Health and social care, Leadership, Patient experience, Quality

Building a culture of compassion is not just about nurses – we all have a role to play, says Lisa Rodrigues

Lisa Rodrigues A few days ago, I tweeted about a beautiful letter  and said that NHS staff deserve a more balanced press.

I didn’t expect 70 re-tweets, nine favourites, 50 new followers and 40 responses. One said that I was wrong and that NHS care was terrible. A couple said that poor care must be dealt with as well as good care celebrated. Absolutely.

The rest were supportive. One doctor said the letter made him cry, because to be compassionate, staff must feel valued. He doesn’t think they are any more. And a lovely parent talked about their two year old, newly diagnosed with leukaemia; the letter apparently said everything they felt about the wonderful NHS.

Chief Nurse Jane Cummings has just launched her 6 Cs campaign. While some view it positively, there is the usual anonymous online cynicism. I challenge those cowardly cynics, especially on the most important C, compassion.

Whether you are a cleaner or a professor, compassion is fundamental to great care. Kindness doesn’t come naturally. Some people are just not cut out for a caring role, because of their personality, experiences or prejudices. But many can find compassion within themselves, as long as the culture is right. Compassion has to be nurtured, encouraged, rewarded and role modelled. That places responsibility on colleagues, managers, boards and commissioners.

And the public. If we want nurses to show compassion, as the vast majority do, we must all play our part. It is of course stressful and frightening to be ill. But 60,000 NHS staff were seriously assaulted by members of the public last year. Examples of aggression and rudeness are rife. Patients and families are far more likely to report experiences of bad care than good ones, despite the evidence that the latter are many times more common. Great care never makes the headlines; poor care invariably does. Politicians fall into modern traps of anecdotes and negative sound bites.

Here’s what patients told Care Quality Commission (CQC) inspectors at one of my trust’s mental hospitals in our most recent unannounced inspection:

“I am looked after very well.”

“Staff here really do care about you.”

“There are loads of activities –  tons to do.”

“I especially like going to the sports hall. That and making pancakes is fun.”

“The night staff are lovely.”

“My privacy and dignity are always respected. They always knock before coming into my room.”

“The staff really do care about you, and they know how to deal with problems. I feel safe.”

Read more on the CQC website.

Not many jobs require people to be on top of their game intellectually, extremely practical, capable and efficient, and consistently kind and compassionate, whatever happens.

They say culture eats strategy for breakfast. If we truly value compassion, we must do all we can to breed a culture of compassion in the NHS. And at my trust, that’s starts with me.

Lisa Rodrigues CBE, Chief Executive, Sussex Partnership NHS Foundation Trust. Follow Lisa on twitter @LisaSaysThis

About NHSConfed .

The NHS Confederation is the membership body for the full range of organisations that commission and provide NHS services. We are the only body to bring together and speak on behalf of the whole NHS. We have offices in England, Wales (the Welsh NHS Confederation) and Northern Ireland (Northern Ireland Confederation for Health and Social Care) and provide a subscription service for NHS organisations in Scotland.

Discussion

5 thoughts on “Building a culture of compassion is not just about nurses – we all have a role to play, says Lisa Rodrigues

  1. What a great post Lisa; I totally agree with you. I once worked with an amazing consultant nurse Brigid Reid who developed a programme called Being with Patients, at East Lancashire Hospitals NHS Trust. This focused on reconnecting staff with patient centred values and used actors and forum theatre. Brigid included ALL staff in the Trust, as each member’s attitude at ultimately impacted on care of patients whether directly or indirectly. I have lots to tell you! Anyway, keep up the good work and I will follow you now of FB…best wishes Sheena (midwife)

    Posted by sheenabyrom | December 21, 2012, 8:05 am
  2. I am a NHS patient. I value good care, and I have always thanked staff.
    Sometimes this is a quietly spoken thankyou, sometimes this is a card and box of chocolates. Sometimes I have made a small financial donation to the latest hospital appeal. Sometimes I have shown my appreciation in other ways – speaking well of the care I recieved at the NHS Dentist, leaving a small bag of bulbs to brighten a little corner of the grounds, emailing thanks and copying it to Board of Directors and Council of Governors……

    Once I had the enormous privilege of thanking my CPN by nominating him for an award. If ever there was someone who lived, breathed compassion it was my CPN. Always charming, reassuring, calm. He made me feel safe and valued.

