses who have high EQ but are unable to spot a deteriorating patient or make a good physical assessment or calculate a drug dosage safely is a waste of 3 years in nurse education.

    It probably won't help stop services from being slashed either.

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  • in response to above, I don't think that having an EQ has to be at the expense of acute care skills which seems to be the gist of your comment, and reducing the discussion to a polarised frame of reference stunts the much needed exploration of this topic.
    I think its easy to end up in the position of feeling a need to prioritise elements of nursing that are all important, particularly if you are on the receiving end. Hierarchies, time pressure, tiredness, financial pressures and lack of self awareness is a heady mix particularly honed with sudden death, cardiac arrests and a whole variety of other people demanding a piece of you or throwing mssiles at you.
    I would vote for counselling and debrief to be an integral part of clinical supervision or have resident counsellors regularly visiting departments as part of the team. However the current climate will dictate what makes business sense, what can be produced in terms of numbers and targets hit, but manipulated to sound like 'service' when it is seriously lacking in humanity, in my opinion.

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  • Mark, one of your best columns yet. You have captured what to many is the 'essence' of nursing (in the real sense, not some DH definition of the essence).

    The priorties of this ward sister were correct and should be inherent in every nurse, whether they have a high "EQ" (is this a new term I have missed?), a degree or have undertaken 'normal' training - ensuring that your patients are cared for before getting 'counselling' yourself.

    These are the things that patients remember and need. Rightly or wrongly, they don't care, nor do they need to know, how 'clever' you are, or what pressures you may be under.

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  • Firstly, I think I can guess what EQ refers to but if someone could enlighten me I would be very interested. Despite exhortations not to abbreviate I sometimes think it's a professional form of 'one-upmanship'. With regards to the senior nurse in Marks article she's the sort of nurse that everyone one of us should aspire to be. I bet her ward is run efficiently too - you don't have to sacrifice caring and going that extra mile on the altar of efficiency they can exhist side by side. What ever changes Thursday brings, whatever the trust heirarchy hurl down at us from on high, there will always be a nurse, somewhere, on the front line who still cares.

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  • Compassion is practiced everywhere on a daily basis, but,like your example, quietly and unobtrusively. Compassion is the little things that go a long long way to making a patient feel human and,more importantly,valued. The compassion that is practiced day to day is lost in the hustle and bustle of the day where so many other more"important" jobs are done-i.e all patients up and dressed and beds made within,it seems, 5 mins of hand over- for what reason? we are practicing 24hr care and I personally do 12 hour shifts so if my patient wants to get up later why not? I am not leaving all my "jobs" for someone else I am ensuring my patients are individuals and not all want to be up at the 'crack of sparrows'. Compassion is practiced by all nurses every day every minute but it is always lost in the minutiae of nit picking and fault finding of the loudest complainer!!!

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  • This nurse has shown what we all should be doing - nursing ! The essence of nursing care has gone in most wards and, I think, in the training schedules. Compassion is at the very heart of "nursing" and the essential element of "care" and I hope all nurse educators will read the article and reflect on it.

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  • Emotional Quotient.

    I wasn't suggesting that they are mutually exclusive. Often people drawn to caring professions have a highly developed EQ when they begin. Nobody is suggesting that nursing is a set of tasks or skills or functions. However, I still feel that we worry about the wrong things - especially when the financial situation will lead a higher amount of compassion fatigue in nursing staff.

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  • Just to add - compassion doesn't come from a special place, it's not magic - it comes from having well selected, well trained, well supported staff. Staff who are looked after by their organization.

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  • bob cat

    Like your comment Mark, renews my faith in humanity a little!

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  • An excellent article and a difficult subject to articulate the benefits of. I believe that it is compassion and caring - in other words nursing - that makes a difference to morbidity and mortality and would love to see some research into this area.

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