Nursing has changed significantly over the years. Since the inception of nursing as a profession the understanding of what makes a good nurse has been debated. “The very elements of what constitutes good nursing are as little understood for the well as for the sick” (Nightingale, 1860). I dare say that as Florence wrote this first text on the art of nursing it was a defining moment which changed the way nurses think, act, and do… However, in the doing of nursing is where the confusion remains. Instead of doing, should we instead focus on ‘being’? Afterall, “To be or not to be, that is the question” (Shakespeare, 1564 – 1616).
When we consider this as nurses, we understand that person centred care is a philosophy that places the individual at the heart of their experience. It is an approach that respects and values the entirety of what makes a person uniquely individual. Yet, this theoretical concept is often confused, and little understood from a practical standpoint. It comes back to the question, as nurses today who adopt a person centred approach, are we ‘to do’ or are we ‘to be’? In spite of the differences of being and doing, a main focus of each of them has been on the way we support the people we care for. But what is person-centred care, and how can one person be expected to say what is and what isn’t person centred for someone else?
Well, the only way I can rationalise this in terms of my clinical practice is to look at what ‘doing’ and ‘being’ actually means. The answer is not simple, the very premise of person centred care is unique and individualised in itself. What does that mean? – essentially for me, it’s different from person to person or nurse to nurse and usually takes a little of both ‘doing’ and ‘being’. So, have we moved on from Nightingale’s preposition that confusion remains in the realm of nursing? Personally, I think we have come a long way!
The argument ‘To do’.
In an article I read on the internet, a quote by Ricky Gervais said “you should bring something into the world that wasn’t in the world before. It doesn’t matter what that is. It could be anything – everyone should do something for self and others, then sit back, and say, ‘I made a difference'” (N.A.Turner, 2019). In essence this is true, as nurses we not only make a difference by the nature of our roles, but we also create the ability to connect with people as well as support best practice and evidence-based care to be a reality. So yes, doing something is important.
The argument ‘To be’.
Socrates said that to find ourselves we need to be ourselves. Your passion, your values, and your extraordinary capacity to make a difference is intrinsically linked to why we decided to ‘be’ a nurse. Compassion is the cornerstone of nursing, a gift that brings solace and healing to those in need and this is the essence of being a nurse. Shakespeare made these words famous in the soliloquy of Prince Hamlet in his play, at the very core it is literally a question of choosing to live (being present) or not (existing). Humanity was not designed to simply exist; we are feeling beings. Emotions and feelings are a universal language. By embracing being not only ourselves as nurses but understanding what this means for those we care for is fundamental to nursing practice.
So now we can see to create a true new culture in nursing and embrace practice in a way which matters, there needs to be elements of being and doing. But how does this reconcile with person centredness? At Meaningful Care Matters we believe there are three essential practice elements.
1. Dignity, Compassion, and Respect at the Forefront
It’s crucial to understand that despite what may be happening medically, physically, psychologically or around the person we are supporting, they still have their own thoughts, needs, and feelings. When we can reach a place where regardless of diagnosis or cognition, we can seek to understand each other’s needs and opinions, ultimately this empowers people to feel more in control of their journey and own health. Dignity, compassion, and respect MATTER.
2. Support people to ‘Find their voice’.
Your voice MATTERS. Supporting people to find their voice and making sure this is heard is critical to support people to live life versus existing in life. Life story, people that are connected through relationships and finding a way for voice to be heard is where individuality and the core spirit of a person comes from. In life, finding your voice is about speaking and living the truth. Each one of us has our own distinctive voice. It’s what drives us and what makes us unique. Voice is not something spoken or shouted, it is about the core essence of who we are as individuals. For true person centred care to become a reality we have to ceaselessly discover that inner voice so you can be heard regardless of whether you can speak or not!
3. Create and promote with purpose a fulfilling life for those we support.
Purposeful living MATTERS. Purpose can be found in many places, and it is at the heart of everything we do:
- It’s about supporting people to make choices that align with what feeds their soul.
- It’s about connecting with meaning and supporting independence regardless of any limitations the person is facing.
- It’s creating moments in care where people can be supported and support others in return.
As nurses we have the unique opportunity to be beside people and provide hope and light regardless of the situation. To me this encompasses both BEING a nurse and DOING what I can do to make a difference, for both the people we care for and their loved ones. Only through demonstration of true caring with heart, soul, emotion and clinical expertise do we empower and create a safe space giving those we support the peace to be able to share their fears and feelings. The privilege to care for others when they are not able to care for themselves is a true calling and one not to be taken lightly.
That’s the new culture of nursing.
Managing Director, MCM
Works Cited
N.A.Turner. (2019, August 5). Ricky Gervais on Chasing Your Dream, Doing the Work and Living a Creative Life. The Startup. New York, New York, United States of America: Medium.
Nightingale, F. (1860). Notes on Nursing. What it is and what it is not. (First American Edition). New York: D. Appleton and Company.
Shakespeare, William, 1564-1616 author. (1623). The tragedy of Hamlet, Prince of Denmark. [London]: The First Folio.