Compassion: Nurse Lead Helen Michael – former sexual health nurse, research nurse and CQC Inspector in adult social care

A self-confessed science ‘nerd’, Helen originally trained as a geologist gaining a geochemistry PhD in 1999 and then worked as an advisor for the Environment Agency. But she switched careers at 32 and qualified as a registered adult nurse in Carlisle. She then added a family planning qualification and started work for Brook, a sexual health charity in Oldham and Salford, working four days as nurse and one day in education outreach. While at Brook, she got a teaching qualification and spent two years educating teenagers and Category C prisoners on health and care issues. She joined NHSP in May 2018.

It all started…

…when I worked for the Environment Agency - first in sheep dip disposal, then sewage, and finally policy. That was my awakening. There’s nothing I love more than writing a standard operating procedure, but I started thinking I wanted to do more for other people. I also recalled my experiences as an auxiliary on a dementia ward during a gap year and decided on nursing. At 32, single and with a mortgage, I gave up my fancy job and company car and went back to university. It was amazing to study again and I had some great placements, including the sexual health clinic at Brook.

I remember…

…when I started at Brook they’d just set it up in Salford, so I did every role going to help get it off the ground – I worked on reception, built flatpack cupboards, cleaned toilets, vacuumed, all sorts.

I spent a lot of time in some of the most deprived areas of Salford and had heart-breaking discussions with young people whose parents were heroin or crack users; those who were subject to abuse or neglect; and those who didn’t think their own lives would amount to much more than playing video games, smoking weed and being unemployed. I also spoke to young girls about abortion, which was difficult when they refused to confide in a parent or other trusted adult. Safeguarding was an ever-present consideration.

I was at the clinic when the riots at Salford precinct started – it was less than a mile away. There had been a weird sense of something building during the day and I don’t think any of us were surprised when it happened. Young people often used to throw fireworks at our building in the weeks leading up to bonfire night. I remember feeling grateful that my rural upbringing, halfway up a fell in Cumbria and years before social media, was so much less complicated.

At times it could be a scary place but I loved working with the teenagers at Brook; talking about sex all day - I don’t think anything can surprise me anymore. I learned a lot about different cultures too, especially from the South Asian community in Oldham. I had lots of highlights when I was teaching – one of my favourites was holding a Christmas party with my college students, complete with music and nibbles. Using a bit of chemistry and some dye in cups of water, I showed them how easy it was to catch and spread an STI. 

Compassion means…

…appreciating that other people might have completely different values, beliefs, principles and ethics to you, but they still have value and deserve care and understanding. Compassion is all about understanding someone else’s suffering and having a desire to help try and make things better for them. I think that starts with listening to people. What are they worried about? Where does it hurt? Patients will forget some details of their care but they will almost certainly remember the nurse who smiled sympathetically and said it was OK when they were incontinent, or who had some banter with them, or found them a phone charger at 3am.

Compassion is the cornerstone of nursing and the reason many nurses go into the profession. If there was no compassion for people in pain or who need help, they would just be treated like machines and all in the same way, regardless of their condition or situation. There would be no person-centred care, and that’s one of the fundamentals of healthcare.

I showed compassion…

…when I supported one of my young patients in clinic after they confided in me they’d been assaulted the day before. The parents didn’t want to come so I made all the arrangements, organised a whip round for a taxi, and supported the patient when they needed it. I found a cash point and got them back home afterwards. Thankfully, the patient came into the clinic regularly after that and I got to see them grow up into a lovely, confident young adult.

…when I worked as a research nurse, we visited people in their homes who were too unwell or who found it too difficult to get to the GP surgery. My job was to carry out breathing tests on the patient for a research trial while support staff nipped to a local pharmacy to collect the patient’s medication. During one visit, a patient starting telling me her sister (who usually helped with domestic chores) was poorly, and she hadn’t managed to change her bedding for a while. It was a fiercely hot summer and I felt for her, so I offered to do it. She was thrilled and accepted. The study support came back from the pharmacy to find me filling the linen basket and thought I’d gone mad! 

Compassion is harder to show…

…when a patient resists advice, refuses support or quotes Dr Google at you. When this happens I always try to take a step back and consider things from their perspective. It’s something I tried to impress on my college students too – I called it WITWU (What If That Were U?). Doing this usually helps us relocate our compassion.

It can be difficult to show compassion when people are kicking off. Once, at the clinic, a young person thought their partner was being unfaithful and things descended into something approaching a lively episode of the Jeremy Kyle Show – chairs flying, people ducking, and lots of shouting. But at the bottom of all this was a young person who thought the love of their life was cheating on them and felt devastated. We still saw them at the clinic afterwards - with the proviso they left the furniture alone.

There were also times as a CQC inspector in adult social care where I struggled to be compassionate towards staff delivering care and support that was inadequate. But I firmly believe most people go into care to do good, and when things go wrong it is usually due to a lack of training or resources, or often both. I would therefore always strive to develop an open and non-judgemental relationship with staff with a view to sorting things out and making things better for the people using the services. 

I saw compassion… 

…during my nursing training on a medical ward for older people and my mentor just had an incredible way about her and oozed empathy. She had endless patience, seemed to genuinely adore her patients and was a passionate advocate for them. She impressed upon me the value of therapeutic relationships, and how they are even more important on medical wards, where patients can have protracted admissions. I remember thinking that if I could be even half as compassionate and caring as her, I’d be doing OK.

What I’ve learnt over the years
When people are being challenging or difficult to support, put yourself in their shoes. This usually gives you the insight you need to find your compassion.
View every patient as an individual, with different wants, needs and beliefs - what you’d want in the same situation isn’t necessarily what they want.
The longer we stay in a caring role, the more danger there is we can get emotionally hardened from experience. We start seeing patients as ‘patients’ – that is, different from us. We need to make sure we always see patients as mothers, fathers, sons, daughters, friends and partners, just like us, who all view the world in their own way.