But…
Back in the 80s, there used to be a tunnel leading from one bit of King’s Cross to another bit of King’s Cross. I used to go through this tunnel on my way from the tube to a fabulous pub called The Bell, that is sadly no more. The remarkable thing about this tunnel was that it had an exhortation to smile plastered all over it, presumably to cheer up the commuters who, unlike me, were not off to get bladdered and listen to a chucklesome blend of 80s indie music and disco trash. It may still be there for all I know, I haven’t been back for years now.
Now, nothing irritates me more than being told to smile. I don’t like being told to smile by friends, and I certainly don’t like being dictated to by tunnels! However, for those of you working as nurses in the NHS, it may serve you well to remember that tunnel. In fact, perhaps you should have the word “smile” tattooed on your inner eyelids, just so you don’t forget. Why? Well, because the Dear Leader, Chairman Johnson has decided nurses should be rated on how smiley and nice they are.
The health secretary, Alan Johnson, wants the performance of every nursing team in every ward across England to be measured, with the results published on an official website.
He believes putting a smile on the face of nurses and encouraging empathetic care is as important to recovery as the skill of doctors in the operating theatre. The proposal is to be announced in Manchester today at the annual conference of the NHS Confederation, the organisation representing NHS managers and trusts.
As is often the case, there is a good point behind the idea. Yes, empathy and niceness are important in patient recovery. Yes, a smile can be lovely when you’re feeling like crap. And yes, nurses should be nice and empathic and smiley whenever they can be. But it’s the mechanistic nature of this proposal, the micro-managerialism, the intensely annoying, interfering checklist-target-and-bloody-feckin-clipboard nature of it that grates like nails down a blackboard
The compassion index will be compiled by health regulators using surveys of patients’ views while in hospital, including feedback about the attitude of staff. It will also measure standards of nutritional care, minimisation of pain, hand-washing, and safety on the wards.
ARGH! More inspection. The government clearly believes that if you keep looking at something long enough, you can turn a dog-turd into a diamond.
Of course, this will all be linked in with Choose and Book, but not yet with pay. So don’t worry, all you curmudgeons out there, you can still be a miserable bastard and pick up your band 5 pay packet. For now, that is…
As is the RCN’s usual response to such nonsense, they’ve rolled over and presented their collective tummy for tickling.
Peter Carter, general secretary of the Royal College of Nursing, said the union would work with government on the scheme.
“These new standards are groundbreaking in that they will directly recognise nurses for the kind of care that patients really value.
“Nurses work tirelessly to ensure that patients are treated with dignity, compassion and sensitivity, aspects of care which are so important but rarely measured.”
Possibly because they are nigh on impossible to measure with any degree of accuracy and certainty, m’darling. Because, well, they’re kinda nebulous and unquantifiable, Peteypoos.
Still, why not tell us in the comments section what your Compassion-o-meter is reading right now. Me, I’m in need of some time off, so I’m hovering in the low digits at the moment (students beware!) Or alternatively, you could just rant and rave at the latest idiocy from the Laff-A-Minute Department of Health. But remember – SMILE!
Hmmm. As an autistic with prosopagnosia and quite serious problems interpreting non-verbal communication, approaching me with a rictus grin is likely to produce a…,err, quite extreme reaction. One size does not fit all; as I’m sure any half decent mental nurse knows. If any mental nurses need guidance on presentation from Alan, maybe they’re in the wrong job. I think getting through a hospital stay without losing your bowel to a secondary infection or being left to lie in your own pee, would more than compensate for an overly formal nursing.
Well, I’m not a nurse, but it irritates the living daylights out of me when some wanker (it always is a bloke) in the street roars at me to “Smile, love!”. Generally, a mixture of aggression and patronising condescension don’t make me feel smiley, strange that.
My usual response, learned with experience? 2 fingers.
Idiots in the street are bad enough, but I’d have a fit if my employer mandated smiling. Luckily they don’t – we’re a whiny bunch in IT, smiling at management is not our forte. Jesus. I’m glad I work in the private sector and could change my employer if they got this daft.
“As is often the case, there is a good point behind the idea. Yes, empathy and niceness are important in patient recovery.”
