Compassionate Leadership – a way forward
RCN Foundation Directors, Deepa Korea, reflects on what has happened since the launch of Follow your Compassion.
A little over a year ago, on a bright winter’s day in London, a group of newly qualified and registered nurses and midwives came together at the RCN’s HQ in central London. They were participants of the Follow Your Compassion project, run jointly by the RCN Foundation and The King’s Fund. Their aim that day was to share their experiences of compassionate leadership as newly qualified staff. Those listening to their stories included senior and national leaders in nursing and midwifery from across the four UK nations.
I will never forget the introductory words of one of the nurses who participated in the project: “please hear us.”
That sentiment set the tone for the day. The project’s participants went on to describe the shocking and harrowing treatment to which they had been subjected in their working environments. Their experiences included working within cultures which were uncaring, inconsistent student experiences, a lack of psychological safety and poor treatment of internationally educated staff.
Compassionate leadership, this was not!
The project was developed following the publication of the seminal report, The Courage of Compassion, in 2020.
As the pandemic was getting underway, the RCN Foundation commissioned The King’s Fund to evaluate the impact of the COVID-19 pandemic on the mental health and wellbeing of nurses and midwives. This involved a detailed examination of available evidence, analysis of key data, and interviews with nursing and midwifery staff at all levels across the NHS and social care in the UK. The resulting report, The Courage of Compassion: Supporting Nurses and Midwives to Deliver High-quality Care was published in September 2020.
Importantly, this report didn’t just highlight the challenges faced by staff. Using the ABC Framework of nurses’ and midwives’ core work needs as its basis, it also provided a route map for how to develop, nurture and embed cultures that were underpinned by empathy, understanding and compassion.
Since its publication, the report has made a significant and meaningful impact. Some health and care providers across the UK have used the findings to begin to develop cultures framed by compassionate leadership within their organisations.
Follow Your Compassion was a follow up project which sought to capture the lived experience of compassionate leadership for newly qualified and registered nurses and midwives. As I sat in that room a year ago, listening to those who had participated in the project talk about their experiences, I realised that things had not gone far enough or fast enough in developing the type of positive culture that was set out in the earlier report.
At the conclusion of that event, I gave a commitment to those in the room that the RCN Foundation would take action to try to reverse the harmful and toxic cultures that we had heard about that day.
These cultures are not just damaging to the mental health and wellbeing of nursing and midwifery staff. They also have a detrimental impact on patient care. As Dr Jayne Chidgey-Clark, National Guardian for the NHS, recently wrote: “Culture is a patient safety issue. Every interaction – whether patient, family member, colleague or consultant – makes a difference to lives and outcomes.”
I am delighted to say that work and thinking has begun on addressing these issues. Our new strategy, which began at the start of 2024, set out our vision for the establishment of a new RCN Foundation Centre for Compassionate Leadership in Nursing and Midwifery.
The focus for the Centre will be the development of a cultural transformation programme to embed compassionate leadership practice across health and social care. As its simplest, this transformation will aspire to create a wider culture of compassionate leadership by aiming to shift individual behaviours.
This programme will form the bedrock of the work of the RCN Foundation Centre for Compassionate Leadership in Nursing and Midwifery in the coming months and years.
I am in no doubt that this will not be a quick or easy fix. It will require courage, tenacity and probably sheer bloody-mindedness if we are to begin to see any change. It will also require us to work outside of our ‘business as usual’ way of doing things – reaching across organisational boundaries, different staff groups within health and care, and at all levels. Work on developing pilots to take the programme forward will begin in early 2025. We expect this to be a long-term piece of work, with any results taking a significant period of time to achieve.
I look forward to making progress and invite anyone who is interested in improving outcomes for nursing, midwifery and patient care to join us on our journey.