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.