Whatever happened to compassion in nursing?

01 January 2013, at 12:00am

THE Government’s chief nursing officer said recently that there was a need to put the compassion back into nursing. Which begs the question, why did it ever leave?

There have been any number of stories over the last few years concerning the care of patients in hospital and after each one there is usually a bland statement along the lines that lessons must be learnt. Apparently, they never are.

What is going wrong? It is too simplistic to assume that things started to go awry when nursing degrees were introduced and the emphasis was changed from caring and compassion to academic skills and form-filling. There is, though, likely to be more than a grain of truth in this view.

Sue Bailey, president of the Royal College of Psychiatrists, chipped in too, suggesting that the tick-box culture was to blame, often at the expense of professional judgement, leading to dissatisfied and demoralised staff – with the all-important relationship between the patient and healthcare worker forgotten.

Prick up out ears

Since what happens in human medicine inevitably finds its way round to the veterinary field, we should all be pricking up our ears and wondering long and hard about how we can prevent this from happening in our own, as yet, excellent veterinary nurses.

Veterinary nursing degrees were first introduced in the late nineties and there have been many well-motivated degree-waving VNs produced since. Bearing in mind, though, what has happened in human nursing, we would do well to review how the VN degree is taught and ensure that caring and compassion are at the very heart of the whole syllabus.

If we do that then we can avoid the pitfalls in caring that seem almost ubiquitous amongst our human nursing colleagues.

As a starting point, it is hard to imagine why anyone would enter a “caring” profession if they did not already have a strong desire to “care”. After all, no one is going to get rich being a nurse, much less a veterinary nurse, and so money is clearly not the motivating force.

So assuming that student nurses and veterinary nurses begin their training with a desire to care for sick people and animals, one can only come to the conclusion (with regard to human nurses at least) that this desire is knocked out of them somewhere along their training or in their subsequent employment. This is a dreadful conclusion to come to but sadly the only one which makes any sense.

Either that or we are selecting the wrong candidates in the first place and there is certainly an on-going debate in this regard with the current selection process for veterinary students.

Clearly, if vets and doctors, nurses and veterinary nurses are going to do the right thing by their patients they must put caring and compassion at the top of their agenda.

Anything less and the results are all too obvious and, when they come to light, are splashed across the newspapers and the national TV and radio.

From the little I know about veterinary nursing training, there appears to be a current trend to push for the use of nursing care plans for animals that have been adapted from the human nursing field.

Bureaucratic nightmare

On many occasions that I’ve seen, the use of such plans has been a bureaucratic nightmare with the emphasis being on completing the plan in the right amount of detail, with the actual care delivered to the animal playing second fiddle.

I suspect that this scenario is all too common in human nursing care and that the auditing and accountability checks carried out by senior management rely heavily on finding the correct paperwork to be all in order, with little emphasis put on the actual patient experience.

Which is why we find ourselves in the position we are in when it comes to nursing care in hospitals. Too many patients treated as medical or surgical “cases” that require a specific set of interventions, and not treated enough as living and feeling humans who need to be cared for and communicated with as individuals with individual needs and wants.

Clearly, in veterinary medicine our patients are not in a position to tell us what they want and need, nor to complain when such needs go unmet.

Even more so then is the requirement for VNs to really spend time with patients and get to know them so that they can at the very least alleviate some of the stress that many of them must feel in a strange environment.

Are we teaching this sufficiently to veterinary nurse students on their current degree and diploma courses?

Are we emphasising enough the importance of understanding each patient as an individual and encouraging nurses to use their skills to ensure the comfort (both physical and mental) of the animals that they care for?

Are we emphasising enough that caring for animals (and people) requires a moral and ethical approach as much as practical skills and scientific knowledge? 

Are we stressing enough that whilst protocols and procedures have their place, no animal or person who is a patient is likely to ask to examine these protocols when it comes to them judging the care they have or haven’t received when in hospital? 

No matter how good the medical care an animal or person receives, if they are not able to relate to and engage with the people providing that care they will almost certainly have a less than optimal experience.

Before our VNs go too far down the road of following their human nursing colleagues, let’s hope that they draw back a little and reflect on why it was they wanted to be VNs in the first place. If they can do that then they can avoid the disastrous situation that human nursing seems to have blindly stumbled into during the last few years.