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'If we care enough, we can teach people how to be compassionate'


So I’m chatting to this nice young man, all youthful energy and floppy hair - him not me - and he’s telling me about his life because I am the only person left in the swimming pool changing rooms and putting his pants on in silence might have been a bit too challenging.

I’m nodding as he tells me about his stepmother, favourite shirt, preferred cheese and PIN number, when he tells me he works in learning disabilities. I nod more encouragingly and he takes the social cue to move from cheese to learning disabilities seamlessly.

“Do you know the hardest thing about working in learning disabilities?”

“Yes,” I say, aware of the fact that he didn’t know until that point that (a) I could speak and (b) I was English.

“I’ll tell you,” he says. “Manual handling.”

“Patience?” I offer quietly.

“Well yeah, you’ve got to be patient. But manual handling is the big thing.”

“Isn’t it easier to get a hoist than to help someone learn not to become impatient?” I offer, momentarily aware that I sound pompous like Yoda and also that I am only wearing a T-shirt and one sock.

And he says sagely, “Yeah but you can’t teach patience; you’ve either got it or you haven’t.”

And I distract myself by looking for my other sock because I want to say, “Why can’t you teach patience? How come you can teach someone to use a hoist, to pilot a space shuttle, make soufflé, tango, understand Kant, draw a face, do algebra, counsel, lie, juggle or perform mime but you can’t teach patience?”

Instead I settle for: “Can’t you?” And he says: “No, it comes from within.” And I think: “Surely that’s wind?”

Of course he is part of the body that is of the consensus - the widely assumed, rarely discussed assertion - that human qualities like patience or compassion, kindness or sensitivity happen to exist in some people and not others, and cannot be engendered, sculpted, developed or protected. As far as I can tell there is no evidence for this belief, it has not been the subject of enquiry and if you ever ask anyone to expand that view they never get beyond: “it just is”.

The subject of investing in education geared towards the development of human qualities is unthinkable because it is caught in some sort of ideological pincer movement. On the one hand, we follow right-wing economics that creates a health service based on austerity and cost rather than need; on the other, we have a distaste for education and a preference for training that defies logic and gets a bit medieval by claiming (too clever to care) that being able to think somehow pushes any ability to feel from the body - implying that only stupid people can be kind. Personally, I think right-wing economics benefits from undermining education because it enables politicians to both pay and teach nurses less but hey, maybe I’m just a one-socked conspiracy theorist.

However, regardless of my paranoia, we do know that at the heart of Mid Staffs and recent Care Quality Commission reports is a crisis of compassion - the struggle for many of us to hold on to the best of ourselves in difficult circumstances. Surely the most important challenge for nurse education is to develop ways of helping nurses protect, grow, sustain and develop their human qualities? Not just because patients need it and not just because nursing needs to collectively reclaim those characteristics, but because nurses, as individuals, deserve to be protected from the erosion to self that the loss of patience, compassion or softness amounts to.

Mark Radcliffe is senior lecturer, and author of Gabriel’s Angel


Readers' comments (16)

  • I am in the middle of writing my personal statement for University and was looking for some inspiration and came across this.... Brilliant article!!!!

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  • I agree with anonymous above! Great article.

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  • Oh so right mark . How do we do it tho ? Return to ward sisters who taught by example ? Well mine certainly did... I can remember their words to this day. We need to reengage with our inner selves , to think of the kindnesses that we would like to receive and stop running like headless chickens chasing targets.

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  • In preparation for the discussion that I'm hosting on Sat 20th at the Battle of Ideas 'A crisis of Compassion: who cares? '
    I've been trying to get to grips with Martha Nussbaum's 'Compassion and Terror'. She suggests that compassionate judgement necessitates that we understand our world as one in which bad things happen to people, and human beings are both dignified and needy. This complex interaction, and our own ability to recognise our personal encounters with future tragedies, is what inspires compassion. Food for thought....

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  • I think it's possible to teach these qualities if the person you are teaching is willing to learn. I believe there are some people in care work (who really shouldn't be) who unfortunately would not be interested in developing such qualities. I am thinking of some of the thugs /bullies who worked at Winterbourne View for example. Yes I know there was poor leadership etc.. etc.. but it doesn't take a genius to work out that you don't treat people like that.

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  • Love this piece, Mark! And want to add Critical Thinking and intuition to the ideals I have heard nurses say they cannot teach, and I have seen that they can be. Critical Thinking is mostly a matter of having the facts and being able to recall them in a timely manner. Intuition is having the observational skills to notice a change from baseline and remark upon it.

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  • Yes But

    Interesting, Mark.

    But whether people can become more caring (or more patient) isn't exactly the same question, as can they be 'taught' those qualities, I think ?

    I'm different in my 50s, than I was in my late teens, in many ways - but I think these changes are largely down to long-experience of life, and I doubt that they could have been 'quickly instructed into me' (as 'teaching' normally works).

    After all, most training is an attempt to short-cut the acquisition of experience: even so, almost invariably people who then have the real-life experience tend to say 'unless you have actually been there ....'.

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  • Fab article Mark. Our work at HSMC (Sawbridge and Hewison 2011. Time to Care?) also considers how we need to create a system which looks to support nurses and recharge their emotional bank account -which is often overdrawn. We are working with 3 hospitals to test the feasibility of introducing a model of support, and will share our findings when we have some! This is an important dialogue to illustrate the complexities of caring and help us all to find ways to get it right for patients and, as you say, for individual nurses, most of whom want to do a good job.

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  • The overriding theme I have noticed in recent years is,
    'the less people are cared for, the less they care',
    and guess what nurses are people too.

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  • Yvonne S: That's exciting. I really look forward to hearing about that. I am trying to do some work in that area myself currently.
    Alice P: Completely agree. Indeed for what its worth I think critical thinking is a cornerstone of any progressive educational process.
    Judy: I think we need to radicalise what we think education and supervision is personally.
    Anonymous at the top: Good luck.
    Yes but:Two things; firstly I believe training is different to education. Secondly if people cannot become more patient, or kinder or more generous doesn't that mean growing up or old is just a decline into misanthropic bitterness? I don't think you or I believe that do we? I think our challenge is to find effective and workable ways to help people hold on to or grow the best of themselves - because our patients benefit from those qualities.

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