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Emma White discusses The Essence of Care

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VOL: 98, ISSUE: 44, PAGE NO: 29

Emma White is clinical editor, Nursing Times

At first glance The Essence of Care (Department of Health, 2001) looks like yet another unwieldy DoH document. It focuses on what are described as the eight fundamental and essential aspects of care.

At first glance The Essence of Care (Department of Health, 2001) looks like yet another unwieldy DoH document. It focuses on what are described as the eight fundamental and essential aspects of care.

Depending on where you work, all eight aspects may not be fundamental at any one time - although some, such as privacy and dignity, cross all aspects of care at all times. However, important as these eight items undoubtedly are, they are just some of the aspects which make up the essence of nursing.

If the eight aspects of care are so fundamental to nursing do we really need to have them spelled out to us? They are taught during training and instilled throughout our nursing careers.

Any initiative that smacks of a return to task-oriented nursing sits uncomfortably alongside patient-centred care, which nurses have striven for over the past decade. The benchmarking approach originated in mass manufacturing and therefore weakens the notion of individualised care.

The DoH has a long history of producing wordy documents on what should be done in health care, with little emphasis on how it should be done. This is like discussing a treatment with a patient then saying you do not actually know how to do it.

Jane Ellis (p30) describes how one trust is implementing the benchmarking process for nutrition from The Essence of Care. This is a good example of putting the how into a process and it could be adapted by other trusts - if they have enough staff to free people to lead such projects.

But implementing these benchmarks can result in vastly increased amounts of paperwork for an already over-stretched nursing workforce. Do nurses really need a document to establish that emptying a stoma bag at a patient's bedside during lunchtime is not desirable and that ice cream melts if it is not kept cold?

Perhaps nurses are so busy that it is only through the use of a DoH standard that they can make the time to meet and to establish how and where care can be improved. If this is the case then nurses need to be vocal about needing the time to evaluate their care, irrespective of whether a government document on that topic exists.

It is not difficult to see what nurses need to allow them to reflect on all aspects of the care they provide - a little less paperwork and a little more time.

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