Here are words I never imagined typing but I heard an interesting comment by comedian Jim Davidson the other day.
He said, when asked how he felt about being criticised: “Being a comedian is one of the few jobs where you are criticised by people who don’t know how to do it.”
It’s interesting because it is of course complete nonsense. Football managers, taxi drivers, ballet dancers, poets, sandwich makers - all of these people and plenty more are criticised daily by people who wouldn’t know a short cut from an arabesque.
Everyone is a critic because everyone is a consumer so, if you are not funny, can’t make a decent sandwich or keep churning out dull poems about badgers and stoats, you are going to get criticised.
Much criticism, of course, lacks incision; it is an expression of taste rather than expertise. However, some criticism is incisive. It is not down to personal taste - and it does matter.
The recent report from the NHS ombudsman saying the treatment of older people is “failing to meet even the most basic standards of care” in some areas will hurt, anger and frustrate just about every nurse who reads it. Coming on the back of the Mid Staffordshire report, it degrades the name of the NHS and it denigrates nursing that sits at the heart of care.
Let’s face it - this is not a new criticism of standards. The Essence of Care sought to try to address such things formally and it was originally published 10 years ago.
Something insidious and frightening is happening in care giving and it seems to be happening too profoundly for it to be dismissed as an occasional incident or an oversight.
The ombudsman talked about a problem of culture and urged a change in attitude. While it is understandable that we may want to defend ourselves from charges of not caring or sometimes not seeing, we can surely do better than that.
I have long believed that a key problem in nursing is the mechanistic and overly administered focus on skills and knowledge ahead of qualities. It may be that these form the bedrock to the grand assumption that nursing is a profession and, because skills and knowledge are relatively easy to measure, it can be regulated and contained. But anyone who has nursed knows that skill and knowledge may underpin good task delivery but it is human qualities that underpin good nursing.
I know that 99% of all nurses who enter training are bursting with qualities such as compassion, generosity, kindness and a desire to care - to be attentive to the needs of others. The question is, however, what are we doing to help those nurses sustain those qualities?
We expect nurses to do their jobs and to retain the ability to care endlessly, tirelessly and attentively, without any focused support on these qualities. It is absurd; it is like treating care as an add-on when it should be the core of the relationship.
Nurse education, professional bodies and organisational managers need to turn their attention away from meeting targets and budgets and look seriously at how to help nurses sustain themselves as deliverers of thoughtful attention.
It means a radical change in what we regulate, what we measure and what we think about when we educate nurses. Without this, we are abandoning our patients and, without even noticing, throwing our nurses into an abyss of emotional burnout.