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Patients view smiling as 'best' indicator of nurse skill


Smiling and being cheerful is seen by some patients as an indicator of good nursing, research has confirmed.

Last year former health secretary Alan Johnson trailed the idea that nurses should be measured on the compassion they showed patients, which was portrayed in the national media as how “smiley” nurses were.

Now it seems overseas research has backed the idea, despite experts highlighting that nursing indicators should be more focused on a nurse’s technical ability.

Patient perceptions of a nurse’s skill are largely based on their interpersonal skills and caring practices, rather than their technical skills, according to a small US study, published in the journal Critical Care Nurse.

Nurse researchers interviewed 32 patients, aged 30 to 96, being treated in a progressive care unit in a US hospital.

The authors said: “It is not always the successful performance of a procedure thatgives patients the impression a nurse is skilled, but oftenthe caring practices that a nurse shows while performing thetechnical task.”

“Patients described nurses who were friendly, caring, compassionate, kind, and good listeners as nurses who were very skilled. ‘A good bedside manner’ was how one patient described the skills and qualities of his ideal nurse, adding ‘interested in me also as a person’.

The authors added: “Cheerful and happy and smiling were qualities several patients said gave them the impression that a nurse was skilled. ‘A friendly nurse seems like they know everything’ were the words one patient used to describe the skill of the nurses who were the best at providing care.”


Readers' comments (5)

  • Harold Shipman was friendly, smiley, his patients liked him - how many people did he kill? I'm not saying nurses shouldn't have good interpersonal skills just that this is part of being a skilled practitioner and that patient perceptions are not always right!

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  • It is out of context to compare Harold Shipman to the whole of the nursing profession - he wasn't even a nurse to begin with!!!
    A nurse may be the best technical expert on the ward/department but if the patient doesn't percieve them to be a good carer, then how can they feel that they are being 'nursed'. The clue is in the job title.

    We (nurses) are all potential patients and have probably all had a relative who has had some experience of needing nursing at some point.
    I know I'd prefer to have a caring person to look after myself or my relative rather than one who came across as without compassion, yet a wizz with all the electrics!

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  • I am glad that Alan Johnson only 'trailed an idea' because that is all it is. Perception as we know is only an impression, and impressions can be oh so wrong!

    Compassion is present and smiling is not necessarily as way of displaying it, it is within our inner self and being a wizz on computers does not necessarily negate the ability to have compassion, neither does smiling all the time guarantee understanding and compassion and knowledge.

    I understand that nursing along with medicine holds the greatest number of suicide attempts, and has the NHS has the highest level of absenteeism. Perhaps we should look at the people providing the care and give them a reason to smile?

    Some days I find smiling at patients easy, and then it is always a genuine smile. Some days my personal life makes it difficult to smile, sometimes bullying in the workplace, physical pain I work through to avoid letting patients down, my childrens' health makes moments at work difficult to smile genuinely. Sometimes patients' themselves can push the boundaries of respect and deserve to not always be right, but tactfully questioned and challenged on unreasonable behaviour as should people in the profession.

    Being a patient and being a nurse is a partnership of care, respect, responsibility and it is time we cared for both so we can all smile all day.

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  • I am currently in hospital and appreciate both the efficiency of the nursing and their friendly manner. No-one can smile all the time, nurses are humans too, and being friendly doesn't always require a smile.

    I feel it as important that I, as a not too poorly patient, communicate my appreciation for their care and attention and give them a smile to help lighten the load.

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  • We can't smile any more because if we share a humorous moment with our colleagues (lying down) we could well be suspended!!!

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