Once something is documented on a form it becomes tick box and measured. Unfortunately not all nurses will recognise that the discussion may be inappropriate or lacking in compassion. There is also the question of time - do these nurses have the time to develop a relationship with the patient or is this seen as yet another chore to complete with limited resources?
..and has anybody invested in the equipment or workforce to scan all the additional varicose vein patients?
This is an excellent summary of the situation. We should not tolerate poor standards or lack of compassion however need to understand what pushes people to behave in this way. If we want a health system to be proud of we have to invest in the people who deliver as there are no health interactions without people.