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EDITOR’S COMMENT

'Compassion alone will not stop the care failings'

  • 13 Comments

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

person-centred care

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

jenni.middleton@emap.com. Follow me on Twitter @nursingtimesed

  • 13 Comments

Readers' comments (13)

  • The failings in nhs care recently publicised could not have happened if nurses had been compassionate and committed to addressing visible problems. This is a different question to how you measure compassion as a generic skill. The government is therefore perfectly reasonable in demanding on behalf of patients that nurses display compassionate and professional behaviour. Contrary to the article's assertion, the government has not suggested that compassion alone is sufficient, merely that it is necessary. It would have been good if this article had at any point acknowledged that fact rather than defaulting immediately to defensive and self-serving arguments.

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  • Nicolas

    What I find interesting is the hypocritical response you have written in relation to this article; your post in clearly self-serving and equally attempts to attribute NHS failings to nursing. It’s also portrayed in vexatious and stereotypical manner, lacking insight into the overall matter and attempting to scapegoat nurses for the ills of the NHS.


    It’s ironic how you additionally assert that if nurses had addressed the “visible” problems (with their compassionate and committed manner), that none of this would have transpired. I really think you live in the deluded world of goldilocks and the three bears, where nurses employing just these basic values would have solved the current crises the NHS is in. You also appear to not have worked on wards where one of the major contributors to this topic was all too apparent; NO minimum staffing ratios.


    Considering the Francis report which you seem to allude to, a significant number of failings were identified which you frankly missed altogether. I would suggest you read that report, The Willis Report and the Kings College report on Staff ratios, before stating such ill-informed and incredulous twaddle.

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  • Nicolas

    What I find interesting is the hypocritical response you have written in relation to this article; your post in clearly self-serving and equally attempts to attribute NHS failings to nursing. It’s also portrayed in vexatious and stereotypical manner, lacking insight into the overall matter and attempting to scapegoat nurses for the ills of the NHS.


    It’s ironic how you additionally assert that if nurses had addressed the “visible” problems (with their compassionate and committed manner), that none of this would have transpired. I really think you live in the deluded world of goldilocks and the three bears, where nurses employing just these basic values would have solved the current crises the NHS is in. You also appear to not have worked on wards where one of the major contributors to this topic was all too apparent; NO minimum staffing ratios.


    Considering the Francis report which you seem to allude to, a significant number of failings were identified which you frankly missed altogether. I would suggest you read that report, The Willis Report and the Kings College report on Staff ratios, before stating such ill-informed and incredulous twaddle.

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  • Nicholas
    I don't find it interesting.
    Do you write for the Daily Mail? Telegraph? Express?
    Are you a spokesman for the Tory Party?

    If you don't, then you should. You sound like them.

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  • "The failings in nhs care recently publicised could not have happened if nurses had been compassionate and committed to addressing visible problems."

    NICHOLAS - I FIND YOU INSULTING.

    I have worn myself out physically by my work with, and care and compassion to patients.

    I agree with above 2:13. I don't believe you are a nurse. I have just read your comments to my colleagues currently on duty in ED. They just shook their heads. Next you will be saying we are paid too much!

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  • Compassion is not a skill, it is a quality, therefore it cannot be measured. But, how we show compassion to others can be. And this skills can be learned, in the same way that communication skills training can help people to communicate better.
    Being compassionate doesn't just mean holding hands, although that can be part of how it is demonstrated or shown to a patient.

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  • Nicolas
    Your arguments get more transparent and flimsy by the second. You make bold statements in your original post about nurses and their deficiencies, relating this to a lack of compassion and attribute this too many problems in the NHS.
    I’ll be honest, you’re a duplicitous individual without any substance to your arguments and attempted to utilize the nursing times as a place to denigrate nurses. People like you like to moan about important issues, without researching it thoroughly and attempting to find a solution. You’re an ambulance chaser with an agenda that my 3-year old daughter would see through. You verbally insult an entire profession without a shred of evidence and come across in a contradictory prejudiced manner that shows you for what you truly are; imprudent and hypocritical.
    You equally mention politics twice, both defending the Tori government for its validity in support of literalistic “compassion”, then have the audacity to call me a Tori. You’re a hypocritical person who likes to criticize a profession but backs it up with absolutely nothing. I don’t mind a constructive debate on any issue, but I can see you lack both the intelligence and wisdom for this to happen. Clearly when it comes to politics, you have about as much integrity as the raving monster loony party.
    Find another forum to troll or do some proper research and I’ll welcome any health debate. I can happily provide you with some reference material, but my sense is individuals like you lack any form of compassion, something which you ironically accuse nurses of lacking.

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  • Who was showing more compassion me answering a patient calling desperately for the toilet or the elderly carer I am working with who is tired, she is sitting resting her legs keeping another patient happy with her chattering?

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  • michael stone

    I'm interested in these comments - I'm going to send them to Anna, because I think she might find them interesting as well (but I'm not sure).

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  • chuckled at anon 2:13 he he!!
    anyways, how about this... to be compassionate it helps not to be demoralised, exhausted and trodden on and generally treated like the smelly stuff we get low paid to handle. A respected and happy workforce will naturally be able to let their compassion shine forth with a smile.

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