In her fourth blog of a series, Clare Price-Dowd talks about the importance of care and the role it needs to play in our day to day lives, both in our work and towards our colleagues.
The 6Cs – care, compassion, courage, communication, commitment and competence – are the building blocks of Compassion in Practice, drawn up by NHS England chief nursing officer Jane Cummings and launched in December 2012. In my previous blog about compassion, I mentioned that somebody once said to me that there is more to nursing than caring for people; that’s what we are paid to do. It’s about caring about them as well and that is often what is lacking. We see a lot of fantastic technical care for people who are ill but do we really care about them as individuals? Do we really care about what is happening to them when they’re not immediately sat in front of us in a hospital bed or in a waiting room? In this blog I want to think about what care means to me and what it means to be ‘care-full’ – or as I like to think of it – full of care. It’s a phrase that gets used an awful lot, ‘take care,’ ‘be careful…’
But do we really mean it?
I think there are a lot of nurses who are still registered but don’t work in traditional nursing environments. We could work anywhere from prisons to offices – like myself, working in non-front line service delivery roles – but that doesn’t mean that as part of the large NHS family we care any less than the people at the bedside.
So where do people such as myself find an outlet for this care? I think one way is caring about the work that we do and making sure we retain a line of sight to the patient, however many steps removed that is. The second is caring for and about the people we work with – our co-workers, peers; call them what you like – but the people that matter to us day in day out as we go about what we do.
Caring about the work we do
I work at the NHS Leadership Academy in Leeds, and on a good day I have direct contact with patients, service users and their carers, at other times I am only one step removed from the patient. I could be working with a nurse who is a full time clinical care giver but on other days I am many steps removed from the patient. Retaining that line of sight becomes quite difficult when you’re bogged down with deadlines, bureaucracy and papers to produce, but it is of upmost importance that we never lose sight of the end recipient of what we do. That piece of paper you’re writing that will go to someone else for approval, then on to a board and a whole project team put together to bring it in to fruition; it may seem far from ever making a difference to patient care or staff engagement, but it could be the thing to make a world of change. Caring in that context is about giving the best of yourself to producing the best work you can, which then gives it the best chance of success.
Caring about including others
Being care-full also means being inclusive with your thoughts on how something could be done. The NHS is huge, and what you’re thinking of doing might touch a few, a few hundred or a few thousand of the 1.4 million NHS employees. Make sure your care extends to getting the opinions of everybody that matters, not just valuing your own because you think you know what you’re doing. We must be inclusive of others’ thoughts and opinions, and mindful that with a diversity of opinions, some may not agree with yours. It’s also about caring that everybody’s voice is represented in everything we do.
Caring about our colleagues
The second thing is around caring for the people that we work with. I can best frame it by thinking about when I have felt cared for by my peers and colleagues, particularly in the Academy. People who have noticed that I don’t look as sparkly as I did or “Blimey you look tired this morning” or “Are you ok – you’re not your normal self?” People who actually take time to notice. We talk about observation in nursing, but when you don’t have clinical charts, vital signs and equipment telling you someone is deteriorating, how do we notice that people are deteriorating and think about how they might be feeling at the time and how we can support them? There is something about being caringly observant and not just saying ‘oh she’s probably just having a bad day’, then ploughing on with your head down. A quick ‘Are you ok, do you fancy a coffee, is there anything I can do?’ can trigger someone to tell you what they are really feeling on that day. You do risk being told to mind your own business and go away but I think that’s a risk worth taking if you can do something that really shows you care.
I had a fabulous instance of being shown fantastic care from my team. My husband was very ill last year and while I really wanted to be part of my team’s training day, I really needed to be at home. I went to the first hour, then left the team so I could be with my husband on the receiving end of NHS care. They had sent me away with a bunch of flowers and a bottle of wine and contacted me the next day. They knew my thoughts wouldn’t be with them but theirs were certainly with me, which made me feel really cared for. It also made me want to check back in with them after he was starting to recover as I felt cared for, which in turn made me want to care about others.
Caring about our future NHS staff
Caring for the people you work with is also about not being precious about your own area of work. I am a great believer in not pulling up the ladder behind you. Working in the NHS means you’re part of an enormous system. Some of us stay for years, some of us stay for months or weeks, but with each place you work you develop skills and get opportunities. I have all too often seen people hoover up every opportunity they can, then not support the generation coming up behind us. I personally care greatly about the skills development of the next generation working in the NHS. I think that passing on what you have gained in terms of knowledge, skills and expertise is one of the most caring things you can do. We are all going to get older and unless we are very lucky, we are going to be recipients of care so don’t we want the people looking after us to be the best that they can be when they care for us? We can support that by helping them progress, not hanging on to the knowledge we’ve got. It is very easy when we are busy to say I don’t have time to sit and talk to people, so take them along to the meeting with you. If you spot talented people, get them involved, get them to shadow you, introduce them to people who may be able to help them as they go through their career. Showing people you are interested in them is just as important;, it is a manifestation of showing people that you care about them as individuals and not just the work they can perform to help you .
Ultimately, you don’t have to be a clinical nurse to be a caring NHS practitioner. It doesn’t matter where you are; you can live that every day. To me, care is one of the things we can get spectacularly right with not much effort and spectacularly wrong with carelessness rather than care-fullness. I would like to see people caring as much as they have the capacity to do so, both about the work that they do and where that might lead in terms of patient care even if that is three or four steps removed and also about the people that they work with.