As the many demands on nurses continue to increase, Nigel Jopson urges us to remember that it is often the small things that make a huge difference to patients
When I think about my life in nursing I realise there have been three major incidents that have changed the way I think and behave. They may seem insignificant and at first glance simple and obvious but, as this week’s Changing Practice article shows, small changes can really make a difference to patients’ dignity and quality of care.
These three incidents did not help me to meet any targets, had no discernible and recordable outcome and certainly followed no care process. Nonetheless, I believe they still made major contributions to my patients’ lives both then and now.
The first was when I was a student and doing a ward round with a consultant. I presented a patient and said we were checking her blood pressure twice a day. The consultant asked why; my answer was because it was on the handover to do it. He asked why it was being done and what we were doing about the results. I was not sure and said so. He told me I should always know why I was doing something and should always ask why. It made a great impact on me and has led me to question many things and to ensure that I always know why I am carrying out a particular task.
The next happened when I was working in the area of learning disabilities. We decided to go out to the seaside for the day and I was looking after one woman who hardly seemed to react to anything. We walked along, me pushing her wheelchair, and passed behind a shelter which blocked the sun. As we went back into the sunshine her face lit up and she started smiling and laughing.
I realised then that I was judging reactions and responses on my expectations and that the things she reacted to were very different and at totally different levels. This always reminds me not to impose my expectations on the people I work with and to try different methods to help with reactions.
The third incident was also trivial on the surface but a significant learning experience. I was again at the seaside with a group of older people. The woman I was escorting was enjoying herself. We had been to lunch, walked along the seafront, and had stopped for an ice cream. As she sat in her wheelchair in the sunshine eating her cornet, she said: “Do you know, it is years since I did this.”
It struck me that, of course, she had not done this for years because she could not do it on her own. It was such a simple thing and one many take for granted but for her it was extremely special. Once more my thinking about the way I helped to look after people changed and I realised it is not the complicated care processes that make a difference. What really makes a difference to people’s lives are the simple things that we take for granted and that show we have choices and some control over our lives.
I can reflect that the question why, a ray of sunlight and an ice cream changed my attitudes and am thankful I realised how important they were. They have improved my approach to patient care in a way no research, training or imposed targets have. I hope they have helped to improve the lives of the people I have the privilege of looking after as well. I am sure you have had similar experiences you may like to share with others (please use the comment function below).
NIGEL JOPSON is support manager, Care UK