Indeed. We know that therapeutic alliance is key to recovery and overwhelmingly is more important than the activity undertaken. Who cares if you do dialectic behavioural therapy, cognitive analytical therapy, rational emotive therapy, cognitive behavioural psychotherapy or whatever else you fancy, it’s having a good therapist that makes the lions share of the difference most of the time.
But the proposal is madness.
How how how can you assess or quantify niceness in a valid, equitable, timely and meaningful manner for every nurse in the UK?
Madness.
“ARGH! More inspection. The government clearly believes that if you keep looking at something long enough, you can turn a dog-turd into a diamond.”
Only if you repeatedly measure it with a number of evidenced based and validated assessment tools (i.e. ruler and pointed stick).
If this is true then I am completely fucked as I have a face like a wet weekend most days. It’s not that I am unhappy in my work you understand, oh no inside I am gaiety and sweetness personified, I just have a miserable face that’s all. (Imagine Geoffrey Palmer sucking on a lemon.)
This is crazy, there is nothing worse than a forced smile. I suppose thats why its called a grimace. This is just targets gone wrong.
Here’s a good article in response to the news story over on Comment is Free:
http://www.guardian.co.uk/comm.....ers.health
People smile at work because they enjoy what they do and are well rewarded in terms of pay, condition and esteem; also, if they have some autonomy over what they do. Is this the case for nurses or other public sector workers? Clearly not, otherwise some clever policy wonk would not have come up with the smile-ometer or the CCTV cameras that are going to have to be put into every ward, to capture how many teeth are on view.
Nurses are paid far too little, given the price of housing and rising living costs. What sort of a society are we, when we won’t pay the workers who keep us alive enough to live on themselves? Then they are fed a constant stream of targets, reorganisation and measures to commercialise the service. The private contractors are praised and rewarded and the public sector workers are told they are never good enough. Would you be smiling?
Quite.
Some of the commments in response to the article are pretty good too. I particularly liked this one:
Is it just me, or does this government remind you of a bunch of graduate job-candidates on a group exercise?
For fucks sake, what exactly were you expecting. Alan Johnson is a postman which gives him oodles more experience of the real world than most of his cabinet contemporaries who had previous lives as perennial students, student activists, political researchers and general nomarks. They`ve never run anything, made a profit or been successful in any other arena. If it sounds good they`ll implement it, oblivious to practical realities. Those of you who voted for NuLabour need to suck it up and stop bleating. You also need to fasten your seat belts as it`s going to get a whole lot worse.
It certainly will be when ToryToffBoy and his Bullingdon Bullshitters take over.
PS, I didn’t vote NuLabourious, nor err, who was the last tory leader we didn’t elect? Come on boys, there’s only one solution, put on thy sandels, light thy pipe and vote Illiberal Beardycrats.
“putting a smile on the face of nurses and encouraging empathetic care”
Uh, one of these things is not like the other. If I’m feeling like shit, I don’t want someone being insufferably cheerful at me. Like Bill Hicks says, do you go and dance at someone in a wheelchair?
Dear Mental,
I had to check the date when I read this in the paper yesterday! And the bloody RCN…. I hadn’t realised there was an alternative to the pisspoor unison, have cancelled direct debit and off to join unite. Unless I can find what union the oil tanker drivers are in
You’re all being a bit cynical I think. It is easy to smile all day when we have easy access to a trolley full of antidepressants! Think about poor Jed, maybe he would be able to remove his hand from his head if people just smiled at him a bit more.
Cynics.
Can we have an annual competition for Stupidest Idea of the Year? This one gets my vote so far.
It’s easy to smile all the time – simply insert a pencil, or a tongue-depresser, sideways into your mouth.
Regarding DandC’s proposal of stupid idea of the year, the dumb ideas are coming so thick and fast that a weekly competition would be more appropriate.
quacktitioner: if all the banners in the background of the news reports are to be believed, the oil workers are members of Unite.
Don’t hold your breath though!
Complete & utter load of bollox !!!! Far too much paperwork wafting around as it is.I can’t help thinking whoever really dreams up these stupid schemes is trying to justify their own job position.
