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Practice comment

Create the right conditions for staff to deliver quality care

  • 5 Comments

The Francis report has got the nation talking of the need to reintroduce compassion into healthcare, but where did it go in the first place?, asks Lyndsay Short

When I first came into nursing, it was because I wanted to care for people and I wanted to make a difference. I think it’s what drives most of us in the NHS. By the time my career took me into education and leadership, I’d realised that bigger changes can be made if you affect the culture of an organisation.

With the release of the eagerly awaited Francis report, it is interesting to see how cultural change is becoming even more important. The nursing strategy, Compassion in Practice, launched in December 2012, says, “creating the right culture” is the key to promoting an environment in which staff can deliver the best care for patients. It is easy to point fingers and say that it is the staff in an organisation who are the problem, but they are often a product of the system in which they work.

A patient recently told me of an example that illustrates my point. During an urgent CT scan she felt extremely nauseous and asked for a vomit bowl. The qualified nurse gave her the bowl and then left to complete another task. It was the student nurse who stayed and reassured her. To the patient, it felt like the expectations of the organisation were that the qualified nurse was to complete a number of tasks within as short a period of time as possible, whereas the student was more able to spare the time to offer her the compassionate care needed.

The NHS has come a long way from the days when patients had to wait months or even years for appointments. Now that we have achieved our targets, we need to take stock and refocus on how we deliver outcomes. The difference will come in rewarding and recognising the true heroes of our frontline teams who give genuinely great and high-quality compassionate care. And who are supported by leadership teams who have an uncompromising patient-centred approach.

The other critical element is to develop a more engaging style of leadership. If health professionals are consulted and informed, motivated and engaged with the organisational vision then they are more likely to provide high-quality patient care. All staff within the health service, irrespective of their role, have a responsibility to shape and lead a caring culture, which is open, honest, authentic and based on values.

I’m heartened that the Francis report and its implications will strengthen our endeavour to create different leaders for the future. It’s simple: the job of every nurse is to make sure that patients are safe and well cared for. The job of every organisation is to create the right sort of climate and conditions that allow nurses the time and space to flourish in doing so.

Lyndsay Short is deputy director at the East Midlands Leadership Academy and has a background in surgical nursing.

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  • 5 Comments

Readers' comments (5)

  • How right you are. The number of times I have done/started a procedure only to have to get a student or an HCA/CSW to stay with the patient (always having given information on what the procedure was, expected outcomes and what to do if anything untoward happens or anything changes and how to recognize changes/outcomes). It is such a delight when I am able to see something through from start to finish - and it usually provides opportunities for therapeutic engagement.

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  • If you really want to know where compassion went, check the 'Project 2000' curriculum. Its all there, much emphasis on academics, how to become ward managers, jumbled up placement with no proper follow ups. No one rarely fails and as a result, the value of the profession has gone down. Nursing has been used as step stone into the world of profession and working class. Everyone graduating wants to be a manager of some sort, but who exactly are they supposed to manage? No one wants to follow and go steadily up the ladder. It is such a shame.

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  • I agree with the author, some of the NHS failings are directly because the environment not supporting their values. Its not all about poor nurse training. I came to front line nursing having had a long career working within a large national, well run and efficient organisation. Sadly, I can not say the same of the NHS- Continually short staffed clinical areas, clerical staff who are often poorly trained, many of who are agency. Badly organised treatment rooms where so much time is lost looking for stock( I feel so sorry for the on- call junior doctors landing on an unfamiliar ward and fumbling around desperately trying to get the basics to do their job). So much money wasted on buying stationary from staples when I could buy many items considerably cheaper at our local supermarket! Does anybody do AUDITS in the procurement department!! They really need to get hold of the clinical governance concept in there- look at what your doing, why your doing it and ask- can you do it better? I'm sure the answer would be YES. It's really frustrating to see money wasted like this, when ward nurses are fighting (not literally of course, cos we are a caring bunch- on the whole) over obs machines. These inefficient processes need to be addressed. There are good people within the NHS who are stretching themselves so much physically and emotionally to give the best care possible. We need to stop wasting money. We could spend this on more staff with permanent contracts, and help the many people within the NHS who want to support Lord Darcy's vision of high quality care for all. Rant over.

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  • "therapeutic engagement"

    If nurses stopped the "speak" I'm sure we'd come across as more compassionate.

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  • when I was a student in the 80's I got more 'tasks' handed over to me by the snotty staff nurses than staying with a patient who vomited, we were really badly treated by some of the staff.

    Some of the staff nurses/sisters didn't bother talking to us and the doctors did'nt know we existed. It wasn't until we were in our third year final management placement that anyone thought of us as part of a team and that was mainly because we were thought competent to look after a bay of patients and so just left to get on with it.

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