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Nurses need to speak the language of compassion


It’s sometimes good for us to be reminded why we became nurses - especially when, like me, it’s been 30 years since I made that decision. I had one of those rewarding, life-affirming moments recently.

In among the hubbub of this year’s Gold Standards Framework (GSF) conference in Birmingham. Royal College of Nursing primary healthcare adviser Lynn Young mentioned the word compassion. She called on nurses to show more compassion, to break free of the shackles of targets and tasks. A few heckles might have gone up, but it struck a chord with me.

As a nurse there is no greater responsibility or privilege than looking after someone in the last months and weeks of their life. End of life care can also be among the most challenging aspects of our work and despite the difficult discussions and decisions it entails we should embrace it - with compassion.

The responsibility of good end of life care falls to everyone involved. Nurses have an enormous role to play in any setting. GSF empowers nurses not only to ensure all the organisational processes are in place for their patients, but also to have more time for compassionate care.

We have a mindset as nurses to always put patients at the centre and a responsibility to get it right. But, with the pressures of targets and task-oriented work, it is not always easy to find the right balance. GSF provides the structure to enable proactive care with communication at its heart. It helps nurses have those difficult conversations with patients, relatives and colleagues. And, rather than creating an extra layer of paperwork, it helps save time.

Since its inception 10 years ago, the National GSF Centre has always listened and learnt from professionals. Now different GSF programmes can be used for primary care, care homes and hospital settings. With nurses being able to take a proactive, coordinating role as the main workers in end of life care, the GSF Centre has developed a new resource - the GSF nurses’ pack, with all the information and practical steps to implement the framework into everyday practice. This will help us to enable more people to be cared for and die in their preferred place of care.

My first experience of GSF was in a GP practice in Suffolk where I worked as a specialist practitioner in the district nursing team. With limited access to hospice and hospital facilities 30 miles away, any challenges in practice encouraged everyone to think out of the box to find solutions. It involved passion, hard work and commitment but we could see the benefits and the patients were the real beneficiaries. A recent survey showed 86 per cent of patients on the supportive care register were looked after in their preferred place of care. Nurses have made a significant contribution to making this happen.

Nurses in care homes have been instrumental in implementing the GSF Care Homes programme. Almost 1,500 homes have been through its training programme and I have witnessed some fantastic transformations in practice.

Listening to some of the latest 31 care homes to have achieved the coveted GSF Care Homes quality hallmark award at last month’s conference describe the effect on the staff, residents and families was a further reminder of the compassion that exists, but goes unheralded, in more than 20,000 homes across the country.

As well as the new development of the nurses’ pack, the framework is opening up what is possibly its most critical front yet - acute hospitals. By linking the work of nurses in primary care, care homes and hospitals there is, at last, an unmissable chance to offer patients well-coordinated cross-boundary care and for nurses to take the lead to deliver the very best care for people nearing the end of their lives, in the place they want it.

The hospital programme, being piloted in 16 sites across the country, will effectively give nurses permission to spend more time with patients, ascertain what they want and help deliver it. The three simple steps of identifying those patients nearing the end of life, assessing their needs and planning their care, puts nurses in charge.

We can improve the systems that don’t work, by talking the same “GSF language”, so that nurses in hospitals can communicate with their colleagues in care homes and the community to join up the work in the different settings - always putting the patient at the centre and achieving better outcomes for them.

When I started out in the community, I had a dual role as district nurse and a practising midwife looking after people at both ends of life. I could deliver babies at home. But helping patients to die at home was much more challenging. Now, with GSF in place, we can facilitate the care of more people at home, giving compassionate care and importantly avoiding unnecessary hospital admissions and crises.

GSF has made a difference, putting the patient and their family at the centre. This is important work. Let us get it right every time, for everyone at the end of their lives. We can do this and make a difference to the quality and experience of the living and dying.

Nikki Sawkins is National Gold Standards Framework lead nurse, National GSF Centre, Walsall


Readers' comments (4)

  • I'm sorry but this is a little patronising and more than a little redundant.

    We are Nurses. We are by definition there for our patients, and we by definition 'speak the language' of compassion. It is the reason we chose to enter the profession, it is the reason we still turn up to work every day despite the hardships and problems.

    The problem isn't with Nurses. I agree that from time to time the majority of us will feel some form of compassion fatigue to a greater or lesser extent, as a lot of the time the system we work within, the management/leadership and the poor working conditions (such as low staff numbers and no funding) actually sets us up to fail. It is almost like an uphill struggle to deliver care with compassion, with our working conditions trying to push us back down again. We can absolutely want to give our utmost compassionate care to a patient, but when you have to divide that between 30 patients or more, with med rounds to do and emergencies occuring every five minutes that compassion can get spread thin. We still know exactly WHY we became Nurses, a lot of us will simply question why we continue to work in a failing system.

    The GSF needs to grow a set of teeth and aim its policies at management and the system. Start by setting a minimum staff/patient ratio for a start (in wards or community/care home settings). It is all very well saying it wants us to free up time to speak to patients, which we would all love, but that is not always possible when there is not enough staff. I know of at least one care home personally with the so called coveted GSF quality hallmark that routinely fails to give quality care or decent staffing levels. Complaints have been made, is anything ever done? Of course not. They simply come out with a lot of hot air like this and lecture Nurses to justify their rhetoric.

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  • Patronising...yes...condescending, absolutely.

    It does not matter what is set in place or how effective it would be. At the end of the day, nurses can only do what is humanly possible given the enormous pressures they face.

    We need to "focus" on the removal of Accountant psychophants in their ivory towers, plough their exorbitant salaries into staffing with good ratio registered nurses. Only then will consistently good care fall into place ongoingly.

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  • Unfortunately it is the senior - supposedly - nurse - managers that call the leadership shots now. Clinical leadership is fast becoming a thing of the past.

    Senior nurse managers see only numbers now - patients and staff - and delegate usually over the phone, they do not even bother visiting the clinical environment - in an acute setting.

    So you see our compassion is being 'sucked out' at a fast rate of knots.

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  • Peter Goble

    Lesson One in Compassionese

    Conjugate the verb "feel my pain"

    I feel my pain
    Thou feelest my pain (archaic)
    You feel my pain
    She feels my pain
    He feels my pain
    It feels my pain
    You (plural) feel my pain
    We feel my pain
    They feel my pain

    Complete the following by filling in the blanks

    I your pain
    Thou feelest pain
    It your pain
    He feels pain

    All examples must be completed! Return to complete unanswered examples by filling in the blanks! Failure to complete the examples may be regarded as competence and/or capacity issue and referred to your line manager for rectification.

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