Kindness: an underrated currency
BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6099 (Published 16 December 2019) Cite this as: BMJ 2019;367:l6099![Loading Loading](https://www.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif)
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Dear Editor
Of course kindness should be a core value in the NHS especially kindness to our clients, the patients, although I do not like our other ones. But kindness works both ways. In order to give out kindness you need to receive some back too. Unfortunately I have found this sadly lacking in the NHS towards Admin staff, and this probably happens to other staff too. I have experienced unkindness and blame and rudeness from both Consultants and Managers and sometimes patients, but I am more understanding of patients as they are often frustrated and ill. There is a song "you have to be cruel to be kind" and I think some people are taking that too literally. We are a valuable asset in the NHS and sometimes people think they can talk to us as if we are nothing and have no respect towards us, even though we are older than them and I do not care what their position is. Respect has been taken out of the core values but should still be there, I feel.
Competing interests: No competing interests
Dear Editor
The catchy title of this important essay conceals a greater wisdom embedded in the text, namely the promotion in medical practice of “relationships, connections, challenge, and trust … [and] gentle honesty is discussions”. This is not simply kindness, but a necessary condition of good clinical care. Lack of attention to the experience of another – whether colleague or patient – deprives them of a sense of being noticed.
“I went to the doctor and he didn't even look at me” said a senior paediatrician of her consultation with a man more engaged with his computer than his patient. Perhaps being patients ourselves is the best way to discover the fundamental need for recognition in anyone asking for help. Doctors are not simply diagnostic algorithms; we are fellow humans who can identify with a patient’s experience. This requires an effort of imagination which is at the core of any kind of looking after, from parental care of infants onwards. Our duty of care is not only a moral obligation but a skill that has to be learned in training (Yakeley et al, 2011), and re-learned throughout our careers.
Yakeley, J, Schoenberg, P., Morris, R., Sturgeon, D., & Majid, S. (2011). Psychodynamic approaches to teaching medical students about the doctor-patient relationship: randomised controlled trial. The Psychiatrist, 135: 308-313
Competing interests: No competing interests
Dear Editor
Traditionally, knowledge and personalised application of that knowledge with good communication skills defined a good doctor.
With, internet enabled, easy access of information, the premium on physician’s knowledge is eroding. (1). Artificial Intelligence threatens to make the possession of knowledge as an redundant intellectual act. (2). Physicians would have to adapt and embrace change or risk extinction.
Helping people to cope when fighting illness and also helping people to die peacefully when the fight is lost would become the predominant act of physicians and health professionals in future .
Kindness and Empathy rather than knowledge would be the essential attributes of physicians in an ‘Artificial Intelligence’ dominated world.
References
1. Goldhahn, J; Rampton, V; Spinas, GA. Could artificial intelligence make doctors obsolete? BMJ 2018; 363 :k4563. doi: https://doi.org/10.1136/bmj.k4563
2. Loh E. Medicine and the rise of the robots: a qualitative review of recent advances of artificial intelligence in health BMJ Leader 2018;2:59-63.
Competing interests: No competing interests
Dear Editor,
Hear, hear!!
This important essay resonates with me. Some thoughts:
1. Robertson Davies in his last book, "The Cunning Man" wrote: “More Humanism and less Science; that’s what medicine needs. But humanism is hard work, and so much of Science is just Tinkertoy.
2. At the end of the day, I often think of Emily Dickinson’s short poem and ask myself if I’ve done what she aspired to:
If I can stop one heart from breaking,
I shall not live in vain;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.
3. Almost two years ago, I read a memorable book, “The Language of Kindness: A Nurse’s Story” by Christie Watson (TM Duggan Books 2018). She tells us that in the past, “Nursing was left to ‘those who were too old, too weak, too drunken, too dirty, too stupid or too bad to do anything else.’ Florence Nightingale.” But goes on to write, “Sympathy, compassion, empathy: this is what history tells us makes a good nurse.” As a physician, Christie Watson taught me more about caring for patients than I have learned in decadess from distinguished professors or our medical journals.
Dr. Klaber’s short piece belongs with these examples I have offered. Thank you.
Competing interests: No competing interests
Dear Editor,
The power of making meaningful connections in the healthcare workforce is often overlooked in a busy NHS so it is refreshing to hear that this neglected area is finding its way onto the radar. But how to achieve this amid the day to day challenges we all face? In our hospital we are starting our Randomised Coffee Trial to help foster better working relationships. Such RCTs have been shown to break down silos, build relationships and improve outcomes for organisations, many within the NHS. They can be a simple and effective way to strengthen the currency of kindness.
Competing interests: No competing interests
Dear Editor
I agree with the underlying statement behind this article that we should all try & be more kind to each other. However, how one achieves that in a busy ED department that can have over 130 patients (as mine did today) remains a challenge. Staff are often short-changed on time & resources. Add to that the fact that most people often haven't worked together & you have the perfect recipe for uncivil rather than civil behaviour.
That being said I do think the introduction of the "Hello my name is" badges have helped in a small but significant way: it allows one to feel that your colleagues are human beings rather than faceless healthcare workers who you pass by in a never ending haze of shifts.
Perhaps efforts like the "Hello my name is" campaign are the way forward.
Competing interests: No competing interests
Every spring, a bluebird flies down our chimney, gets trapped in the flue, and frantically flaps its wings to get free. But birds cannot fly vertically, so the little fellow falls into our woodstove, exhausted and defeated. Then we gently rescue him, take him outside, and watch him fly away. Like the bluebird, mankind is trapped, unable to escape or ascend. And man is waiting for the gentle hand of kindness to lift him up.
Competing interests: No competing interests
Re: Kindness: an underrated currency
Dear Editor
You would have thought that kindness was an essential ingredient of caring and curing a patient.
Yesterday (18 Feb) , BBC News from Royal Liverpool Hospital carried an item about uncaring staff.
An old patient lying in his excreta, ignored by staff. Visiting relatives discovered
The relatives complained.
What was the response?
1. Apology. 2. Writing out a care plan.
Not a word about the staff being reprimanded.
Not a word about staff recruitment. Do the recruiting officers assume that anyone who applies for a nursing job will care for a patient unable to care for self?
I ask the consultants of the said hospital: have you taught your junior to look out for NEGLECT?
Competing interests: No competing interests