Sister Simone Roach, (1992), states that caring is the human mode of being (p.2). Roach (1992) discusses how people in healthcare professions care for others not because they are required to do so by their jobs, but because they are human beings and this trait of caring is intrinsic to all humans (p. 3). According to Roach (1992) caring is the underlying concept that forms the basis of what nurses do each and every day (p. 17).

Roach (1992) posed an interesting question during her work on caring. This question is: What is a nurse actually doing when he or she is caring? The six C’s of caring have been developed by Simone Roach (2002) in response to this question (p.43). These six C’s are described as attributes of caring that aid in identifying the specific caring behaviours that a nurse engages in when providing care for a patient (p.58).

COMPASSION?Answer

Show a genuine interest in the other person's suffering. Listen to their problems without interrupting. Use

body language that shows interest and that you agree with them, such as nodding your head at an

appropriate time. If you know the person well enough, a warm hug goes a long way to comforting a

distressed friend. Think of something special to do for him or her, whether it's cooking a meal, sending a

little gift, or anything else that could brighten their day and let them know that someone truly cares.

CONFIDENCE:

The Confident

ManThe Cocky Man

Posture Comfortably erect Slouching or too erect

EyesLook right into her

eyesShifting around - not into

her eyes

HandsRelaxed, at the sides,

on table, etc.Constantly touching something or himself

SpeechRelaxed, slow and

specific.Strained, tense, choppy, fast and too loud or soft

Talks AboutHer, others and things

in generalHimself

FacePleasant, easy

expressionFacial "ticks" or odd

expressions

A Plan Has one! Doesn’t think he needs one

CONFIDENCE

1) Dress and groom yourself well.

Dress better than the best-dressed person you expect to meet. If you don’t, you’ll feel inferior subconsciously which will manifest itself as nervousness outwardly. Also, make sure you’re properly groomed. You do this for the obvious reasons just stated, but even more important - if you’re not well groomed, you give any woman you meet a reason to look at you more closely - and, women can be critical enough without your help! She’ll start to pick up small details that translate in her mind into your lack of confidence. By grooming yourself well, (including your hair, nails, moustache and beard, ear and nose hair, eyebrows, and having a good shine on your shoes) you won’t have to worry about this on top of everything else.

2) Build it up from inside.

Confidence is very difficult to fake, so you’re going to have to help yourself by adopting a confidence "physiology" What does this mean? Specifically, by creating thoughts of confidence in your mind, your body will react and display that confidence. So many of the "quirks of confidence" come out in very small things - like an almost imperceptible smile from the corner of your mouth or the brightness in your eyes. These are all subconscious indications of confidence. You want as many of these coming through as possible.

First, give yourself an easy pep talk. Tell yourself, "I look great today!" and "I feel good about myself." These seem silly at first, but consider that your subconscious mind doesn’t know the difference between reality and the things you tell yourself - if you do it with conviction. Of course, you’re going to have to actually think you DO look good, so give yourself a leg-up and dress well, be well groomed, etc. Then, when you look in the mirror and say you look good, your brain adds the thought, "Yep - he’s right!"

Next, run some confidence-building thoughts through your mind. To do this, get into a comfortable, quiet place - your living room or bedroom is best, but even your car will do - sit quietly for a moment and relax. Try to remember a time that you felt totally comfortable and confident. Try to remember the exact feelings you had and then recreate them. Try to feel exactly like you did when you felt calm, comfortable and confident. Now, with these feelings in place, imagine walking up to a woman you’ve never met and saying "Hello." If you lose the feelings, go back and recreate them and try again. Continue this until you can keep the feelings going while imagining talking to a new woman.

What you’re doing here is programming your mind for success. You’re telling your mind in the most direct way possible what you expect of it. It will respond if you give it the right messages clearly enough. Most of us spend time thinking of the worst thing that could happen. Then, what happens? The worst thing! Don’t do this to yourself. Use your mind to build positive experiences and expectations.

3) Remember the term "Calm Confidence."

One of the most obvious signals to a person’s lack of confidence is in their nervousness. A confident person is usually calm and has easy, natural gestures and mannerisms. By adopting the correct physiology through the techniques just discussed you will add greatly to this. However, pay attention to your actions (but don’t dwell!) and, if you find that you’re gestures become erratic or large, play them down. Focus on the calm confidence you’re trying to show.

4) Hold a drink in your LEFT hand!

First, holding a drink (even if it’s only water) gives you something to do with your hands and prevents you from fidgeting. This is important: always hold a drink in your left hand - not your right! Why? Because drinks, being cold will give your hand a cold, clammy, wet feel - a dead giveaway to nervousness!

5) Don’t smoke before or while meeting someone.

Many people use smoking as a relaxing activity and falsely believe that it makes them calm. In fact, cigarette smoke is a stimulant. If you smoke before you meet someone your physiology will change, giving off all kinds of signs of being nervous including:

* Increased blood pressure * "Flushed" face and hands* Constricted pupils* Dry mouthAnd a hundred other signals - any one or two of which are enough to set off red flags in her head. Further, it gives you "smoker’s breath." Women constantly report that bad breath is one of their main turn-offs.

On the other hand, if you are a smoker and you don’t keep the nicotine level high enough in your blood stream, you’re going to get minor withdrawal symptoms including the "shakes" - another giveaway. So the answer is to have your smokes well before you plan to meet someone. Then, brush your teeth, use mouthwash, etc. to help eliminate the breath problems. Your body will have a chance to even out the nicotine levels and return you to a more balanced state.

