A lack of compassion is not what is at the root of care failings in the NHS. At long last, someone is saying “evil” nurses aren’t to blame for everything that goes wrong.
An academic at the University of East Anglia believes the government’s focus on compassion is preventing it from seeing - and fixing - the health service’s real challenges.
Anna Smajdor’s fascinating paper “Reification and compassion in medicine: A tale of two systems” (see news, page 5) suggests that, far from bringing about more compassion, incentivising nurses for displaying compassionate behaviour will see less compassionate nurses on the wards. She says prime minister David Cameron’s contention that nurses be hired and promoted on the basis of how much compassion they display, is “peculiar”. I think she’s right - in fact I’d go so far as to say it’s dangerous.
How likely is it that nurses will learn what things they “should” say to make them look compassionate so they win the job or the promotion or the university place? Compassion is immeasurable, I believe. By its very nature, it cannot be standardised. The way one nurse shows compassion is not the same as another. And creating a guideline for what compassion looks like, to be followed as an example, completely undermines the idea of person-centred care.
Creating a guideline for what compassion looks like, to be followed as an example, completely undermines the idea of
We’ve all been to fast food restaurants and hotel chains where staff greet us with stock phrases. Do we really want nurses to be just going through the motions? Should compassion be made into a mould so that it can be replicated tirelessly again and again?
Dr Smajder’s paper goes on to say that compassion alone will not ensure patients are well cared for. Again, I agree. While compassion will ensure a wife holds her husband’s hand when he is feeling low, or plumps his pillows or changes his sheets if he wets them, in itself it is not enough to ensure all those tasks are done with many patients in a hospital or on a community round.
Performing tasks - especially caring tasks - requires skill, time, planning and resource - compassion alone won’t suffice.
And she also contends that too much compassion can make it difficult for nurses to perform those duties. While parents can weep for their child in surgery and feel that child’s pain, it would be too much for nurses to bear if they did this for all their patients - and would detract from their ability to do their jobs effectively.
At last a bit of sense about compassion. Stop pretending, Mr Cameron, that all nurses need to do is stroke someone’s hand and say: “There, there.” Because there’s a lot more to nursing than that.
Jenni Middleton, editor
email@example.com. Follow me on Twitter @nursingtimesed