Sections'Caring is a fundamental part of the job, not an optional extra'
My father was in hospital after having had a severe stroke.
As I entered the ward for the first time, I saw a poster on the wall advertising “Making Time to Care”, which had been created by someone with the title of dignity nurse. The poster featured a number of ideas on how a busy nurse could create space in a busy schedule.
I was incredulous. I imagined boarding an aircraft to be faced by a poster with suggestions for the pilot about “Making Time to Concentrate”. I also envisaged entering my daughter’s school to see a poster advising people on how teachers might “Take the Time to Educate”. If I went into my bank and saw a poster suggesting ways in which the staff might “Make Time to Get the Sums Right” I would promptly close my account.
The essential element of a pilot’s role is concentration, a teacher is an educator and a bank has to demonstrate that it will not lose my money. These are not optional extras in an otherwise busy day, they are key functions. A nurse’s role is surely about caring? It must be the central task and not something to be done in bits of time that can be freed up.
The care my father received was good in so many ways and yet I arrived on the ward to find him lying naked on his bed in full view of others. This must have been humiliating for a dignified man. He was being called by the wrong name despite the fact that his notes made it clear what he preferred to be called. His Parkinson’s medication was changed - as a result of which his shakes became uncontrollable - and it took the threat of a complaint before his long-established medication was reinstated. His cards and photographs went missing.
None of these things was really a matter of time. Drawing the curtains takes seconds. Presumably the notes had been read but it had not registered with the nurses what he preferred to be called. I discovered that the change in medication had been a matter of cost to the hospital.
Whoever moved the photographs and cards did not care enough to remember to return them. None of these issues is really about time - each one comes down to mindfulness. They are about caring sufficiently to make sure that the things that probably mattered to him most were done.
My father did, however, have a lot of things done to him - things that he grew to dread and things that all the members of our family (he included) knew to be futile. The things done to him appeared to be the priority. His care seemed to epitomise task orientation at the expense of caring.
There appears to have been a flurry of recent reports of neglect and abuse being carried out by nurses in all specialties. The extreme cases illustrate an extreme lack of caring. Examples such as the one I’ve described here demonstrate a subtler lack of care, no matter how well-intentioned the nurses were. How do we put caring back at the centre of training and practice? Can we relocate “tasks” to a position of lower priority? NT
Steve Mee is senior lecturer, Faculty of Health and Well Being, University of Cumbria
Hi Tinkerbell. I love what you said about not taking life too seriously. And the wee book '' Make someone happy today. Mind your own business '' sounds great. I do tend to take things on board that I have little control over and that are often nothing to do with me.( Laughing at myself as I type) Thankfully I have enough sense most of the time to keep my ''observations & wisdom'' to myself. But I do waste a bit of valuable time worrying needlessly. When I could be channelling the energy much more usefully. I think its all been said before. We lack the resources to care. And we lack the time to teach our Students, Juniors and HCA'S. Yesterday at work, before I succumbed to the Noro virus at lunch time- embarrasing myself by vomiting in our clean clinical room !! I was able to do something I feel I hadn't done in a long time. I had enough time to spend with my Patients and my First placement Student. We worked together. We planned our mornings work, we administered the meds, we fed our patients and she did a drinks round without being rushed. We bedbathed and talked with someone who was frightened and had a lot of unanswered questions. I felt for the first time in a long time that I was able to administer good care. I was able to teach my Student properly. And we were able to care for this Lady properly and reassure her.It was a joy to be able to do something simple like get the Patient an old fashioned slipper bedpan, which she finds easier to use, this had not been handed over to us when she was transferred to our ward. However I was horrified to find out that the Lady had been waiting 3 days for pelvis X-Rays to be reviewed. And that she had a grade 2 pressure ulcer which had been missed. I understand why it happened. Poor communication and poor staffing- medical and nursing. My colleagues are very concientous.However our ward is not consistently properly staffed and our Students and HCA'S are not properly supervised Nowadays I dont have many days where I feel I make a real difference at the bedside.I spend little time even as a Band 5 at the bedside. I do supervise my Girls and make sure the Patients get what they need. And Im lucky to work with some very competent HCA'S who I trust. However yesterday. Before Noro virus took hold I spent the morning doing exactly what Im supposed to be doing at work.
Unsuitable or offensive?
I trained in the early 70's doing what was then called the Diploma in Nursing. Time spent at college was only one day a week in year 3 and 4 and at other times I worked on the wards and went into "block" study the same as those doing the traditional SRN programme. Even then I had to face staff who said we diploma nurses were "too posh to wash" which was certainly not true. Many just felt threatened by someone doing a different style of training. The degree nurse of today is necessary if nursing is to be recognised as a profession but that doesn't mean they have a lack of compassion. I no longer work in the NHS but visits to hospitals leave me disheartened with what I see. Pressures on staff are great because of having high dependency patients, staff shortages and far too much paperwork. However even allowing for these challenges there appears to be no empathy shown to patients. A little understanding of what they are feeling is needed and a simple smile or a good morning acknowledgement goes a long way. The idea of having to teaching compassion to nurses horrifies me but it is necessary. Society today is generally lacking in compassion, and selfishness and the "me" culture thrives. On a recent visit to the local eye outpatients with an elderly relative we had a long wait with plenty of time to observe. Many of the staff acted like automatons, they did their job, there were no failings there, but the nurse who shone was the one who greeted patients with a cheery hello and smile and it was fascinating to watch the patients themselves mirror this back.
Unsuitable or offensive?