Reducing the compassion deficit one heart at a time
Compassion is at the centre of nursing - and a caring relationship upholds the dignity of all involved
by Tony Lolb
I have reason to be very grateful to the National Health Service. When I was thirteen years old I needed an operation that kept me in hospital for a couple of weeks.
The procedure was a success and the majority of the nurses who looked after me were kind and cheerful. That was helpful for an anxious teen not used to being away from home.
Nevertheless, there was a problem on the ward. One of the night nurses was, to put it politely, very brusque. She had no patience with my discomfort and made that very clear. It left me feeling guilty for being in distress and disturbing her.
The word compassion doesn’t exactly sing in my heart when I think back on her.
Following the Mid Staffordshire NHS trust inquiry, there are probably many around the country recalling times when the NHS was not the dreamlike comforting machine vividly portrayed at the London Olympics. Whether we have struggled because a healthcare worker has not lived up to the “care” in that title or have watched loved ones suffer a lack of compassion, the memories can be very raw.
As the report by Robert Francis QC makes plain, such compassion deficits need to be fixed.
The Prime Minister picked up on that theme when responding to the report in Parliament. He said: “Nurses should be hired and promoted on the basis of having compassion as a vocation not just academic qualifications."
That’s easier said than done. How do you ensure someone expresses a quality of the heart?
Addressing journalists, health industry workers and European Union policy makers last week patient advocate Julie Birch spoke of suffering often excruciating pain for decades. Sadly her efforts to find the right medical help were marred by a significant lack of compassion on the part of both her gynaecologist and her GP. As the founder of the Pelvic Pain Network she’s calling for a patient-centred approach, including the need for empathy from everyone who works in health care.
During a Q&A session that concluded the European Voice sponsored panel she was on, I asked Birch if her call for empathy was aimed at individuals or whether she sought a more systematic approach to ensuring it as an NHS-wide ethos. With what seemed like regret, she said she couldn’t see a way to mandate empathy and compassion. It was up to each carer to be willing to listen, hear, understand and respond to each individual’s need.
A 2010 survey by the Royal College of Nursing (RCN) found that over 95 per cent of nurses felt it was their job to identify the spiritual needs of patients. This resulted in the RCN producing a pocket guide explaining how the nurses could more compassionately address the patient’s spiritual needs and their own.
Some might say that's a nice thought, but point out that health care workers often lack the time to do the basics properly, let alone add something else.
But what if that "something else" is a benefit not a burden - a vital ingredient that helps these workers fulfil the highest sense of their calling by building on those basics and fully engaging with the patient?
Award-winning columnist Professor Stephen Wright, has devoted much of his life to practising and articulating what he regards as the core qualities of good nursing, regularly pointing out that a spiritual maturity in the nurse benefits their patients.
He told the Nursing Standard: "If nursing is anything it is an expression of heartfelt compassion for the wellbeing of another human being. It is heart-centred work."
Law needs to mandate and management needs to implement a framework in which compassion is rewarded. That is really important. But the individual call for compassion comes from a deeper place than even the best code of conduct.
Following that inner compass more consistently could elevate the hospital experience for both carer and patient. It not only places them in a relationship that uplifts and upholds the dignity of both, but perhaps points to a reform element needed not just in the NHS, but by society as a whole.
