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'You can hand out packets of cornflakes - but not dignity'


Well, I for one am pleased to hear the NHS chief Sir David Nicholson say improving patient dignity is going to be the top priority for the health service next year.

It is fantastic news that in a few weeks we will be delivering dignity to pretty much anyone who wants it.

It’s only December so it might be too early to speculate where we will get all this new dignity from but, rumour has it, we’ll be shipping in a lot from northern Europe. In return we’ll be sending them our excess sarcasm. It’s a very good deal for everyone except the Swedish. At this point how we might integrate these new and, in all probability, self-assembly packs of dignity is yet to be decided. It may well involve some new targets, some protocols, maybe some dignity officers. And we’ll definitely need a big bunch of those allen key things.

But first things first. It isn’t next year yet so let’s get on with finishing off this year’s top priority. I can’t remember what it was. Could it have been communication? Efficiency? Paper-free offices? Folding?

Or were we concentrating on another managerial restructuring? Whatever it was, let’s finish that before moving on.

Apart from anything else I’m not really sure what the mechanics of genuinely improving patient dignity might be. And I am wholly unconvinced by the idea that a vague suggestion for more “training” means very much either. Do you train people to give out dignity? Might we be confusing dignity with cornflakes or painkillers? And aren’t we confusing training with education?

I would wholly agree that the most pressing concern for the health service at the moment is actually how patients receive and experience care. There is, as we know, a lot more to it then handing out packets of dignity.

In truth, it is the nature of attention itself that requires prioritising and investment. And let’s not fall into the trap of not stating the obvious. A large part of what constructs attention and care is resources. It is simply far harder to bring gentleness, well-focused and person centred-attention and a skilful humanity to someone when you have 17 other important things to do within the next 30 minutes.

However, the issue of training, particularly in this political environment, is an important one. Training implies the delivering of a skill. Being able to summon up, construct and deliver the right sort of thoughtful attention is more than a skill – it is an art. It requires the obvious things like time, context and resources. And it certainly requires an organisation that genuinely values and facilitates the delivery of the right sort of attention. It also demands willingness, self knowledge, energy, thoughtfulness and emotional labour on the part of the nurse or healthcare assistant and, frankly, those things are not born of a couple of training days wedged somewhere between a mentor update and fire training. They are born of a proper commitment to ongoing investment in staff education – an investment of time, supervision, support and practice.

Saying we want to prioritise dignity is one thing; demonstrating a thorough and meaningful commitment to it is quite another. We need a wide-ranging educational programme that genuinely invests in care giving – one that would invigorate not just nursing but the health service. Yes it requires resources and, yes, it requires hard work but let’s at least be honest – if there is no political willingness to provide both of those things, setting any sort of priority is simply talking for talking’s sake.

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


Readers' comments (2)

  • tinkerbell

    Not usually considering myself suggestible i found myself reaching for the cornflakes after reading your title to this article. I sat with a bowl of frosties after my late shift and read the rest of your piece and thoroughly concur.

    All these sound bites (bytes) no longer appear to have any substance attached to them and sound vaguely familiar to other words just being bandied about to the point of tedium. Fitting, as you say, dignity training in between fire training and other mandatory courses, is just another layer in a bland sandwich and doesn't give dignity the priority or sense of importance that it deserves, even the word 'dignity' is losing its dignity as it is so diluted down by over usage and no action, just another course ticked off on the matrix turning a red box to green and appeasing any CQC inspector who visits and wants to see the matrix.

    When i was a CPN i once visited one of my clients in prison as he was reportedly 'going up the pole' and 'demanding' to see me. When i got to see him he asked 'were you searched?', i replied 'yes' and he asked 'what about your dignity?' to which i replied 'oh i'm not really that bothered about it?' not really knowing how to answer him but just wanting to get in, offer him some encouragement to do his time, keep his head down etc., and get out again, (which proved a harder task than getting in in the first place as no one seemed that keen to let me out or concerned that i'd been left alone with someone allegedly 'going up the pole'). What I really meant in answer to his question was that i expected under the circumstances to be searched, patted down etc.,( but not have my teeth examined and my mouth looked into and asked why i was carrying a pen knife - small souvenir from greece that doubled as a nail clipper and key ring). Regardless, i understood what was occuring and i had a voice, I could just as easily have said 'no i am not prepared to be subjected to this' and turned on my heel in self righteous indignation but hey in for a penny in for a pound. Those without a voice however should be our first priority to ensure that their dignity is maintained. There have been times when i haven't always managed to achieve this, left a patient on the toilet with the door ajar as i am also keeping an eye on 15 other patients, told a patient i would get back to them and then got involved with other situations and totally forgot about them, juggling all the plates on one of those sticks so that nobody actually topples off and smashes to the ground. Of course dignity is vitally important but sometimes it slips because of other demands placed on us, but if they are handing out some majic panacea for all this that can get us to achieve true dignity for our patient group, maybe a 'bogof' (buy one get one free) i will certainly sign up for it, in the meantime i will strive to provide as much dignity as i can within the resources available. NHS chiefs make it your priority now and start walking the walk, we're all getting pretty fed up with the talk.

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  • I thoroughly agrre with Mark and Tinkerbell (I wasnt expecting to be saying that this morning).

    Is this any different to the task shuffling agenda setting merry-go-round that we have seen in the past?

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