The Chief Nursing Officer for England, Jane Cummings, has called for more emphasis to be placed on nurses providing compassionate care in hospitals. She plans to ’embed values such as compassion, communication and commitment in public health care.’ This comes amidst concerns over neglect and falling standards of care in hospitals and care homes. This also echos the College of Medicine identification of a crisis in care and commitment within healthcare.
At the same time, another report states that hospitals are ‘full to bursting’ creating a potentially dangerous environment for healthcare. High volume and throughput of patients combined with inadequate staffing levels leads to an over-worked and stressed out workforce and undoubtedly the quality of care provided suffers as a result. I am aware of the stresses and strains that the nursing profession are placed under on a daily basis and that they too are increasingly frustrated at not being able to provide the quality of care they would like to as a result. These demands can come in many forms, be it the high turnover of patients, reduced staffing levels, sickness levels, bureaucracy and red-tape, mutliple form filling and documentation, targets, managerial and medical staff demands, ever-increasing patient/relative expectations all leading to significant pressure on the nursing workforce. So they might well be wondering how are they to fit in ‘compassionate care’ to the already long list of tasks and to-dos that fill their already over-full working day? As highlighted in the article, Prof Crome stated that ‘without adequate numbers of trained staff, this agenda – which must be welcomed – will be difficult to implement.’
It is great that recognition is being given to the fact that the nursing and medical professions have lost touch with their caring and compassionate roots and that measures are to be taken to enhance the quality of care provided. A number of initiatives have been or are being implemented to increase awareness on this matter. Dr Robin Youngson, an anaesthetist, has started an intiative called Hearts in Healthcare which is also designed to enhance compassionate care in the healthcare arena. In addition, the NHS Leadership Academy is undertaking a major programme investing more than £46 M to develop leaders with compassion.
So what does it mean to provide ‘compassionate care’ and how easy will it be to make a true and signifcant change in the NHS or other healthcare fields in the provision of compassionate care? Compassion is not one of those things that is easily measured by the usual ways we examine a programme of study or learning: it is possible to conceive that someone could answer all the questions in an exam about what compassionate care is in theory, yet fail to deliver it in practice. Common qualities that are associated with it are that the individuals feel truly listened to, they feel heard and met, truly seen for who they are and not just another condition in a bed, another operation on a table. They are recognised as an individual with their own set of concerns or worries and they are treated with respect and dignity and feel cared for. It need not necessarily take a lot of time to do this and rather than being something that is set aside as a separate task – ‘provision of compassionate care’ tick box exercise, it can be conveyed in simple ways: how you speak to someone, the tone of the voice, how you look at them, how you listen to them and pick up on not just what is said but what is not said. It can of course take time to go more in-depth in listening to a patient’s concerns but it would be a mistake to think that all compassionate care requires a lot of extra time. It can be delivered in small ways in every single encounter.
A key factor however, in the provision of compassionate care is understanding the importance of self-care. We cannot truly care for another if we do not care for ourselves. To do so only leads to burn-out, exhaustion, resentment, de-motivation and perhaps one could say the lack of self-care has also been in part responsible for the current crisis in care that we are experiencing. Research has shown that the more healthcare staff look after themselves then there are better outcomes for patients also. Healthy practitioners leads to healthy patients. Those who self-care are more likely to inform patients of how to care for themselves also and encourage healthy behaviours. So in order to truly deliver compassionate care in the health service, part of the focus of any campaign to do so should be aimed at encouraging self-care and understanding what that means. There is a tendancy to focus on the patient and the provision of care to the patient without first considering what is the quality of care the nurse or doctor is providing to themselves. In my opinion, if any true change in the provision of compassionate care is to be achieved then the focus needs to shift to the healthcare provider in the first instance, ensuring they are truly self-caring, for then it will be an automatic fall-out that compassionate care will be provided to another.
My own understanding of self-care has been significantly enhanced by the teachings of Serge Benhayon and Universal Medicine, which is based on understanding what is going on energetically and understanding how our daily choices affect us energetically. There is no choice that does not affect us and our physical health in one way or another. By listening to our own body and honouring what we feel, we have a marker or barometer for how our daily choices affect us. I use to be very dismissive of these understandings, in the arrogant belief that I had eaten and drank most things, had the same emotional ups and downs as everyone else and was still ‘alive and well’. However, as I have put the teachings into practice it is clear to me now that I was very mistaken and very arrogant and ignorant about this whole subject and how my daily choices were actually affecting me. It continues to be a daily work in progress, as I too can struggle with the demands of working in a busy NHS hospital and getting caught up in the stress that such an environment typically engenders. However, I personally have no doubt that the more I truly care for myself, go to bed early, eat healthy nourishing food, stay emotionally centred then the more present I am to care for patients, to listen to them, to see them for who they truly are and not just another number in the system. Whilst I applaud initiatives to enhance the quality of care and the provision of compassionate care in the NHS and further afield, experience has taught me and research is beginning to affirm that this will only be truly achieved when heathcare providers become truly self-caring. So let’s encourage intiaitives that raise the awareness of self-care for healthcare practitioners and the steps that can be taken to enhance self-care.
Feel free to share your own experiences of receiving compassionate care and what it means for you or how you have changed your own practice by implementing self-care, or anything else that this blog raises for you.