There is something incredibly simple, natural, easy to deliver, easy to comprehend, wanted, needed and with a huge power to heal that I believe everyone desires when they interact with a fellow human being. It’s almost indefinable, and yet when you are touched by it you know you have been. It can be momentary and yet be remembered forever. It costs nothing, and yet is priceless. It is called compassion.
When I say we all desire it, I would add that there are times when it is more important than mere desire, it’s essential. When we are at our most vulnerable, emotional, confused, in pain, frightened and fearful of the future, then it can be the ultimate medicine for bringing calmness and serenity, security and comfort. Such power should surely make compassion the cornerstone of health and social care, and yet sadly that isn’t always the case.
In the wake of the Francis report into the Mid Staffordshire NHS Foundation Trust, I heard one commentator say that compassion was unachievable in the NHS. Another ‘expert’ claimed that he didn’t believe staff could be automatically expected to be compassionate, and concluded by saying that he didn’t believe you could teach compassion. So just how do we inject this vital quality of understanding, empathy and love into the way we care for people?
After the gross negligence found within Mid Staffs, and the appalling way it was allowed to happen, and continue to happen, until many hundreds of patients and families were affected in the most devastating way, it could perhaps be easy to conclude that all hope is in fact lost. Compassion wasn’t on the radar of the staff who allowed those patients to suffer, and die, in such horrific circumstances, and you cannot help but wonder how many other NHS trusts have harboured employees responsible for similarly negligent practices.
Certainly the systems of regulation leave a lot to be desired if such catastrophic failings can occur, and a fundamental re-evaluation is urgently needed of how we care for patients across health and social care. Organisational change will certainly result, in some form or another, from the findings of Robert Francis QC, but what about on a personal level – when did healthcare stop being about one human being genuinely and sincerely caring for another?
In my view care isn’t defined by how many pills you can give someone or how you can cut them open, however important both those approaches may be for an individual’s treatment and recovery. It is how you treat that person on a personal level every time you see them, every time they need your help (even if that is the twentieth time of asking in the last hour) and every time you go to them to give them something or do something for them, even when they may appear hostile or indifferent.
By putting yourself on the same level as the person you are caring for, seeing the world through their eyes, and adjusting everything you do or say as a result, you are being compassionate. You are putting their need to be understood and shown love above your need for speedy completion of a task. Ultimately it is about treating that person, who you’ve possibly never met before and may never meet again, as you would wish to be treated yourself.
I believe such qualities, if they aren’t immediately apparent within a person are, generally speaking, something that can be taught by those capable of setting that example. Simple observation of compassionate care in action, explanation of the principles above, role-playing situations, and finding that point within an individual that touches their heart and soul is what will show most people the need for a compassionate response within their work. Give them the freedom to express that compassion and voila, you have compassionate care.
Many of the structures within health and social care actually directly preclude the delivery of compassionate care. We put staff under huge pressure, give them unmanageable workloads, put paperwork before patients and fail to allow for the need to stop, take stock, approach someone with a compassionate attitude and give that person the time they need with their patient so that both the professional and the patient has had a meaningful interaction.
Of course I would be the first to acknowledge that some people do not have the ability within them, no matter how much time you invested in them, to be compassionate in their care. They are the people for whom the Francis report needs to herald a change of career. I have seen for myself (and wrote about it here), what happens when someone who is a registered nurse, and yet doesn’t have a caring bone in her body, is allowed to manage a care home of extremely vulnerable and frail people with dementia. The outcome of that decision was, ultimately, my father’s death. That situation isn’t just reserved for social care settings either. She could just as easily have been a nurse on a hospital ward – at Mid-Staffs there were many like her I suspect.
I don’t, however, feel that all hope is lost. I saw compassionate care given to my father on many more occasions over his 19 years with dementia than I ever saw practices or interactions that I considered unacceptable. Whether in care homes, hospitals, primary care or support services, we met some amazing people, dedicated and compassionate, doing the very best they could in often extremely difficult circumstances.
So what does the future hold for compassionate care within the entire health and social care systems? I remember at a conference last autumn I was chatting with a colleague who pointed out that so much in society could be improved by simply showing kindness to each other. So simple, so vital, and so undervalued. Maybe in the wake of the Francis report those who control our health and social care services, and those who deliver that care on the frontline, will look again at whether what they do is compassionate and if it isn’t, why it isn’t.
Until next time…