Skip to 0 minutes and 8 seconds SPEAKER: Why are we talking about compassionate care? Everyone knows about this, right? Health care careers are often described as the caring professions. Nursing in particular is seen as being about care and despite best efforts to improve balance, is a female-dominated profession with much debate about women being naturally drawn to caring roles, a debate for another day. Although care and compassion have always been part of health and social care, they have come to the fore in recent years because of high-profile reports following deficits in care. In this step, we will briefly explore some of the key reports from the last five years that have highlighted the issue of compassion or care deficit.
Skip to 0 minutes and 58 seconds While the reports tackle specific cases and situations, the issue of compassionate care has been identified in them all. In 2011, the health services ombudsman reported on issues around care of the older person where there have been a number of cases where compassion seemed simply to be absent. The contents page of this report lists the 10 cases in a single sentence, each of which expresses an extraordinary absence of compassion. The ombudsman, Ann Abraham, wrote, “The actions of individual staff described here add up to an ignominious failure to look beyond the patient’s clinical condition and respond to the social and emotional needs of the family and the individual.
Skip to 1 minute and 49 seconds The difficulties encountered by the service users and their relatives were not solely a result of illness but arose from the dismissive attitude of staff, a disregard for process and procedure, and an apparent indifference of NHS staff to deplorable standards of care.” In 2012, the Willis commission undertook a review of nursing education following its move into higher education. This was called Quality with Caring– The Future of Nurse Education. It was a response to populist claims that nursing was no longer a vocation but was seen as a career within which nurses were too educated to care.
Skip to 2 minutes and 32 seconds Phrases such as too posh to wash, too clever to care, nurses don’t need a degree to change a bed, and so on were common in the two decades following nurse education’s move into universities in 1996. The Willis Commission found no evidence of this impact, concluded that a degree in education in nursing led to competent, caring nurses. However, this came into question again after the Francis Report in 2013, following serious failings of care in Mid-Staffordshire NHS Foundation Trust. Despite all staff groups having contributed to the outcomes, it was the nursing profession that was most publicly vilified, and it responded most explicitly. In 2013, the report of the Mid-Staffordshire NHS Foundation Trust Inquiry was released.
Skip to 3 minutes and 27 seconds In the Lessons Learned section of the Francis Report, Item 1.122 states that patients must be the first priority of all of what the NHS does by ensuring that within available resources they receive effective care from caring, compassionate, and committed staff working within a common culture and protected from avoidable harm and any deprivation of their basic rights. Although specific to the NHS, this principle is so basic that it could be applied in any context. You’ll also find echoes of this principle in much of the content of this course as you progress. The apparent simplicity of compassionate care is prevalent throughout.
Skip to 4 minutes and 15 seconds Following the Francis Report, American quality guru, Professor Don Berwick, was asked by the then UK Prime Minister David Cameron to help make zero harm a reality in our NHS. The focus of this report was to help him build compassionate care and move on from the Francis Report into an implementation phase of sorts. Berwick’s first recommendation focuses not on compassion of health and social care professionals but on leadership and the compassion of the organisation. The recommendation includes the statement, “Leadership requires presence and visibility. Leaders need first-hand knowledge of the reality of the system at the front line and then need to learn directly from and remain connected with those for whom they are responsible.
Skip to 5 minutes and 14 seconds Culture change and continual improvement come from what leaders do through their commitment, encouragement, compassion, and modelling of appropriate behaviours.” Leadership and its role in compassionate care will be the focus of week four of the course. This brief overview of some of the key incidents and reports has been designed to offer a bit of background and context to the current debates on compassionate care. But the aim of the course is not to look at what has gone wrong and why but to look at compassionate care that goes well. As Berwick says, “The only conceivable worthy honour due to those harmed is to make changes that will save other people and other places from similar harm.
Skip to 6 minutes and 1 second It would add tragedy to tragedy if the nation failed to learn from what has happened and to put those lessons to work.”
Debating questions of compassion in care
There are many debates around the issues of care and compassion in the health service.
For example, can compassion be learned? Has nursing’s move to higher education led to a shift from vocation to career, making nurses ‘too clever’ to deliver compassionate care? Is compassion driven by individual practitioners, or must it be led from an organisational perspective?
You will explore these questions and others as you work through the course. Have a look at the presentation above, and then join in the discussion to debate these questions with your fellow learners.
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