Access provided by
London Metropolitan University
Even with huge work pressures, every team member can help create a culture of compassion in which we learn from our mistakes
Kind, considerate and empathetic care is provided in our hospitals on a daily basis. Sadly, this isn’t always the case. I am reminded of this when I recall a hospital encounter between an older couple and a care assistant. The couple, who appeared to be in their eighties, were sitting together when the refreshment trolley arrived. Both looked unwell but the woman had been admitted as a patient and her husband was visiting.
Nursing Standard. 38, 8, 33-34. doi: 10.7748/ns.38.8.33.s17
Published: 02 August 2023
The patient was offered a cup of tea by the care assistant attending the trolley. Her husband – no doubt tired and thirsty following a long wait by his wife’s side – asked for a small cup of tea. His request was flatly and abruptly refused. The sick wife shared her own cup with her husband instead.
This image has stayed with me. I wondered how a hospital staff member could respond with such a lack of empathy to such a simple request.
Blaming one person will not prevent such a situation from happening again. Punitive methods of dealing with staff behaviour focus on dealing with poor behaviour rather than encouraging positive staff behaviour, and lead to a lack of learning from incidents.
We must look more deeply into the organisation’s culture to understand why this staff member felt they could not offer a cup of tea when there was a large pot on hand, and why they did not offer an apology or solutions?
It is likely in this case there were protocols in place to protect hospital resources, such as refreshment trolley supplies allocated for patient use only. The staff member was probably adhering to these. However, sticking to the protocols compromised the visitor’s dignity because he was left visibly embarrassed in the busy ward. This was made worse by the abrupt manner of the response.
Healthcare staff can sometimes underestimate the impact a kind act has on someone. Compassion in the hospital setting means acknowledging suffering and using initiative to do something about it. This might be a small act of kindness initiated by nurses, or any staff member, in keeping with the ‘no wrong door’ approach, in which any staff member – regardless of role – is empowered to deal with local issues such as minor complaints and care concerns.
‘Perhaps we turned away when we should have displayed kindness. We are human and make mistakes, but we can use these to reflect and improve’
Creating a culture of compassion is integral to our healthcare values, but the responsibility is not that of one staff member alone. Principles of kindness and empathy need to be integrated in all aspects of the organisation and managers should lead by example.
To create a compassionate healthcare culture organisations require strong, inclusive leadership supported by team-focused staff in a structure that acknowledges the complexity and unpredictability of healthcare. This ensures a high standard of care is provided in an open and timely manner.
Compassion in healthcare improves patient outcomes and strengthens working relationships in the multi-disciplinary team. A kind and caring healthcare culture can encourage transparency and protect against harm.
Attitudes and communication methods of nurses and healthcare staff contribute to the culture, seeping into the surroundings of a hospital, creating either a pleasant or unwelcoming atmosphere. The language of leaders and staff affects the culture and sets the tone of the organisation.
We all know the saying ‘it’s not what you said, it’s the way you said it’. The way in which information is provided determines how it is interpreted. Perhaps the visitor who asked for some tea would have retained some dignity if he had been more kindly informed that the refreshment trolley supplies were only for patients. Staff could have acknowledged his long wait, apologised and offered information on where he could get some refreshments.
We often reflect on the way we reacted or responded to someone and wish we had behaved differently. Perhaps we were tired, burnt-out or worried about something at home, and absentmindedly snapped or turned away when we should have displayed kindness and compassion to those in our care. This does not necessarily mean we do not care for our patients and their families, it means we are human and make mistakes but we can use these experiences to reflect and improve for the next interaction.
The provision of compassionate care is simple yet impactful – it is when we display empathy for what the patient and family are going through, are polite and listen.
Kindness and empathy are not a show of weakness but of strength. This strength should be developed across healthcare structures through the work of healthcare leaders and their teams, making compassion the hallmark for how we do business.
Kindness – a practical support guide for nurses and patients rcni.com/podcast-kindness
