A little while back I had the misfortune of being admitted to a hospital in London as an emergency for 24 hours. At the end of that brief period of time I felt as though I had been cared for in three different hospitals. Here’s why.

I was taken initially to A&E where I was assessed and stabilised. The Staff Nurse looking after me showed personal concern for me. She didn’t spend vast amounts of time with me, but whenever she walked past my bed she looked my way and mouthed the words “are you okay?”. Whenever she attended to me she would lean forward and look me in the eye. I could feel her compassion. I realised after a couple of hours that she was actually the team leader, not just my ‘named nurse’. I was transferred out of A&E a little later to the hospital’s Clinical Decision Unit. Slightly to my surprise, but also to my pleasure the same Staff Nurse continued to supervise my care. I felt I was in good hands and I felt reassured.

The night staff came on several hours later. The Staff Nurse was very personable and humorous; she introduced herself to each patient, but she was also very forthright. When she walked by the bed she would look my way so I knew I was being supervised. Later however she had an argument with a patient who wanted to discharge himself and she could be heard by the whole ward saying “Well walk out then and if you drop dead with a heart attack you’ve only got yourself to blame”. A Nursing Assistant came over and spoke with the patient a bit later when the Staff Nurse had left the ward on a break. She listened to him and empathised with his situation. She showed him compassion and understanding. I felt I was in competent hands with the Staff Nurse, but wondered why the Nursing Assistant had to wait until the Staff Nurse was off the ward to show my fellow patient some compassion.

The Staff Nurse leading the morning shift came on to the ward sounding like a Sergeant Major. She probably thought that was how old-fashioned Matrons would behave. Soon after the shift change a newly-admitted patient was being sick in the bed next to me. No-one came to her. After 2 or 3 minutes another patient went to alert the Staff Nurse. She said “It’s okay, it’s the drugs she has taken”. She barely glanced the patient’s way, but just drew the curtains around her bed. None of the other staff went near the patient. Not the remotest trace of compassion except from other patients. I now felt I was in business-like hands. I couldn’t wait to be discharged. I was so glad I was not admitted on this shift.

24 hours in one hospital. Three shifts. Three different team leaders. Three different experiences as a patient. I went from feeling I was in good hands to feeling I was in competent hands, to feeling I was just the number of a bed they needed to vacate. Why?

The difference was in the leadership of each shift. For all I knew they were all equally competent and skilled. But they were not equally compassionate. And it was only under the leadership of the compassionate Staff Nurse that the other nurses on the ward felt free to exercise their compassion with the patients.

I know which hospital I preferred.

Roger Greene