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EDITOR’S COMMENT

'Time must be set aside for compassionate care'

  • 10 Comments

Nurses should stop attempting to defend the profession against charges of poor standards and accept responsibility for trying to make things better.

Nurses should stop attempting to defend the profession against charges of poor standards and accept responsibility for trying to make things better. That’s the view of Mid Staffs chair Sir Stephen Moss. His point, made last week, was that nurses have the technical expertise and knowledge to look after patients but don’t recognise the importance of doing that with care and compassion.

I don’t believe that’s true of the majority of nurses. Ask them why they enter the profession and they certainly never say “to show off the size of my brain” or “to flex my prowess in practice”. Their motivation is always to make people better and, more crucially, to make people feel better - but this isn’t the perception of the public or senior managers. Sir Stephen says caring must be put higher up the curriculum, but if someone needs to be schooled in how to show kindness, I suspect this isn’t the profession for them. Instinct must play a part in nursing at all times.

The unilateral cry from nurses is that they simply don’t have time to deploy their best bedside manner. Forced into fulfilling more administrative duties than ever before, they are too stretched to hold a patient’s hand. But it is unacceptable to forego what may be the most important part of the NMC Code: “Make the care of people your first concern, treating them as individuals and respecting their dignity.”

We all know the impact of compassion on recovery and wellbeing, so trusts and senior managers need to find ways of releasing time to care through Productive Ward and other initiatives. It is too vital to dismiss.

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  • 10 Comments

Readers' comments (10)

  • Treat nurses with compassion and they shall return in kind treat them as a easy target to save money reduce their numbers and blame them for dropping standards when there are less of them. I have never heard of a nurse loosing their job through not showing compassion but have seen nurses being sacked for completing all the red tape

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  • Compassion and humility should be at the foreforntof nursing and, for many nurses, I think this is the case. I feel bedside care remains the most important element to nursing - this means the most to patients too - yes, there are staff shortages and time constraints which make this difficult to achieve but, nonetheless, it is must remain the focus for nurses - as stated in the NMC code. Yes, paperwork is important but it should be secondary to giving individualised, dignified care.

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  • I entirely agree with the vast majority of the content of this article, but we are seriously kidding ourselves if we think this is anywhere near achievable in the current climate. A close relative recently underwent emergency surgery and I spent 4 hours with her in the ward prior to her operation, during which time the nursing staff spent the entire time preparing and administering oral, sub-cut, IM and IV drugs. At no point did I see any signs of any compassionate (or any other kind) care ) delivered to any of the patients in that time. Following surgery the intimate care and that human touch was again provided by myself and other family members (who are all nurses) - I don't know how the other 5 patients in the ward received their essential nursing care as once again the nurses were completely occupied with drug administration. We didn't complain as it was obvious to us that they were seriously under-resourced. We do however have to face up to the facts; managers and their budgets call the shots, despite the tragic shortfall in care delivery associated with the funding gap demonstrated by the Mid-Staffs experience...sadly this doesn't appear to be being heeded, in my own organisation an element of my service that I have been running for 15 years has been cut in order to save £9K...I am currently recording the evidence that the removal of the service is having a negative impact on patient care and the quality of outcome. Will they ever listen?

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  • I think that the vast majority of nurses are compassionate and find it very sad that Sir Stephen Moss believes that this is not the case. I agree that nurses are increasingly required to have more knowledge and technical expertise but this does not detract from the way in which we deliver our care. Next time you are in a healthcare environment take time to look around are the nurses talking with the patients as they give care, are the smiling where needed, are they putting the patients at ease, are they treating each patient individually and with respect ?? However busy we are as nurses the vast majority of us do this naturally as we go along .... I think that Sir Stephen Moss needs to take time to develop some compassion for nurses !

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  • Jenni I agree.

    'Time must be set aside for compassionate care'

    Then we must be given the staffing levels and working conditions that GIVES us that time!!!

    Stephen Moss is an arrogant and blind fool if that is his opinion on our profession, and frankly he should know better. Nurses ARE compassionate, we WANT to give the time and care to our patients, but when our staffing levels are being scrapped to the bare bones, when we are being inundated with paperwork and admin and doing everyone else's jobs, this just isn't bloody possible!

    It is very easy to say that we should still make the patients our first priority and make the time, but in reality when I am giving my time to one patient, what about the other 30, 40, 50 patients who aren't being seen because there are no other staff? How long would I actually have my job if I didn't complete all the paperwork, care plans, daily reports?

    Bloody idiots at the top. We scream the answers to these problems at them constantly yet they never listen and STILL come up with crap like this!

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  • Jenni Middleton

    Mike your comments are very similar to loads of nurses that I hear from. If you read Graham Pink's book on the subject, you really can tell how mortified he feels at having to neglect patients in order to look after those he is just about managing to take care of. He is simply overstretched.

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  • I am a mature student of 40 years of age just starting my third year of training. The main worry for me about qualifying is that I won't be able to be the nurse I have always wanted to be. Currently I try to be caring, compassionate and deliver care holistically - and as a student I can do that. Once qualified the "documenting & target meeting" side of the job is a daunting prospect and one that I am extremely nervous about. From watching other staff members when I am on placement or working HCA bank shifts it is most definitely the main issue on the wards. Nurses are not considered to be "nursing" in the old sense of the word as they cannot spare the time to just sit and talk to patients. And it is a complaint I hear from patients and relatives all the time. It is a real shame that the time for a little pat on the hand or a hug when it's needed is not availabe anymore - which is how I remember nurses from my childhood and where my ambition to be a nurse came from.

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  • Just been to two hospitals to see dying patients. Both in wards heavily stretched. one patient lying peacefully in a clean and dry bed, the other in pain, in a filthy nightgown and a bed soaked with tea - which she must have spilt a lot earlier as the tea had stained the sheets and was now drying!
    The latter patient's nurse came in and attempted to do her blood pressure(this took 20 minutes) - failing, well she was dying, and despite my requests had not succeeded in putting the poor woman into a dry bed by the time we left about two hours later!
    Some of the lack of perceived compassion is training and ward culture. Patients come before paperwork. Perhaps we should adopt that as a slogan for nursing!

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  • June, "Patients come before paperwork. Perhaps we should adopt that as a slogan for nursing!" very very true, I absolutely agree with you, but no paperwork comes before a sacking or an NMC witch hunt, and there is still the issue of too many patients, too few staff...

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  • George Kuchanny

    Mike, Jenni,
    Thanks for illumination cast by your comments. Compassionate care takes time. It is valuable time for nurses and it goes without saying (but clearly needs to be shouted!) even more valuable for patients. It can give them the little bit of fight to get through a critical recovery. Indeed it can be the difference between life and death. So what can be more important?
    I would suggest nothing is more important for a patient. For nurses the importance is that they have the time to exercise sound nursing sense and compassionate empathy. If things do not get exercised appropriately they may well (again, unsurprisingly) atrophy and die.
    I see Graham has written a book – any more details? I intend to buy it.

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