Challenging questions and ethical obligations: the ethics of everyday practice > 21 January 2015

Katie Borg and Tracey Davies


A Compassion Gap in NHS culture?

There exists a curious compassion gap in NHS culture. It is well known that following the recent Francis Report, “compassionate care” has become a prevalent theme within nursing training and practice (Francis 2013; Department on Health 2013). Nurses are expected to treat patients as whole beings, valuing their life history, emotions, physical status and family, and to understand them on a level that means they receive individualised, holistic care. However, nurses are concurrently also not expected to react strongly when things go wrong for their patients, be it acute deterioration, loss of independence, or even death (Maben 2014).

The discrepancy can lead to nurses being left feeling strongly for their patients, with no organised way of discussing their emotions after negative and traumatic things occurring at work. Clinical supervision exists as a compulsory part of working in mental health, but for general nurses, there is often no debrief or structured opportunity for discussion and reflection of difficult work-based matters, except for a 6 monthly appraisal. Guilt, and thoughts wondering if situations could have been handled better or differently are common amongst staff following a traumatic event, particularly as it is required to care compassionately for our patients – with no way of voicing this, or working through scenarios with others, nurses can be left feeling inadequate and alone (Bannister and McInnes 2005). Nurses are expected to dehumanise themselves, with negative emotions considered a sign of weakness, and even drinking tea being a sign of laziness (Smith 2014). We suggests compassionate care will improve amongst nurses once their emotional and physical needs are seen more compassionately in NHS culture.


Bannister C and McInnes B (2005) RCN Working Well Initiative Guidance on traumatic stress

management in the health care sector.

Department of Health (2013) Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values. A mandate from the Government to Health Education England: April 2013 to March 2015

Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery office.

Maben J (2013) NHS culture: how can the ’empathy gap’ be bridged? The Guardian, 2 July 2014

Smith L (2014) NHS staff banned from drinking tea or coffee on the job because it looks like they’re not working hard enough. The Independent, 20 October 2014


Biography of Tracey Davies

I am a neonatal nurse and clinical academic PhD student at the University of Southampton. I graduated from the PGDip Nursing programme at the University of Southampton. I was fortunate during my training take part in the Erasmus scheme and spent 3 months in Denmark on a clinical placement on a neonatal unit, which is where I found my passion for neonatal nursing. Before beginning my nursing career I worked in sport development, I was previously Head of Cricket Development at Essex Cricket. I volunteer as the Kenya Country Manager for charity, Cricket without Boundaries, which uses cricket to teach HIV/AIDS awareness messages in Africa; in Feb 2015 I will be leading a FGM project in Kenya with the same charity.  I also have founded and run my own charity, THEY are Africa, which sponsors young people through education and training in Africa. My friend Katie and I set up and run a nursing blog, United Nurses, and I am also a digital literacy champion (iChamp) for the health sciences department at University of Southampton.

Biography of Katie Borg

(to be confirmed)


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