As health care professionals, we have incredible jobs that place us in the extremely privileged position of looking after our patients with care and compassion through dedication, motivation and enthusiasm.
For many of us this is what makes our chosen career so rewarding. We know that we can make a significant difference to the health and social care experiences of the vulnerable people we meet by ensuring that we provide the best possible quality of care at all times, through open and honest communication, competence, courage and commitment (NHS Specialist Commissioning Board, 2012).
We also know that the care that we would expect as service users is not always the care that some of our patients receive or deserve. Recently, the author accompanied a family member as they were admitted into a hospital ward and was disappointed by the complete lack of communication, care and compassion. No one in the ward introduced themselves or asked anything about my relative, other than to check that they had the right name and address (which, in fact, they didn't).
There seemed to be an expectation that the ‘patient role’ would be adopted, that no questions would be asked of the care received or the time it took for investigations to be organised and performed. There was also a distinct lack of interest in the individual, what the patient was experiencing, and what could be done to help; most significantly in relation to relieving pain and discomfort…no one even bothered to ask.
As a nurse, this attitude frustrated and disappointed me—where was the person-centred humanistic care? When did we return to a task–oriented system of care delivery where the patient became a number, a body in a bed, another statistic, or a tick box to demonstrate that quality indicators had supposedly been ‘met’? There was no quality in the care received; there was no care and certainly no compassion.
True, this experience transpired in a hospital setting, but let us transpose the situation to the pre-hospital environment and focus on one specific aspect of care—that of pain assessment and management.
Pain is the most common reason for an emergency call to the ambulance service (Health Care Commission, 2004) so competence in this area is essential for the practicing paramedic.
Take a few moments to reflect upon your own practice and that of your colleagues and consider whether, when on a callout, you listen to the individual in pain and what they tell you they are experiencing, or whether you merely manage the condition. Not everybody demonstrates pain in the same way, some will whimper, some may cry and some may be stoical. Pain is unique to the individual who is experiencing it, and it is important that we try to understand their emotional response to pain as well as gathering the numerical data, which is important for patient care and as a quality assurance measure.
Finally, take a moment to consider how caring and compassionate you are about and with your patients and whether there is anything that you could change.
‘…we need positive role models to foster these qualities in others, encourage challenges to the status quo…’
Care and compassion are high on the agenda following several recent reports highlighting stark failures in health and social care (brought about by Winterbourne View, Mid Staffordshire Foundation Trust), and we await the report from Robert Francis QC on how to manage these failures forthwith. Additionally, the NHS Specialist Commissioning Board (2012) have published a vision building on the values set out in the updated NHS Constitution for England (DH, 2012a) and in the Caring for Our Future governmental white paper (DH, 2012b).
‘…to deliver high quality compassionate care and to achieve excellent health and well being outcomes…’
There are some fantastic examples of excellent healthcare that we can all learn from, as well as reflecting upon the less good examples, to consider how we can all respond dynamically to offer a better quality service for our patients and their families.
Being a traditionalist I believe that the values of care and compassion should be inherent in every health care professional, but we need positive role models to foster these qualities in others, encourage challenges to the status quo, and prevent socialisation into cultures that are perhaps not always the best for our patients.
Have you got what it takes?