More attention should be paid to the psychological impact on nurses of providing care to increasingly acutely ill patients, according to a report produced by a health think tank for the Mid Staffordshire Public Inquiry.
It recommends that nurses and other staff be given specific opportunities by trusts to reflect on their practice.
The report draws on research by psychologists that found death, disease, and physical and mental degeneration generate a primitive fear in people.
It argues that to deal with this, nursing staff may distance themselves for their own emotional protection – the uniforms, procedures and targets found in healthcare settings providing “organisational barriers to retreat behind”.
Report author Jocelyn Cornwell, director of the King’s Fund Point of Care Programme, told Nursing Times it was easy for nurses to become “overwhelmed”, as they dealt with more acutely ill patients in increasingly shorter times.
She said: “You can’t expect staff to provide thoughtful, sensitive care unless they themselves feel supported, and part of a team which allows them to reflect on the nature of the work that they do.”
The Point of Care Programme works with hospital staff to help them provide quality care. It was asked to produce a report by the Mid Staffs public inquiry to help it form recommendations on improving patient care.
One of the approaches the programme advocates is the introduction of regular meetings between hospital staff to discuss their experience of providing care.
Known as “Schwartz rounds” – after a successful US programme – they begin with an informal presentation from two or three members of staff, usually about an issue that presents a particular challenge, before discussion is opened up to those in the room.
So far six hospital trusts in the UK have started holding them with four more, including a mental health trust, planning to introduce them. They are held at lunchtime and the trust is asked to commit to providing lunch.
Dr Cornwell hopes more organisations will consider introducing them. She said: “We try to stop people trying to solve problems or telling each other what to do; that’s not what it’s for. It’s an opportunity to reflect, no more, no less than that.”