THEFrancis Report is extensive at 1,782 pages and with 290 recommendations. However, reading the harrowing accounts provided by people who were fundamentally and often cruelly let down by a system and by those who were there to care for them takes us straight to the heart of what Francis is about.
When I was invited to write about Francis from a mental health nursing perspective, it was these powerful stories about patient experience that really connected with me in thinking about the key messages from Francis in relation to nursing.
The importance of culture
The scale and magnitude of what was uncovered by the inquiry is seemingly incomprehensible and it could be easy to distance ourselves from it, by thinking ‘it could never happen here’. However, the key theme appears to be ‘culture’ and therefore in order to keep our service users safe, we must try to understand how such a toxic culture can develop and flourish.
Whilst we should be rightly proud of the care that we provide, Francis is a poignant reminder of how cultures and teams can become disconnected from our core NHS values of care and compassion.
In my role, I spend time in clinical areas and I listen to people’s stories about their journeys. I am always struck by the humanity in the care that is being provided for people in our Trust services.
The stories we hear in our everyday practice bring meaning, significance and context to our understanding of a person’s experience of care. They also allow us to connect with human issues and to communicate in a human way with people who are often at their most vulnerable.
Why I’m still here as a nurse
Compassion is a human quality; it involves giving something of yourself. It’s about having empathy for someone in a way that makes you want to reach out to them and help alleviate their pain, distress or suffering.
Francis does not place responsibility for the outcome of the inquiry with a specific professional group and rightly so – care and compassion should be central to the care provided by all professional groups. However, as a mental health nurse, I welcome the focus on compassionate nursing in the National Nursing Vision and Strategy, Compassion in Practice.
Within this framework, compassion is defined as one of the 6Cs of nursing. The 6Cs: Care, Compassion, Competence, Communication, Courage and Commitment are essentially nursing values and behaviours, and they symbolise for me what is special about nursing. They remind me why I became a nurse and why I am still here, 20 years later.
Nursing is a remarkable job and it attracts some really remarkable people. Every single working day, my nursing colleagues are caring for and supporting people in circumstances that can be very challenging and difficult. Every single working day, nurses make a difference to people’s lives and they just get on and do what they do, with a minimum of fuss.
Taking care of ourselves We must be mindful that working regularly with high levels of emotional distress has an impact on nurses. Opportunities for reflection, supervision and support are crucial for our wellbeing and to enable us to do our jobs with care and compassion.
We shouldn’t underestimate the importance of both giving and receiving support, as its central to the care that we provide to others. Compassionate care has to be the focus of all care provided across the NHS.
However, when I think about times that I have received care from the NHS, it’s the nurses that I remember most, as it’s often nurses that spend the most time with a person during their journey of care. It makes sense to me therefore that we should have a renewed focus on compassion in nursing.
I want to conclude by saying that one of the key messages from Francis relates to why we must nurture compassionate values as nurses. Francis conveys an important message to us all about the special and privileged nature of the relationships that we form with the people in our care, often at a time in a person’s life when they are feeling most vulnerable.
We must always have the interests of the people in our care at the heart of everything we do and we must ensure that we consistently provide care that is caring, compassionate, dignified and respectful. To know that we have achieved this, we must truly listen to the human stories that people share with us about their care, every day.
Vanessa Garrity is a Mental Health Nurse, Social Media Nurse and Director of Sociable Angels Ltd