Tuesday, 15 February 2011

Can you teach someone how to care?

A shocking report has been issued in the UK today, outlining some serious failings in the quality of care given to elderly patients in the NHS. 10 cases of neglect and poor care were investigated by the Health Service Ombudsmen, Ann Abraham who stated ‘.... these accounts present a picture of NHS provision that is failing to respond to the needs of older people with care and compassion and to provide even the most basic standards of care’

The tragic cases include a relative forgotten in a waiting room, denying him the chance to be with his wife as she died, and an elderly lady being transferred from a hospital to a care home in a disheveled, urine-soaked state.

Before we leap to criticise the beleaguered, bloodied and bruised NHS, I think we should remember the personal responsibility of the ‘carers’ in each case.  Yes, an employer is responsible for the service it provides and the NHS is no exception. But lack of resources, staffing levels or the depressive state of the country’s largest employer is no excuse for laziness, lack of thought and lack of compassion.

My mother spent nearly ten years in a nursing home, suffering from severe dementia. She was a vulnerable, weak scrap of humanity who was wonderfully cared for until the day she died. Every time I visited her, she was beautifully dressed, immaculately clean and apparently content. When she became seriously ill, the staff continued to care for her with respect and gentleness. I suspect that these carers were paid no more than their counterparts in other homes or hospitals, but the culture of professionalism, dignity and caring was apparent in every aspect of the organisation. The birth and nurturing of this culture clearly originated from the management.

I was recently visiting a friend in the high dependency unit of an NHS hospital near London. She was very poorly as was everyone else in this ward – the clue is in the name ‘high dependency’. As I waited to see my friend, I was horrified at the noisy, unprofessional banter coming from the nursing station as two nurses loudly, and with some hilarity, discussed the intimate details of one of their patients. They were sitting at two separate desks and hadn’t even bothered to lower their voices as this inappropriate conversation continued.

In the end, it was too much for me. I marched up to the desk and suggested that the nurses should lower their voices as clearly their patients were unwell and needed rest. I also mentioned that patient confidentiality was being breached. My request was met with much disdain and as I visited my friend, the conversations continued, with increased volume, as I was now the target of the vitriol. As I left the ward, I asked the main perpetrator for the name of the ward sister as I intended to make a complaint. She sneered at me – ‘I’m the sister’

And thereby lies the problem. Management and leadership. Most NHS staff are caring and compassionate, but anything less should not be tolerated by their managers. I don’t believe you can teach someone to care. Yes, quality of service is compromised if funds and staffing levels are short. But considering a patient’s dignity, however old or seemingly unaware they may be is a basic human trait. If you don’t care about the wellbeing of people, or if you are not interested to note the distress of a concerned relative, don’t work in the NHS.

What the NHS needs most is strong leadership. Managers who lead by example, who are aware of the value of good emotional intelligence in a team, whether it’s an outpatient department, an intensive care unit or a GP surgery.

Forget your ‘big society’ Mr Cameron, it is these ‘micro-societies’ that count when it comes to good patient care.

This post is dedicated to the loving memory of the adored Bob Jackson, who died eight years ago today and received the very best of care with the help of nurses from  Iain Rennie Hospice at Home.(http://www.irhh.org/)


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