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'Without empathy and compassion, nursing isn’t nursing'

Charlene Pressley
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Qualifying as an registered nurse (adult) in 2001, I’ve always loved nursing. Everyone has a story, a reason why they became a nurse; this story is about why I became a nurse leader.

Last week I sat on a safe staffing panel, confident that decisions being made were safe and in the best interest of the patients we care for. I attended a Royal College of Nursing workshop, where Andrew Morris, director of NHS Improvement, spoke about the importance of organisations having a people strategy, valuing staff and the culture of leadership at all levels.

Then, on Friday my team was kindly invited to present to the RCN and Professor Hayashi and Professor Gregg from Kobe City College of Nursing in Japan, on our workforce support and development strategies. On leaving, Professor Gregg asked if she could publish our workforce strategy – honoured, we agreed.

As with every fantastic outcome there is a journey before it. I’d like to share a bit about my journey and the defining moment I personally realised ‘what nursing is’ and the instant I recognised the part I wanted to play in shaping the future nursing workforce.

My mum was a social worker and for much of my childhood we spent Saturdays traipsing around undertaking random acts of kindness for service users on mum’s caseload, from fixing sinks to fitting porch carpets. My dad, a joiner, was always told a story of woe and thus deployed onto a fix-it job. I would be lying if I claimed how at the time I thought this inspiring, as in reality, as a child of the 80s I wanted to be at home watching Knight Rider and Chips on TV.

In 2011, mum was diagnosed with stage 4 grade 3 ureteric transitional cell carcinoma. Mum took the same ‘let’s make the best out of this situation’ approach to living while we waited for what felt like forever for the date of her radical cystectomy.

Sadly, on the day, the operation wasn’t able to proceed, and her cancer had wrapped around the femoral artery rendering it impossible to safely excise. Mum was closed up, taken to the high dependency unit and told the devastating news.

My dad, elder sister and I went onto the high dependency unit where mum was resting, still drowsy from theatre. On our arrival, mum stirred and woke sobbing, apologising over and over again. When asked why she was saying sorry, mum explained how she wished she could have died and not woken up from the operation. She knew the next part of the journey all too well, as did I – a nurse of then 10 years – and she selflessly didn’t want to put us through it.

We all stood over her bed crying, hugging her, telling her not to be daft and explaining how she had some living to do before she died.

During our conversation, the nurse looking after mum (the same nurse who had 30 minutes earlier told her she was dying) lent over the easel that she had been writing mum’s observations down and said “its two visitors to a bed, one of you needs to leave”. My sister apologised and asked if we could make an exception given the circumstance but the nurse simply repeated “one of you needs to leave”.

As I sat outside the high dependence unit, stricken by sadness, it stood out clearer than ever what nursing isn’t. This nurse working in a highly skilled area was probably technically excellent but without empathy and compassion, nursing isn’t nursing.

Mum died eight months later, and she lived until she died, there was no other option. She died on 12 May – International Nurses’ Day – and on this day this year, I am running the Leeds half marathon as I am my mother’s daughter.

So why do I write this now, seven years after her death? Perhaps because it’s less raw and I now can, but moreover, I think it is because I want to share the brilliant things that have been happening professionally recently and the timing feels right.

Since mum’s death I have completed an MSc in healthcare management, and gained a qualification as an academic fellow and university lecturer. I was driven as Steve Covey advises to seek first to understand. I wanted to truly appreciate the theories of leadership to support my decade of clinical practice.

In 2012, the Department of Health commissioned Compassion in Practice. As a then somewhat under-confident and naive ward manager of a busy acute medical ward I welcomed the 6 Cs as a structure to support my understanding of what nursing was.

Debate aside, as to whether nurses should organically understand the importance of practicing with care, compassion, competence, communication, commitment and courage, the reality was that we, the nursing profession, had pockets of our workforce whom for whatever reason were not embedded in these values and behaviours.

When I later went onto bump into Jane Cummings leaving an event, she said to me “I like your dress”, and I replied with the ridiculous comment “I like your 6 Cs”. She smiled at me and said “not everyone does”, explaining how they had been met with controversy.

I could see that as when I had workshopped them at the time with my team some had commented on finding them patronising, but I reflected on this as preaching to the converted. What cannot be argued is that the policy gave us a clear framework of the nursing agenda.

”I have pushed my own personal boundaries to position myself in an organisation where we are now finding ourselves presenting our workforce strategy”

I now work as a matron at Mid Yorkshire Hospitals Trust in the professional development and education team. I have been fortunate enough in recent years to work with two outstanding nurse leaders: Dawn Parkes, deputy director of nursing; and Alison Ward, associate director of nursing, who unequivocally know ‘what nursing is’.

I didn’t set out to become a matron and am still plagued from time to time by imposter syndrome. I was a band 5 nurse when I was told it was “two patients to a bed”, and driven by the epiphany of what nursing was not, I have pushed my own personal boundaries to position myself in an organisation where we are now finding ourselves presenting our workforce strategy and how this is implemented in everyday practice.

Our strategy is simple in many respects. We live our trust values and behaviours of caring, respect, high standards and improving; underpinned and overlaid by the 6 Cs and we invest in and promote a culture of leadership at all levels of the organisation.

Over the past year we have been finalists in the Nursing Times Awards as Employer of the Year; we have presented to NHS Improvement and NHS England; and have been nominated for an NHS Parliamentary Award.

Recognition aside, more important is the confidence I have that our workforce plans strive for excellence and that our organisational culture is growing towards ensuring that every patient and their loved ones receive care embedded in the essence of what nursing is.

Thank you for reading my story.

Charlene Pressley is matron for staffing support, Mid Yorkshire Hospitals Trust

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