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InFocus

Whatever happened to compassion in nursing?

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.

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