    I needed a CPN because I was so traumatised in my local hospital – in recovery suite – that I was temporarily mute. As I came round from the aneasthetic, I asked for my baby. The nurse repeatedly, willfully lied, saying my baby was asleep, when in fact he was dead. I believed I was going to be given him to cuddle. All the information she needed was in my notes – I had told enough people of my hospital based PTSD and how I needed to be looked after (reorientated to the present), but she chose to lie. That is not compassionate, and that choice continues to impact on my life. Compassionate staff would have ensured I left hospital with appropriate support, not a bag of painkillers, a broken heart and a sense of overwhelming sorrow and bewilderment. I feel I was processed – not loved, respected, cared for as an individual with specific needs.

    I nominated my fantastic CPN anonymously, but the Trust went onto breach my confidentiality. They published person-identifable clincial information in booklets which they gave out at an award ceremony, and sent to all it sites including a local prison, and left the surplus on the coffee table in HQ reception for anyone to take away. They put out a press release with my name. They put this on their website. They put it on Twitter. They put it on a poster on the wall outside the toilets in HQ. At no time did the Trust / Membership Office ever contact me.
    And that was the situation for two months, until I was identified and sent a copy of the booklet, by a ‘well wisher’. Even now I cannot find the words to descibe how betrayed, distraught, humilated I felt when I walked into HQ to see my information everywhere. A compassionate Trust would have put ‘appropriate’ therapy in place immediately. But they let me walk home distraught.

    The Trust boasts that it puts patients at the heart of everything it does. Twice I attended HQ before I recieved an apology of any sort. Once I was left in reception for three hours, actually sitting on the door mat.I was given conflicting, incomplete, erroneous information. FoI proved quicker than the complaints process. The Incident Reporting form was not completed until 6 months later. The SHA was not informed. I was obliged to involve the PHSO and the ICO. None of this is a compassionate response.

    What I asked for was simple: I asked for certain things to benefit others – signage in the local hospital, the Chair’s blog to be written more regularly, to be involved in PPI etc. I wait…..
    I asked for certain things to benefit me. I asked – 18 months ago for appropriate therapy to help me adjust. Once I asked the CEO what she wanted me to say to others, seeing as they know all about me. I’m not sure if the response can be classed as compassionate: She said to tell them ‘to mind their own business’ Hang on? Your Trust went and published mine!!!!
    And I asked for a picture. A photocopy of an item from a corporate gift ware catalogue. A piece of A4 paper. I had the nerve to ask for a photocopy of the gift my CPN was given to celebrate his wonderful care to me and all his patients. Twice the CEO signed a letter to say it was enclosed, and it wasn’t. I got it, only after I offered to send £5.

    People tell me to sue. How can I? How can I possibly do that? My CPN deserves his Award. There ARE fantastic people in that Trust and in the wider NHS. The resources are limited. How could I possibly take money out of the budget and so harm the provision of services for others? That is my compassioante response.

    Posted by Patient zero | December 11, 2012, 9:06 am
  3. I remember hearing about the culture in Bellevue from my late mum, where even the guy who changed the light bulb was part of the caregiving ethos. Seems like we haven’t learnt from that yet!

    Posted by John Rumbold (@DocInsanity) | December 10, 2012, 5:42 pm
  4. I agree with you Lisa, some patients are just rude, but sometimes this is due to staff who don’t care and should not be in the caring profession or because patients they have been left to wait with no information nor communication and therefore get angry. I don’t agree that all nurses care, some of them are burnt out and stressed that they can’t any longer and then they and the patient suffers. Or they might care but have little ability nor skills to show it effectively. More compassion and communication would reduce some incidents of aggression am sure.

    I would fight for the rights of people who work in the NHS and I ALWAYS tell people when they have done a good job and thank them. But I would fight for the vulnerable ill patient who is scared, confused and needing to see that someone cares.

    Something has to change and these changes need to be more support for workers, less pressure and more praise and at the same time the NHS should not employ people who don’t want to work with unwell people or who don’t have the skills nor personal qualities as this does a huge amount of damage to ill people who then need to take up more NHS resources to get well.

    So glad you are talking about compassion.

    Posted by Jim William | December 10, 2012, 5:26 pm

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