Abstract
Compassion isn't even a dirty word in the National Health Service since it is a behaviour that, according to popular belief, isn't displayed by clinicians who are too preoccupied with targets, efficiency drives, and restructuring to care for their patients—in the Florence Nightingale sense. A spoonful of compassion helps the medicine go down but also helps nudge your institution's performance on patient satisfaction surveys in the right direction. These attacks on heartless unfeeling clinicians are a little unkind; plenty of compassion is displayed every minute of every day although admittedly not enough.
Ken Schwartz, an American lawyer who died in his 40s from lung cancer, wrote in the Boston Globe that ‘the smallest acts of kindness made the unbearable bearable.’ Schwartz was grateful for the care and compassion he received during his illness, a sentiment that perhaps too few patients are able to share. Clinicians are expected to control their emotions, a stiff upper lip preferable to a wobbly precursor to a tearful outburst. 1
The debate on compassion in healthcare focuses rightly on patient experience, although the emotional needs of clinical staff are usually forgotten and addressing them may lead to benefits for patients. Illness or death can profoundly affect carers yet where is the debate on compassion towards staff? What of their emotional trauma? As our clinical lives become more disjointed and insecure, the wellbeing of staff will be increasingly difficult to maintain. 2 Schwartz's family were so grateful for the care he received that they set up a legacy to support monthly meetings where staff freely, and confidentially, discuss their feelings about the care of a particular patient.
Known as Schwartz Rounds, these meetings have become established in the United States and are now being introduced in the United Kingdom. A pilot study in two trusts suggests that Schwartz Rounds are a source of support for participants, benefit patients and team working, and have potential to change hospital culture. 3 These are bold claims for a fascinating initiative. Failing that, a social influence approach based on nudge theory and custard creams might be worth considering. 4