Time to Care

A 2008 study by the King’s Fund, “Seeing the person in the patient” has concluded that nurses are failing to communicate compassion, respect, and emotional support when providing nursing care.  The authors of this study point out that patients are generally satisfied with the standards of medical and nursing intervention, but often feel on the receiving end of depersonalised and dehumanised care.

The recent NHS review & the subsequent department of health documents including “High Quality Care for All: NHS Next Stage Review” appear to emphasise the position of nurses being at the fore-front of improving the quality of patient care.  However, at the same time significance is equally afforded to the need for nurse to strive to achieve targets and outcome measures in other areas of their clinical practice that may impinge on their time and ability to provide holistic patient-centred care.

Maben & Griffiths (2008:5) suggest that “nurses have lost their way while navigating the complexity of the increasingly technical environment that is contemporary health care.”   Undoubtedly, technological advances, organisational, and educational changes have influenced the position and role of nurses in the provision of healthcare. 

Yet, within this fast-paced technological world has there been a shift in the central primacy of care and caring within the ideology and values of nursing practice? 

The nature of caring appears synonymous within the core qualities, skills, and competencies of nursing practice.  Effective communication, listening, conveying empathy, integrity, and positive regard are some of the interpersonal attributes at the heart of caring relationships. 

However, it has been suggested that “the bureaucratisation of health has contributed to the hospital setting and care becoming a soulless, anonymous, wasteful, and inefficient medical factory performing medicine as medicine demands it, not as the patient needs it”.  (Porter 2002 cited in Goodrich & Cornwell 2008: 1).

Is it always possible for nurses and their allied healthcare colleagues to provide the highest level of individualised care that meets the multi-factorial needs and wants of the individual and their family?  Furthermore, what are the central drivers influencing receivers (patients) and providers (nurses) experience of care?  Finally, as professionals with a vested interest, how can we engender the values of compassionate and personalised care in today’s student nurses that form the fulcrum of their future practice?  Remember, they are the workforce of tomorrow.

One thought on “Time to Care

  1. I agree with the recent study that you mention in your blog Paul. I am in the process of preparing a presentation workshop for the mental health conference and aim to address similar issues. From my experience as a student nurse and a temporary bank staff worker, I have witnessed both good and bad basic nursing skills.
    My biggest concern is the lack of basic communication between staff let alone interactions with service-users. How do nurses aim to build therapeautic relationships with service-users if they cannot even communicate with each other in basic conversation. Is this an example of poor communication skills or is it just rude behaviour?

    Everything we learn throughout our nurse training revolves around communication, so how can there be such a poor example or lack of communication out in practice?
    Yes we all have responsibilities, targets and paperwork to do, but this is no excuse for lacking the basic core nursing skills.
    We are required to provide nursing care to people with mental health problems, vulnerable people who may be feeling lonely,scared, or confused. Now imagine been in an environment where people (who are supposed to care for you)barely talk to you, or if they do, shows no genuine interest or respect you as an individual.
    The interpersonal skills you mentioned above (empathy,
    effective communication, listening and positive regard) are all core nursing skills that I beleive every nurse should display in practice.

    If we as students do not value and develop these basic nursing skills,then I feel we have chosen the wrong profession.
    It would be useful to take a moment to reflect on your experiences in practice and think about how you communicate in practice.

    To end on a positive note, there are nurses out in practice who provide excellent nursing care, possess the
    relevant interpersonal skills and effectively communicate with staff and service-users.

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