Dignity must be seen as the essence of nursing care, says Sara White
Ensuring the patient is at the centre of our care has been the ethos of good nursing practice for many, many years. Consequently, it both saddens and shocks me to read stories of nurses not delivering essential care, that water needs prescribing, that basic nutritional needs are not being met, and that neglect and abuse are occurring.
A consequence of this, and something undertaken in an effort to avoid such events occurring again, is the production of numerous reports and documents - the latest offering being the Commission on Dignity in Care’s Delivering Dignity: Securing Dignity in Care for Older People in Hospitals and Care Homes. A Report for Consultation, which was published in February. This has led me - and, I am sure, many others - to reflect on nursing and possibly question where the profession has gone astray.
Dignity is a complex phenomenon, which takes time to fully understand and appreciate. I believe the ability to comprehend care, compassion and dignity can only be fully understood with good education - not “training” as suggested in the report. Dignity is not “delivered” but is an integral aspect of a nurse’s role, part of which means being able to foster feelings of value and self worth in every patient and having the ability to encompass mutual respect.
“Dignity is not “delivered” but is an integral aspect of a nurse’s role, part of which means being able to foster feelings of value and self worth in every patient and having the ability to encompass mutual respect”
The week that the Delivering Dignity report was published, third-year student nurses at Bournemouth University were scheduled to present a topic that “considered national influences on healthcare delivery”. Here two groups - independently of each other - chose to explore dignity and both incorporated the Delivering Dignity report. Although discussion resulted in some students voicing their frustrations with the NHS - such as lack of staff, high workload and constant change, which they felt limited their time with patients and the ability to offer all the care they wished to - they felt the Delivering Dignity report, although “quite basic”, could be used in a practical way when working with junior or new staff and fellow students. They also thought it could be used constructively when challenging poor care.
So, having been a little despondent regarding the necessity of the Delivering Dignity report, I was proud that students could see its value and offer strategies regarding its use. Indeed, these same students will be the future leaders of healthcare and will be educated and empowered to change poor practice and role model that, which is good.
So where do we go now? I feel we all need to take ownership of the recommendations in the Delivering Dignity report and offer our thoughts. We need to reflect on our own opinions, together with the views of older people so we confidently see old age as a normal part of the life cycle that we will enter and enjoy.
Nurse educators need to ensure nursing programmes not only have dignity embedded in them, but also that the humanisation of healthcare is an everyday focus. I strongly believe higher education provides the knowledge and skills needed to be able to offer care that respects the dignity of patients and that an essential component of this education journey is the role modeling offered.
It is up to each and every one of us to make sure that dignity is not only part of who and what we are, but that it is also integral to how we are “living” nursing; if not, we must be willing to change. This means you - or, rather, we - need to find the time to, as the third-year students eloquently quoted, “Be the change you want to see in the world” (Mahatma Gandhi).
Sara White is framework leader undergraduate nursing, School of Health and Social Care, Bournemouth University