The single most important thing I want to achieve during my time as CEO is to reconnect our staff with what motivated all of us to join healthcare in the first place – to care for patients with compassion. Over the last 20 or 30 years, I’ve seen healthcare get so complicated and pressured, and I worry that the system simply squeezes the motivation out of us all. As part of rekindling that, we hosted a wonderful line up of speakers and workshops for the Patient and Whaanau Centred Care Programme last week. I’m joined by Dr Robin Youngson, the founder of Hearts in Healthcare, to talk about compassion in care and why it’s so incredibly important in healthcare delivery.
Robin describes compassion as the humane quality of understanding suffering and wanting to do something about it. It’s not just a feeling, but a motivation to act. But, as we’re sure you’ll agree, healthcare has become characterized by overwhelming demand, an almost frantic pace of caring, the need to focus on a very large number of tasks and a near-constant juggling of competing priorities, all of which make it hugely challenging for compassion to be articulated in the care we deliver. In our rush to meet demand, we often treat a pathological process, a diagnosis or a number and fail to see the person in our midst. Nurses, who were once able to concentrate on delivering the core tasks of nursing with compassion, are now expected to simultaneously manage all the patient care tasks, records, handovers and new technology. Sadly staff who quickly complete all their tasks are often rewarded, while the nurse that sits down quietly with a frightened patient for ten minutes to hold their hand, listen and provide reassurance, comfort and loving care may be told to stop wasting time.
We know that a patient’s psychological and emotional wellbeing is intrinsically linked to their physical health outcomes so we need to understand and care for the whole person. A recent study in Italy of some 20,000 patients with diabetes investigated the degree of empathy displayed by their GPs. The patients cared for by doctors with high empathy scores had 40% fewer hospital admissions for diabetic keto-acidosis – a life-threatening complication of diabetes. This is just one of many studies which show the close relationship between the relationship skills of doctors and the clinical outcomes of their patients.
Demonstrating compassion does not just bring benefits to our patients. Reconnecting health workers to the purpose of their work can also help with motivation and act as an antidote to burnout and tragedy. Each of us has two jobs every day we come to work – to care for our patients and their family/whaanau, but also to care for ourselves and our colleagues.
By the very nature of what we do, we all go through hell at times and are witness to awful tragedies. Robin tells a story about working as an Anaesthetic Registrar at Middlemore, one Saturday in 1990. “I witnessed in quick succession the death of a mother, a baby and a 19-year-old trauma victim. It was an utterly awful day but there was no suggestion that I shouldn’t just keep working. In fact, I anesthetized five more patients on that long shift and then came to work the next day for another 15 hours. There was no support, no debriefing and no acknowledgement that I, as a human being, was profoundly suffering and traumatized by the experience and that that would impair my capacity as a doctor at that time.”
Robin continues, “Compare that to an experience I had two years ago when I was involved in a similar case, the death of a young mother. I had to go and tell the husband that his wife, who’d walked into the hospital an hour before, had passed away and that he was now left with three small children and a newborn baby. It had tragedy written all over it. This time I recognized the situation for what it was and took two weeks leave to look after myself. Compassion isn’t just what you show others but also what you show yourself. I was a better doctor to my patients and a better team member for my colleagues when I acknowledged this.”
As part of last week’s Patient and Whaanau Centred Care Programme, Robin ran Compassion in Care workshops for staff. These weren’t about teaching compassion but about how to liberate knowledge and skills which are already deeply embedded within this organisation and its staff. Participants were encouraged to recall times when patient care was exceptional, when love and compassion was amazing, and when somehow it all came together. In doing so, they were reminded of the personal strength, skills, knowledge and environment that enabled this to flourish. One participant summed it up by saying “it appealed to my heart much more than the tick-box type of care that I think we have moved towards”. For Robin, what was hugely inspiring was the heartfelt commitment and unbelievable compassion for patients the participants shared, showing the capacity we all have to demonstrate compassion in care, even when we’re busy. Some staff talked of bending the rules and taking personal accountability to do the right thing for the patient.
The organisation is also working to foster an environment in which compassion can flourish. We offer Mindfulness training for staff, we’ve recently changed the rules around visiting and we now have a Patient and Whaanau Centred Care Programme. Perhaps one of the clearest examples of compassion in action is our Six Hours Can Be Ours campaign to reduce waiting times in EC. That wasn’t motivated by hitting a target, but by the acknowledgement that sticking a patient who is at their most vulnerable on a bed in a corridor for 18 hours was unacceptable. It didn’t pass the Granny test – it wouldn’t be good enough for our own family and therefore wasn’t good enough for our patients. As you know, through a whole-of-hospital effort we now provide compassionate care to the majority of EC patients in less than six hours.
I really want to build on these examples and create an environment that helps staff reconnect with their purpose and their motivation for joining healthcare. Especially at this challenging time we’re going through, fostering the compassion among us will help improve experiences, not just for our patients but also for our colleagues and ourselves.
Geraint and Robin