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No sign of indicator for nurse compassion

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The Department of Health has so far failed to deliver a way that the compassion of nurses can be measured, despite it being name-checked as a ministerial priority.

The lack of a metric for “compassion” appears to bear out previous warnings from nurses that it would be a very difficult quality to measure accurately.

It is now more than a year since former health secretary Alan Johnson first announced that he wanted nurse compassion to be measured. His comments preceded the NHS next stage review, which formally announced that a range of indicators would be introduced to measure the quality of patient care.

As a development of that policy, the DH recently published a shortlist of quality indicators from which trusts can choose to measure quality of care. But analysis by Nursing Times shows that while there are around 50 indicators dealing with patient experience – including issues such as dignity and respect – none deal specifically with compassion.

This is in spite of it being specifically highlighted by Mr Johnson as one of the reasons for introducing a way of measuring nursing care quality.

A DH spokesperson said: “There is no single measure of compassion but it is a theme that incorporates a number of elements of the patient experience, including being treated with dignity and respect, which we do currently measure through patient surveys.”

He suggested that quality indicators might be developed on the measurement of compassion in future. “We are always looking to improve the quality and span of these indicators through out programme ‘indicators of quality improvement’,” he said.

RCN head of policy Howard Catton said the importance of compassion and other patient experience factors must not be lost. “We’re really keen to see that the importance of patient experience isn’t diluted,” he said.

But he said he thought these areas might in future be measured through patient reported outcome measures – introduced for some NHS surgical procedures in April – rather than the new quality indicators.

Dr Jill Maben, deputy director of the national nursing research unit at King’s College London and co-author of the influential State of Art Nursing Metrics report, warned against over-auditing non-clinical areas such as compassion.

“When Alan Johnson announced that the compassion of nurses would feature in NHS metrics, I think he was trying to describe a crucial aspect of the nursing contribution to patient experience that few nurses would argue with. But that doesn’t mean that we should measure smileyness,” she said.

“Where possible we need to try and measure first order activities – care given rather than create a greater industry of audit around second order activities – those processes that should ensure good care is given,” she said.

The issue of compassion in modern nursing resurfaced in the public domain last week with the publication of a Patients Association report, which collated 16 individual examples of poor care. It called on the government and the Care Quality Commission to conduct an “urgent review of the standards of basic care being received by patients in hospital”.

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Readers' comments (2)

  • Have you tried Neil Clark Warren of eharmony fame? I am sure his lengthy questionnaire includes some measures of compassion.

    I also think a liekert self-report might be of some use with phrases such as:
    "Watching too much nightly news depresses me"
    "I listen to opposing political viewpoints occasionally to learn the objections to my way of thinking"
    Another way to go might be to see if people can correctly match the emotions expressed by patients:
    Pt states, "Why is this happening to me?"
    Nurse response, "It sounds like you are taking this random illness as a personal assault."

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  • A patient knows whether or not they are being treated with compassion, dignity and respect. Their experience in our care is the most important indicator of whether we offer compassion or not.

    I find I have greatest capacity for compassion when I am well-supported in my role, have adequate staffing to complete complex nursing tasks and increasing paperwork, have visible control over my shift patterns and feel that my contribution is valued.

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