Florence Nightingale Commemoration Service, Westminster Abbey, 14th May 2008

Preacher: The Rev'd Fr Dominic Fenton


An elderly matron and her friend, who haven't seen each other in twenty-five years, meet for a special meal. Afterwards, in the matron's apartment they reminisce about days long ago. '''The conversation goes on for hours. Night falls. The friend says to the matron, "I'd better be going - look at your watch. What time is it?" "I don't have a watch," says matron. "Then look at the clock."'  "'I don't have a clock."'

'"You don't have a watch, you don't have a clock - then how do you tell the time?" "You see that trumpet in the corner, says the matron? That's how I tell the time."'

'"You're crazy," says the friend, "How can you tell the time with a trumpet?" " I'll show you" The matron picks up the trumpet, opens the window and blows a deafening blast. Thirty seconds later, an angry neighbor shouts out, "It's two-thirty in the morning, and you're playing the trumpet?" The matron turns to her friend and says, "You see? That's how you tell the time with a trumpet!"'

What time is it?

In my work as a hospital chaplain, the length of our days and the precariousness and fragility of human life are themes which constantly challenge and chasten me: the young mother with breast cancer whose prognosis is poor; the fit twenty three year old brought lifeless into casualty; the loving father of two young children with no history of ill health whose sudden brain haemorrhage leaves him on life support; the man with a once elephantine memory, now diminished by Alzheimer's and unable even to recognize his devoted wife of forty eight years.

These are just some of the life episodes to which our skilled and dedicated clinicians, doctors and nurses respond - as they seek to provide good quality dignified patient care, as a means to healing and recovery.

There have indeed been dramatic improvements for patients in recent years brought about by a universal determination to make things better:

And more recently:

And yet, our 'Nurses admit that patient dignity is neglected' as screamed the recent headline from the Sunday Times. The subsequent article suggested that almost two-thirds of nurses admit that their patients are not treated with dignity and respect. In the article, the author says that patients are often 'subjected to intimate examinations behind curtains which do not close; that they are forced to wear gowns which do not fit and that they are sometimes denied help to go to the lavatory'. The Royal College of Nursing claims that the inability to treat patients with dignity is caused by overcrowding on wards, staff shortages and pressure to meet endless government targets -and this, in a Health Service which has seen greater investment in recent years than at any time in its entire history.

There may, of course, be some truth in this report - yet it is also the case that the vast majority of patients with whom I have contact do, speak overwhelmingly positively about the quality of care which they receive -and marvel at the enormously high standards, both required of and discharged by, all those directly involved in their care; - and whether this be in terms of the cleanliness of the hospital, the efficiency of the administration, the quality of the food - or, and most importantly - the sheer dedication and commitment of all those whose job it is to nurse them back to health.

When Florence Nightingale founded the modern nursing profession she understood, not only the fundamental importance of personalized and dignified care - but that sensitivity to individual patient needs was undoubtedly the key to recovery. That attention to the mechanics of the body - could not be seen in isolation from the patients mental and spiritual health. That is, that the individual must be considered as a 'whole'. As the World Health Organisation reminded us with its definition of health 'at its 52nd World Health Assembly:

'Health is a dynamic state of complete physical, mental, spiritual and social well being, and not merely the absence of disease or infirmity'.

In hospital and away from the comforts of home and the society of family and friends, the patient journey is not always an easy one - especially for those confronting serious or life threatening illness or injury. They face ultimate questions about life and death. They search for meaning in the experience of suffering, loss, loneliness, anxiety and impairment. The patient is forced to address in depth, perhaps for the first time, the realities of the human condition. And all these things play a crucial part in the journey towards wellness.

For real personalized care means much more than allowing the patient to choose a hospital for elective surgery or the provision of patient passports. It is about the whole person - body, mind and spirit - about care which is 'whole' - 'holistic'. For as the emergence of relatively new fields like behavioural medicine show, there is a very definite link between a patient's general well-being and happiness and their prognosis and response to treatment, and all those of us involved in the provision of healthcare, neglect this insight at our peril.

On Monday we marked International Nurses Day and we rejoice again in the dedication, empathy, compassion and skill of all who work at the coal-face to bring care which is both dignified and holistic to those who are sick. We celebrate sixty years of Marie Curie and their wonderful provision of end of life care, both in hospices and in patient's homes. And in this 60th anniversary year of the National Health Service, each one of us here tonight re-dedicates ourselves afresh to those shared values of excellence which in responding to patient need, facilitates their pathway towards healing, wholeness and well-being in their lives.

That is surely the daily inspiration and prayer of all in the nursing profession - and one to which our heroine, Florence Nightingale, would have undoubtedly said a loud 'Amen!'