28 / 10 / 2014 12.01am
By John Holden
#Blogtober Day: Tuesday 28 October
Since primary care was re-organised in April 2013 the removal of all supervision for nurses in general practice has become an ever increasing issue. This is unsatisfactory in many ways; the most obvious being that doctors and nurses have very different approaches to care and patient relationships, a view from practice nurses I have been working with.
Recently I was asked to support practice nurse appraisal training for a local Clinical Commissioning Group from an organisational development perspective. It is clear that the demands placed on nursing care and our nurses have risen; and in light of a number of influential reviews, the pressure to perform at the highest standard and ensuring that patient care and the patient experience, are at the top of everyone’s agenda. This is in turn is placing increasing demands on the system to deliver.
On a rare but inevitable occasion, sometimes the systems set up to ensure this excellent care for patients fails. Arguably often as a result of lack of support, clear guidance, appropriate measures to support healthcare professionals and organisational cultural issues, the appropriate care is not given. While the whole system needs to be accountable for any care delivered, there is also a responsibility on the individual to understand what excellent care looks like and to raise appropriately, concerns and challenge to the system when needed.
When I looked at developing a framework to support the appraisal process that could potentially align with revalidation, the Compassion in Practice 6Cs jumped out at me, providing an excellent framework for developing conversations around the challenges currently facing health care practitioners especially those working in isolation within the community settings.
Care, compassion, competence, communication, courage and commitment lend themselves beautifully as the cornerstones of a great conversation with healthcare professionals. Using these cornerstones to develop a mature, meaningful, challenging and reflective conversation, between two people exploring and examining the successes and challenges faced on a daily basis, has proven incredibly valuable. It enables individuals face those every day complex situations and respond with professional competence and genuine care for the patient.
The coaching style conversation methodology we have developed, built around the 6Cs, allows the individual to close the gap between current and potential performance. The coaching relationship allows the health care professional to unlock their resourcefulness, helping them to desired sustainable change. Yes the conversation can be uncomfortable and difficult, such as asking: “when haven’t you been compassionate?” but with skill and sensitivity this reflective approach can allow support to be given in a non-threatening way through self-exploration which aims to facilitate necessary changes in behaviour.
Health and care systems are traditionally geared towards targets, but placing an organisational development philosophy and mentality at the heart has opened up a potential revolution within the system. By helping to realign and reignite care, compassion and a positive culture back into the value base of those with direct patient contact, has the potential to be liberating for both patient and practitioner. Long live the revolution.
John Holden is the Organisational Development and Transformation Senior Manager at North West CSU. John is passionate about change, empowering individuals and supporting those that society has turned its back on. You can contact John via Twitter @JohnHolden13 or via email address.