Tag Archives: Mental Health Nursing values

The value of human life

Hospice Cares For Terminally Ill During Final Stage Of Life

After reading Simon’s blog post last week I got thinking about why his ideas made me feel so uncomfortable. I can’t help agreeing with many of his points, but when you add them all up – well, I felt there is something in the middle of it that is a larger issue, and one that I think we in nursing need to get to grips with. 

In trying to say how we feel about the value of human life – our own and others –  it is hard to articulate it without using spiritual language – there’s nothing wrong with that, but if you are not coming from a spiritual perspective then an alternative is required.

Being human is, I feel anyway, more than just rights and responsibilities, and more than comparing ourselves to a ‘beloved pet’. Maybe it’s also about acknowledging how difficult – and in fact impossible – it would be to ‘press the button’ on another person’s life.

In this situation, the difficulty would not be for the person leaving, but for those left behind. What do we become once we have agreed to sign away another person’s life, even if they themselves ask us to do so? Does this mean that life is only worth something when we are intellectually and functionally 100%? What does this say about our relationships with other groups of vulnerable people?

To me, this discussion is not just about what a person loses when they have dementia, or another life-limiting and damaging condition, but about the culture which we live in, and which it is our responsibility to guide.   

Hospice Cares For Terminally Ill During Final Days

The ‘right’ to say you want to die in certain circumstances does open possibilities for foul play, as Simon suggests, but more importantly, I believe, it damages our sense of community, our cultural heritage and recognition of our inter-dependence. Individualism seems to be increasingly prioritised in our society and in nursing itself – the trio of autonomy, independence and intellectualism seem to be valued above other qualities with little argument.

To me this route ignores the reality that we are all strong and vulnerable in different respects and at different times, all have hidden or visible disabilities, all work better together than we do apart, and all are damaged when one (and who’s next?) chooses suicide or euthanasia.

 

Instead, we should be campaigning for inclusion and for investment in sensitive provision of excellent standards of care. For those who need it now, and for those who are planning ahead, we shouldn’t be assuming that lack of intellectual ability makes us less of a person, and thinking about how to ‘jump before we are pushed’.

 How can we recognise and celebrate the individual differences that make us all who we are, in different parts of our lives, as part of a caring supportive and accepting community with mutual interests at heart?

 

(all images from Picapp – click image for info re source etc)

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.