Dr Maria Flynn and Dr Dave Mercer from the University of Liverpool‘s School of Health Sciences
“We are pleased to see that the Francis Report recognises the negative impact of organisational culture on nurses and nursing practice. The findings and recommendations of the Report echo an evidence research review that we have recently undertaken.
“Our research review indicates that nurses hold compassion, empathy, dignity and respect as core values. The evidence also shows that the delivery of compassionate care is the result of the interaction between individual nurses and social context of nursing, and that organisational factors can exert a damaging influence on professional values and practices.
“The failings at Stafford Hospitals may suggest that care standards are in decline, largely due to the organisational culture, but the reviewed evidence would not support an argument that there is a compassion deficit in the nursing profession.
“The recommendations of the Francis Report are to be welcomed by all those wishing to see improvements in NHS care. In our opinion, though, when the social welfare ideals on which the NHS is built are being systematically dismantled it is likely to be at the cost of compassionate care. Compassion is not a recognised feature of competition, market forces or privatised service cultures.”
Thanks for this commentory. A couple of points. First, nurses (or anyone) can hold a compassionate view but they may or may not act compassionately. Nurses are now being found to act in an uncaring way at times and this remains a clear ethical concern for all concerned. Second, there is a risk in your analysis of countering one form of explanation (of psychological reductionism about nurse conduct) with another (the reductionism of political economy). Not only are both important, a range of other systemic factors are relevant, such as hospital design, norms of nursing action (for example about checking patients and hygiene) and whether acute care can ever be holistic, especially when dealing with elderly patients. We need to reflect on systemic complexity and not slip into reductionist reasoning. There is no one reason why scandals happen just like there is no one reason why cancer happens!