Being treated like I was somebody

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The treatment of one person by another in a manner which respects their dignity is a relatively simple matter as these quotes from a recent study show (Matiti and Trorey, 2008):

“If you are not talked to, you feel you do not exist and feel ignored.”

“…even if the curtains are closed sometimes people come in and out – for example nurses looking for colleagues.”

“…when one is able to do things it boosts self confidence and esteem. I would like to be in control of my own things… unless I cannot manage.”

Over the past two years or so there has been a campaign in the UK which focuses on the provision of dignity in care. This is mirrored in similar and different formats in other parts of the world. Numerous documents since the early 1990s have highlighted the importance of health and social care staff who treat those in their care with dignity. A more recent publication (Cass et al.. 2008) clearly identifies dignity in care as a basic human right:

‘a state, quality or manner worthy of esteem or respect; and (by extension) self respect. Dignity in care, therefore, means the kind of care, in any setting, which supports and promotes, and does not undermine, a person’s self respect regardless of any difference’.

The notion of dignity is linked with the ethical codes of respect, autonomy, empowerment and communication – the foundations on which modern health and social care are based. The very fact that this issue reappears on the agenda so regularly indicates that, thus far, health and social care services and the professionals who work within them are not always providing care that respects this most basic of human rights.

Those in need of orthopaedic care are often vulnerable and, therefore at risk of not having their dignity respected. The focus of the most recent campaigns, which have promoted the idea of ‘dignity champions’, has been on older people in health and social care settings and, in the last year, on those with mental health needs. Orthopaedic services are provided to people in both of those categories. These groups are chosen for particular attention because they are especially vulnerable. Even so, the principles of providing dignified care should be the same whatever the nature of the needs of the patient.

Throughout the last few decades many campaigns have focussed on improving the care of older people in hospital and community settings. Yet, if a need for a specific campaign about dignity is necessary today, we must wonder if any progress has been made at all. There have, for example, been numerous publications since the 1980s, setting out the processes and practices involved in quality care for elderly patients with a fracture of the hip. Again, it seems that little progress has been made if there is still a requirement for such crusades. It is likely that the attitudes amongst practitioners that lead to a lack of dignity in care are so much a part of health care culture that they are difficult to tackle.

Burscough and Smith’s article (in this issue) tells a story about a lengthy episode of care in which the most basic of dignified existence was not maintained for the receiver of that care. As you read this article – do not simply be shocked by the messages it gives and do not deceive yourself into believing that care never fails to meet the right to dignity for those receiving it. It would be wiser to think about how you might use this story and the many similar ones around you to champion dignity in your own workplace, maybe using the guidance from Cass et al. (2008) to develop dialogue and real change in practice with your colleagues. Make sure you do not tolerate failure to treat patients with respect amongst those you work with.

The bottom line is that it is everyone’s right to be treated with dignity and for those who work with vulnerable people such as orthopaedic patients this means treating others as we would wish ourselves or those we love to be treated. We need to be sure that those in our care can say that they were being … ‘treated like I was somebody’.

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References 

1. Cass, E. Robbins, D., Richardson, A. 2008. Dignity in Care. Adults’ Services Practice Guide 9, Social Care Institute for Excellence, <http://www.scie.org.uk/publications/practiceguides/practiceguide09/files/pg09.pdf> (accessed 10.12.2008).
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2. Matiti MR, Trorey GM. Patients’ expectations of the maintenance of their dignity. Journal of Clinical Nursing. 2008;17(20):2709–2717
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