Care and compassion: primary needs for staff

Following recent discussion of The Courage of Compassion report, Kate Woodhead RGN DMS further considers the importance of ensuring ‘autonomy, belonging and contribution’ in order to retain and safeguard the wellbeing of those working in health and social care.

An article published in the last edition of The Clinical Services Journal told half the story1 of The courage of compassion – a report which commissioned the King’s Fund to examine the necessary improvements in the workplace to enable nurses and midwives to flourish and thrive at work. The article reviewed the conditions under which many nurses and midwives work in the NHS in primary, secondary and social care and made recommendations on how this could be made better to address the very real and imminent threat of healthcare workers leaving the professions in droves. The story is one of being undervalued, unempowered and underpaid. The local conditions under which they work often include being unsupported, they may even be bullied and harassed, as well as trying to maintain the service under COVID-19 stress. So, while the public were clapping key workers, which signalled their support, the employers were, in many instances, unable to provide suitable environments in which to work. The care givers, as many readers are, will frequently put their patients first at the expense of their own wellbeing and, only when there is time to raise one’s head to look around, will the damage be apparent. This article reviews the other aspects of

the report and explores the three core needs identified which nurses and midwives require, to have a worthwhile and satisfying career in which they are enabled to deliver high quality care. Examples of good practice pepper the

text, allowing other Trusts to review means of change. The three core elements are ‘Autonomy, Belonging and Contribution’.


Three subsections are addressed in this chapter, each of which has an impact on autonomy. Autonomy is defined by the report as the need to have control over one’s work-life, and to be able to act consistently with one’s values. l Nurses and midwives feel they have real influence and voice across their organisations and within their teams and departments in relation to decision-making, innovation and their working conditions.

l Nurses and midwives should work in just and fair workplaces characterised

The care givers, as many readers are, will frequently put their patients first at the expense of their own wellbeing and, only when there is time to raise one’s head to look around, will the damage be apparent.


by equity, positive diversity and comprehensive inclusion.

l Nurses and midwives have the right work conditions in relation to their physical wellbeing, required resources, time, facilities and sense of the right to and necessity for breaks, and flexible and predictable work schedules and rotas.2

In order to ensure that nurses and midwives work in an environment where they have a voice and feel they can influence the way of working and management of their organisations, or at least to be able to express an opinion, a culture of inclusive leadership needs to be in place. This way, staff will feel that their workplace is a just and fair place to work. Bullying and harassment and all discrimination must be eradicated, as well as ensuring that all procedures are transparent and fair to every staff member. Fundamental to our sense of autonomy is the sense that we can help to shape decisions within a team and that we have a voice which is heard. Our suggestions and opinions are listened to and respected. One of the strange paradoxes in nursing is



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