Acts of Kindness
In his book, Dr Youngson describes the personal impact on him when individual patients helped him to behave spontaneously instead of 'correctly'. He also writes about a time when his daughter was involved in a life-threatening car accident, and he found that small acts of kindness by hospital staff gave 'indescribable comfort' to himself and his wife. Dr Youngson criticises the way that doctors and nurses are forced to conceal their vulnerability, building up an emotional 'armour' that causes harm both to themselves and their patients. He draws extensively on fields like positive psychology, mindfulness, meditation studies and neuroscience, to build a case in favour of caring for yourself and loving your work – as a pre-requisite to being an effective health care professional. He points to the paradox that, when you are under pressure, it is better for you and your patients if you slow down or even to stop than to drive yourself even harder.
This is all persuasive as a moral argument, but people will want inevitably to know about specific interventions, and evidence of improved outcomes, before investing time and money in something as nebulous as kindness. 'Time to Care' includes a number of examples. In a hospital in Alabama, for instance, a chief nursing officer told staff they should see every patient once an hour to inquire about the need for pain relief, a visit to the toilet, whether they needed turning, or if they could reach everything they needed. The nurses found their work was interrupted less frequently, and they walked a mile less per shift, while patient falls declined by 58% and bedsores by 39%. Patient satisfaction scores rose, and so did results on a questionnaire asking if they would recommend the hospital to their family and friends.
In a similar project in the United Kingdom, leaders increased the time that nurses spent on direct care by 20%, and consequently cut handover time by a third, reduced the medicine time round by 63% and cut meal wastage rates sevenfold One nurse commented: 'The ward usually appeared calm – however busy. There was a place for all equipment so it was less cluttered, cupboards were tidy and only contained what was actually needed; vital observations were recorded, there were less patient falls, reduced drug errors, and above all, happier patients and staff.'