That said I would love to see this ‘scheme’ extended to the Docs too & maybe the Physios, Social Workers, OT’s etc !!! Now that would put the cat amongst the pigeons.It’s just papering over the cracks in the NHS ffs !!!!
Right, I’ve joined unite, and fired off a rant to the RCN while I was at it.
Now, does anyone know what qualifications I need to be an petroleum product solutions quacktitioner?
A bend over and touch your toes medical, an ECG, EEG, blood tests. A letter from your GP saying you’re not a looney, junkie, alcoholic, asthmatic, diabetic, blind, wife-beater or have anger management problems. A police AND securety services check. A stable and verifiable long-term work record. An HGV licence. An petroleum products HGV licence extension. Yearly medicals. And a letter from mummy.
If you’re working offshore, being a non-smoker helps too
.
I recommend for further reading: “Don’t tell mum I work on the rigs: (she thinks I’m a piano player in a whorehouse)” by Paul Carter.
He has a particularly good story about flying first class with amoebic dysentery…
Have you ever seen behind the doors in a bank or a McDonalds? They have a sign that says something stupid about ‘SMILING’. Watch the space behind the nursing station for something similar soon?
And what will the managers say? “Well, OFMN… your average compassion-o-meter from patients is 6. We need it a little higher, so smile a bit wider. You know, maybe start using the word ‘fantastic’ more.”
cAsAcambs, If you are dismissing David Cameron for being a Blairalike idiot with no policies, no beliefs and no vision then fair enough. If you are dismissing him simply for being a “toff” then you are a fool.
OSB, With my non-partizen hat on, I can honestly say I don’t know what the Torys stand for, nor Labour nor the Beardycrats. If I come across as a pot smoking, grauniad reader it’s only ’cause I’m baiting you. I’m an ex-boarding school, telegraph reading, wild mammal strangling countryman. Hanging’s too good for ‘em! Make ‘em eat NHS food.
You`re hardly winding me up cAsAcambs, I`m permanently infuriated by NuLabour. Although I`m way more right wing than the average “mammal strangler” I respect left wingers such as Tony Benn and even agree with left wingers such as Frank Field. What I can`t stomach are the class warrior buffoons such as Prescott. This country is in desperate need of decent leadership and I, for one, don`t care which strata of society it comes from.
Leadership all round I think. Cmht’s that are led by consultants, not like Toryheartland Town’s that “Has input from a consultant psychiatrist”. What!
cAsAcambs> the clue to the name of the town in question wouldn’t be in your username, would it?
Of course you could all move over here – smiling comes more natural in tropical climates
Has anyone ever thought up a government target scheme – other than voting? I’m guessing “no”.
This being the case – lets use that for health care improvement – If the public don’t like the NHS care they get – they can just go to another one – once their 4 year subscription is up.
We ought to campaign for a “lie-o-meter” or “turnaround-on-policy-o-meter” or “manifesto-promise-what-manifesto-promise?-o-meter”
and rate each delegate for our wizened poliquacktitioners.
DeeDee, Doh! Knew I’d slip-up one day…
Worry not cAsAcambs, I used to live in the same hamlet and also experienced the joys of the mental health service there. Let’s just say that you may not be losing out much in not seeing many medics on your CMHT.
after several years here, I’ve met all of the consultants, several of their spouses and could give you a run down of their relative strengths and weakness, both clinical and managerial. (Which I’ve often been good enough to share with them). I like to think their hearts sink when they see my name on their clinic list. And I’m not shy about telling the younger ones “I was doing this when you were still at primary school”. I’m always happy to share with them, my knowledge of pharmacology as applied to autistic spectrum disorders. Nightmare patient. TeeHee!
I, too, hate being told to smile. My friends do it all the time and it gets bloody irritating. Someone I flat shared with would always tell me to “turn that frown upside down”…why don’t they just piss off and leave me alone…if I want to be grumpy and miserable (which I sometimes am) then I bloody well will be and nothing they can say or do will stop that!
My employer has signs on the doors from the warehouse to the shop floor saying “you are now entering a customer area, remember to smile”
Anyway, what a load of rubbish! It’s all intangible and therefore it is impossible to measure!
“lie-o-meter” for politicians???? There already exists a foolproof way to tell if politicians are lying – simply watch them to see if their lips move.