۱٫۱٫ Importance of caring in health care

The importance of caring in the nursing profession has long been recognised; Notes on hospitals (Nightingale, 1863) highlighted the need for sanitary conditions, warmth, clean air, light in rooms, and a nutritious diet for all patients. Over the last 20 years however, there has been increased emphasis on the need for compassion and empathy in health care professionals, rather than simply tending to a patient’s physical needs (Duffy and Hoskins, 2003; Kerfoot, 1996; Kret, 2011; Williams, 2001). Currently, a holistic view of care is emphasised, highlighting the need for health care professionals to provide physiological, psychological, and emotional care to their patients (Zamanzadeh et al., 2015); a shift from caring for to caring about (McQueen, 2000). There are many definitions of caring behaviour, with one example from Mosby’s medical dictionary being “actions characteristic of concern for the well-being of a patient, such as sensitivity, comforting, attentive listening, honesty, and non-judgmental acceptance.” Caring behaviour has many benefits for patients, including increased satisfaction, psychological wellbeing, and health outcomes (Al-Mailam, 2005; Dugan et al., 2014; Meyer et al., 2006; Willard, 2006). Despite this, over recent years the culture of the UK’s National Health Service (NHS) has been criticised for lacking in care and compassion, sometimes resulting in negative patient outcomes. The Francis and Lingard (2013) highlighted that a lack of basic care and compassion from NHS staff contributed to the failings at Mid Staffordshire Foundation NHS Trust. The subsequent Berwick Review (2013) and Cavendish Review (2013) again underlined the need for improved care within the NHS, and provided recommendations for this. As a response to these reviews, there have been several policy guidelines issued by the government relating to patient care (Department of Health, 2015; NHS England, 2013). Prior to the publication of the Francis and Lingard, 2013, the policy document Compassion in Practice (Department of Health, 2012), sought to embed a caring culture within the ever-changing NHS. Within this, the 6Cs of nursing were introduced: care, compassion, competence, communication, courage, and commitment. The vision of this document was to create a culture where these values underpin care provided by all health professionals (Department of Health, 2012).