Kindness and Patient Safety
By Adam Mohamed
There is a growing recognition that kindness is vital for human connections and relationships. However, it is often seen as ‘fluffy’ to talk about being kind or compassionate or caring. It is seen as more of an afterthought than a driving force. Being kind is seen as a quick ‘thank you’ tagged on to the end of a sentence at the end of the shift because that’s what we were taught rather than a sincere way of demonstrating gratitude.
Kindness comes from the Old English word kyndnes, meaning ‘nation’ or ‘produce, increase’. The word is further derived from the Middle English word ‘kindenes’ meaning ‘noble deeds’ or ‘courtesy’. Aristotle defined kindness as ‘helpfulness towards someone in need, not in return for anything, nor for the advantage of the helper himself, but for that of the person helped’.
Nowadays we define kindness as the quality of being friendly, generous and considerate. But this can often be equated to simply being nice. Being nice and kindness are two different things. While being nice is great it doesn’t encompass the full intention and strength of kindness and in fact, an act of kindness does not have to be nice. It is kind to help someone find a new role if their skills don’t fit for the one they are currently in, it is kind to help someone improve their abilities or performance, it is kind to help people address their weaknesses rather than leave them to flounder and struggle.
There are lots of lovely synonyms associated with the word kindness; kindliness, kind-heartedness, warm-heartedness, tender-heartedness, goodwill, affectionateness, affection, warmth, gentleness, tenderness, concern, care. All of these words could be used to describe the way in which we would like to care for patients and how we would like to be cared for.
Kindness and being kind are important if people are going to work safely. The big challenges facing patient safety is about behaviour change. How do we get people to be kinder towards each other, to be more respectful, to allow others to share their concerns and speak up when they things are not going as planned? There is research which tells us that when people are not kind or supportive how that impacts on people’s ability to perform and think. You can find the evidence on the Learning from Excellence, Civility Saves Lives or Kaleidoscope website.
For me, I thought immediately of kindness when sitting in the audience at last year’s Patient Safety Congress and hearing the brilliant Sidney Dekker talk about the three questions that he feels should always be asked when something hasn’t gone to plan.
- Who is hurt?
- What do they need?
- Whose obligation is it to meet that need?
That feels like Aristotle’s definition of kindness being bought to life, being helpful towards people in need.
Julia Unwin, a Carnegie fellow, has written a report on the role of kindness and emotion in policymaking. Unwin’s report champions the need for greater understanding, intelligence and acceptance of kindness as a vital part of the way we work and not just an add-on. She talks about the importance of kindness in a world of instant judgement and communication that it is vital for forming relationships that in turn are vital for helping people work safely.
Julie and others steer away from toolkits, frameworks or checklists for kindness. Rather they seek institutional change so that kindness becomes an expected norm. Kindness is in all of us, we don’t need specialist training but we do need to make a concerted effort and we do need to role model kind behaviours for others to see the positive impact. By observing positive actions we are more inclined to repeat them. What can you do today?
- To be kind is to be fair
- Consistently apply a just culture in your organisation so that people know they will be understood rather than judged and supported when things don’t go as planned
- To be kind is to be open
- Encourage people to talk to each other, to listen and respond so that people feel able to be open no matter who they are talking to
- To be kind is to be safe
- Be constantly aware of others and their needs and kindly ask them if they need help, if they need a break or they need more information
Kindness matters. It is not fluffy or something that gets lots the more stressed people get. It needs to be taken seriously if we are going to be serious about keeping patients safe.