Hospital life : The 6C’s of nursing


I saw something of my attention today. It was called the 6 C’s of nursing. I was very curious as I saw it conspicuously posted on the noticeboard in the hospital. 6C’s? I thought. A further look reviewed the wheel where each of the C’s were outlined. They were, care, compassion, communication, competence, courage and commitment. It makes sense that these C’s appeared to be the main things nursing was supposed to deliver. I furrowed my brows as I walked away giving each item further thought.

I immediately embarked on an unintentional mental assessment of the standard of nursing that I had been exposed to since my son was born. As a team, hospitals dwindle around the standards they are able to deliver from time to time. For example on the weekends hospitals become like ghost zones lacking staff and standards. Facilities are not as looked after as they are during the week. Medical staff are not enough during the weekends. You rather find that weekends are covered by a few familiar staff, predominantly “locums” and  “bank staff”.

To me these are mainly roving staff who otherwise have no way of appreciating the delicateness of some patients. Many have no way of knowing the promptness individually required to care appropriately for each patient. In this case not because they lack the skill or competence to do so, but because they have no prior knowledge of the patient as a result of their roving nature. The essential knowledge that familiar staff possess about the delicate patients is taken for granted by the recruiters of these roving staff. It should a prerequisite for caring for people with life-threatening diseases.

Notwithstanding, we would never survive without the input of these roving “bank staff and locums” because they not only make up for the ever dwindling workforce on the weekends but stand in when staff go on holiday. Support from the weekday staff may help bridge this knowledge gap if their presence on the weekends can become more proportionate.

With that said, sadly even the familiar weekday staff fall short of these 6C standards. Unfortunately not all familiar staff meet these standard 6C’s. The nurses to me should be an embodiment of the 6C’s of true nursing. Here is my layman understanding of what the 6C’s on that wheel should mean. Hopefully I will not be far from the truth but somehow pondering their deeper meanings may help put my thoughts in perspective about the state of nursing in general.

  • Caring for the patients means that nurses should be interested in their patients. This will help them to know and care for them adequately. This level of care proposed by the existence of the 6C’s helps nurses bond with their patients enabling them tailor the care to suit each patient.
  • Compassion to me is another essential ingredient of nursing. A heartless person without any human feeling or sympathy has no business nursing people back to health.
  • Communication as a requirement is quite straightforward. Nurses must be able to understand or find ways to understand the needs of the patients. They in turn must be able to explain clearly their plans to their patients or the carers. Communication also entails understanding clear plans handed down by doctors and carrying them out carefully and accordingly. Nursing will certainly be brought to a halt if this element is missing.
  • Competence is a prerequisite of nursing. A nurse cannot be a nurse until proper schooling and acquisition of the skills required for nursing has taken place. Personally, nursing as an institution has this responsibility to the public. They ensure that the nurses in hospitals are competent before permitting them to practice. I have noticed that further training of students are carried out through hospital placements. When new nurses are licensed, they still undergo further training on the job and are initially paired up with more experienced colleagues before getting signed off for things like medicine administration, cannula handling, using of equipment and so on. This ensures that competence is not only acquired but supported.
  • Courage is another essential element. Nurses have to undergo many scenarios on a daily basis. Some are easier than others. From wound dressings, to highly pressured resuscitation scenarios. Nurses confront humans in their most vulnerable forms for example accident victims, mental health and even death. To expect a nurse to be courageous is an understatement. Courage is the element I think that gives nurses the strength to confront the various challenges that the nursing role throws at them on a daily basis.
  • Commitment was the last element of nursing on that poster. It means that the staff who call themselves nurses must be willing to uphold all their standards of nursing every single time both in and out of the hospital. For example you expect a nurse to be a nurse at all times. You expect that they will show care, compassion, communication competence and courage whether they are in the hospital, on the street or train. There will be committed to saving human lives and fostering public health everywhere possible.

As such, nursing is an extremely demanding job both physically and psychologically. However, as with every job done daily, over time, many nurses master these skills until they become second nature. Having been through many scenarios of care delivery, I find some nurses become either “more nursey” or “totally un-nursey”. I appreciate that these are not really words but I am sure you get the point.

In my personal experience, some nurses take ownership of the job. The skills and experience acquired over time make them not only excellent nurses but transform them into extremely humane individuals. For these category of nurses, when you’re in their care you can feel at home. They become the embodiment of the 6C’s of nursing. On the flip-side, the other group of nurses allow their experience of nursing turn them into ogres without any human feelings. They become like ice, disregarding every single element of their 6C’s of nursing. They allow their experiences get into their heads. They begin to treat patients like articles disregarding their feelings.

One might call it their coping strategy because arguably nursing can be a very psychologically demanding profession. Having encountered many extremes of emotions during the course of carrying out their work, nurses can be left feeling the need to shield themselves by keeping everyone (sometimes including colleagues as I have personally noticed) at arms’ length. In the end, what you unfortunately have as a patient is not a nurse but someone who makes you uncomfortable. Someone you cannot wait to get away from.

It makes you question the whole essence of the rudiments of nursing. Those 6C’s. If any health practitioner feels psychologically drained on the job there is support for them. This can be discussed with the team leaders, ward sisters, matrons and so on. In the end nursing is an essential service that requires these standard 6C’s to be upheld at all times. Nursing cannot be for everyone. Therefore, if a nurse starts to finds it difficult to deliver on any of these 6C’s, then, that nurse needs to have a rethink. Perhaps a break from the job to put things in perspective might help. A reduction in the number of hours worked weekly can also reduce the pressure on such nurses long term.

Patients and carers are encouraged to participate in surveys, feedback and appropriate communication to help highlight areas where nurses fall short of these 6C’s. They are not only the standards to be expected from nursing. Nurses should also expect to be held accountable for their actions when you fall short of any of these 6C’s. The health sector as a whole welcome complaints and compliments. Such participation by patients and carers help to highlight either areas where there is need for improvement or areas where the standards are being met.

Thank you for reading.

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Photo credit: Pixabay