Saturday, 27 April 2013

Inspiring belief: the compassion that exists in practice

Like many people, I was inspired by the wonderful speech and poem thatMolly Case did at the recent RCN Congress - it has gone viral. What she articulated (and I don't think that anyone else has done this so far in such a powerful way) is that nursing students are compassionate; that they care about what they do every day, even when they find the requirements of compassionate nursing practice challenging; and that perhaps some of the people who are making policy decisions about nursing education do not understand the realities of practice, and the amazing work that nursing students do each day. Now, please do not think that I am complacent. As a nurse educator I am passionate about continuing to enhance nursing practice through ever-improving nursing education. There will always be things that we can do to improve the way we (by we I mean educators in universities and in practice) educate students. I also believe that with the changing demands in nursing, there will always be a need to continually evolve how we select students who are going to be the 'right' ones for the evolving context in healthcare. However, what I do believe (and this belief is based in evidence - for example the NHS Education for Scotland annual survey that is completed with students, mentors and charge nurses for HEIs and their practice partners to learn more about perceptions of our students as they enter newly-qualified practice; and based on experience of working with students) is that most of the people who choose to enter the nursing profession do so because they believe that they have the intelligence, the characteristics, and the behaviours that will enable them to make a difference to patients and others that they work with. I am interested in understanding more about the place that previous experience plays in students' subsequent performance on nursing courses. It seems intuitive that experience of some sort in health or social care should help with decision-making about right choice of career. However, my own PhD research did not reflect this. Although the study did not focus specifically on previous care experience, what I found from some of my respondents was that previous care did not necessarily lead to right career choice. We need, of course, to find a balance between ensuring that people are helped to make the right decision in relation to course and career, and that we as selectors of student nurses have the information that we need to make the strongest choices that we can.

As readers of the blog will know, I am not a fan of the one-year HCA pre-nursing idea. I am a fan of continually focusing on building the selection evidence-base so that we can make the best decisions for the students, for the educators and - most importantly - for the patients and others. There is a great deal of work going on across the UK in relation to this important area - let's make sure that we gather the evidence, learn from each other and help students to feel valued in the process. As Molly says in her speech, it is discouraging to hear the negative comments (on an almost daily basis) about nursing and nursing education. It would be great if politicians and the media noticed, reported on, and used the evidence to appreciate that compassion exists in bucket loads in our student nurse population!

Sunday, 7 April 2013

Where did all the compassion go (a question to the government)

Like everyone, I feel senses of anger, shame, sadness and bewilderment at the findings of the Francis Report. As we have seen in the media and elsewhere, this sense if bewilderment prevails. As I was asked when I was interviewed by BBC Radio Essex - why does it need someone to tell a nurse to offer a drink to a patient (and then to make sure they can drink it). The implication is that many 'nurses' are ignoring the needs of patients purposely. Is this the case? I really hope not.

At the same time as we have a government who is bemoaning the lack of compassion within the nursing profession in particular, I have spent the past week wondering where their compassion for our society has gone. Let's take the issue of welfare and look at some of the views expressed:

Osborne's view that the welfare state has somehow funded the 'kind of lifestyle, that Mick Philpott led - as though there is a particular kind of lifestyle that leads to mass murderer. I am loath to promote the Daily Mail, but their headline says it all in relation to a particular view that is held about welfare by some in this country. and don't even get me started in the terminology used in relation to him being a father ('bred' the children). The government seems to see fit to blame the 'system' for Philpott's crimes (in my view because he represents to them what they most dislike in society more broadly) while conversely blames the individual for wealth-related issues such as lack of employment, poor nutrition and other inequality related areas.. A complete lack of compassion for the people in society who need help sometimes.

As a welcome counter-balance to the government's current messages, the following article puts right some of the falsehoods that are fed to us through the media (such as the Daly Mail) -'Separating fact from fiction'.

So - how to relate this to nursing education? Firstly, as people responsible for educating students in practice and/or university settings, we need to be informed and educated ourselves so that we understand our own views in ways that relate to the patients (and others) that students work with. Secondly, a call for compassion within healthcare is absolutely right - the many nurses and other healthcare professionals who care every day demonstrating compassion in challenging circumstances would agree with the current emphasis on ensuring that we are person-centred in our interactions with patients. Role modelling is vital in healthcare - where there is compassionate leadership, there is likely to be compassionate care. So let's hope the government realises this before too long. At the moment, there's not a lot of compassion evident in the voices that we hear in the leadership of our country.