Embracing tender loving care

We may not feel an emotional conection with all of our patients, but we should still treat them in a loving way.

We may not feel an emotional conection with all of our patients, but we should still treat them in a loving way says Elaine Strachan-Hall.

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Many of us can recite three Donabedian dimensions of the quality of care of structure, process and outcome. Recently, I was introduced to another of Avedis Donabedian’s quotes about the ‘secret quality of love’.

‘You have to love your patient, you have to love your profession... if you have love, you can then work backward to monitor and improve the systems,’ he said. Personally, I refer to loving my job and loving the privilege of nursing, but rarely talk of love in nursing. The term 'tender loving care' is perhaps the exception, although this is too often a euphemism for end of life support.

Taking subjectivity

Some might argue that such emotion is too intimate and detracts from the objectivity required for sound decision making. I disagree – if we love those we serve and are more subjective in putting their needs first, then I would take this subjectivity every time.

We know we connect with some people better than others, so what if we don't feel this emotional connection for every patient, for every client? Love, as a feeling is involuntary, but acts of love are purposeful actions performed in a tender, thoughtful manner. I don't always feel that loving connection with every patient, but I can be loving and tender in my approach. 

Loving decisions

Is this relevant to nursing management? Absolutely! Nurse managers must make sound managerial decisions with a clinical focus and sometimes have to be ruthless to do the right thing. However, we can also be loving in how we implement these decisions. Wanting the best for each person in every situation is an act of love, as is thinking through the way we articulate the decision, the way we actively listen and seek to understand and seek to do what is best.

Let’s liberate the term ‘tender loving care’ from its end of life connotations and see if love, as the essential ingredient that influences the ‘how’ of what we do, can be a guiding principle to good management and quality improvement.

About the author

Elaine Strachan-Hall is a member of Nursing Management’s editorial advisory board and a registered nurse on a clinical commissioning group governing body who has worked in chief nurse roles in the NHS and private sector

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