You should never smoke while you’re meeting someone new. Why not? First, there is a heavy backlash against smoking these days - sometimes even by smokers themselves! Having your prospective woman complain about smoke in her face is not a good sign. Second, holding a cigarette in a nervous hand amplifies any shaking you may have - no matter how minor. Third, it really doesn’t look very cool to have a burning weed hanging out of your mouth, regardless of what the ads say!

Remember: it is never inappropriate NOT to smoke.

6) Limit the coffee, tea, sodas and other stimulants.

Just like with smoking, these increase your nervous signals. One cup of coffee may help clear a fogged mind, but an entire pot is going to make you wired. So too with sodas and even candy - many contain high levels of caffeine, and should be avoided.

7) Shut the hell up!

Nervous people just yammer on about only things they know about. By being quiet, other than to ask "leading questions" (those that require more than just a "yes" or "no" answer), you let her do most of the talking. Not only does this help to conceal your nervousness, it also gives her another focus - herself. You’d be surprised how great a "conversationalist" you become by letting the other person do all the talking!

Obviously, you can’t go on and on without saying something, but don’t confuse a speech with a response. Especially when you first meet someone, you just need to make contact and focus on your goal - getting the home phone number. It doesn’t take many conversation tools to do this. Further, she is probably better at talking than you are anyway. Let some mystery help you along to your goal.

8) Practice.

Many people spend years perfecting their crafts. Consider making a speech; very few people are born good public speakers. However, wouldn’t it be easier to speak in public about something you already know well rather than about something you don’t? And, wouldn’t it be even easier if you had hours of practice beforehand? Of course! You can practice these confidence-building techniques anytime and you’ll find that they eventually become second nature.

COMPETENCE:

Some scholars see "competence" as a combination of practical and theoretical knowledge, cognitive skills, behavior and values used to improve performance; or as the state or quality of being adequately or well qualified, having the ability to perform a specific role. For instance, life, management competency might include systems thinking and emotional intelligence, and skills in influence and negotiation.

CONSCIENCE:

Paul uses the term συνειδησις - often translated as 'conscience' and 'heart' - to describe the human ability to know and choose the good. He taught that all people, whether or not they are Christians, know what is right and wrong. He said it is written on our hearts:

Augustine had used the term 'synderesis' to mean an innate knowledge of right and wrong. He held that this was faulty, due to the fall, and that Christians should look to the authority of the Church and Scripture. Aquinas disagreed, holding that conscience has binding force.

COMMITMENT:

Bringing energy and initiative to your job every day shows commitment. Caring more about your work and your organization will show in the results you produce. Showing commitment can demonstrate your leadership potential to managers and lead to career opportunities. Additionally, an effective and dedicated manager is the most influential factor in employees’ commitment, according to a 2010 Zenger Folkman study that asked nearly 100,000 employees about why they commit to their jobs.

Keeping motivation strong

Keeping yourself and your co-workers or subordinates motivated can show your commitment to the overall challenges and demands of your business. It can be challenging keeping up high performance standards when your co-workers’ commitment to their jobs wanes. Encouraging employees to develop new skills, improve operations and process or take new risks to advance the business can awaken new levels of commitment, suggests Michael A. Olguin in his “Inc.” article, “Worn Out Employees? Five Ways to Crank Up the Energy.” Also, practicing and encouraging a healthy balance between work and personal life shows commitment to worker well-being that’s good for business

Work Schedules

From an employer's standpoint, one of the most obvious signs of commitment is how employees approach the length of their workday. Good employees accept that sometimes, they might have to show up early -- or stay later -- to help a company accomplish its mission. By contrast, workers who can't wait to punch

out at 5:00 are probably more concerned about the employer's ability to make payroll, and less interested in the organization's welfare -- or their own role there

Show your commitment to your new job by developing your skills

NEW C’s

Compassion for practice - The Vision and Strategy for nurses midwives and health care staff (2012) requires ‘nurses, midwives and health care staff to deliver high quality compassionate care and to achieve excellent health and wellbeing outcomes. This has been captured in what is now called the 6 C’s. These 6 C’s will be reflected in many aspects of your current practice assessment documents. Mentors will be seeking evidence that you are able to demonstrate the professional behaviours reflected in the 6 C’s below.

Care – the public feel that we need to be able to measure the quality of nursing, midwifery and care giving to ensure that it is delivered on a consistent basis, first time, every time in the right setting and the right way.Compassion – the public speak about the importance of recruiting nurses/midwives and care givers with compassionate values; measuring and assessing compassion; and the processes used to promote compassionate care, for example the use of annual appraisal and feedbackCompetence – a high level of competence is required to deliver appropriate care, recognise a deteriorating situation, challenge poor practice or decision making of othersCommunication – good communication involves better listening and shared decision making ‘no decision about me without me’ and making every contact countCourage – many people felt nurses, midwives care givers might be afraid to speak up – it takes courage to stand up to poor care and to innovate, suggest and implement new ways of workingCommitment – commitment to take action together as a profession to unlock its potential

Having effective leaders throughout all care givers (so not just nurses but including all allied health professionals, healthcare assistants etc…) is also key to the delivery of this strategy – are you a leader? Could you be a leader?

Thinking about your own career, who would your role model be as a leader? Mine is the ward sister on the very first ward I experienced as a student nurse. She was central to how the ward ran; knew all the nurses and auxiliaries, got to know student/pupil nurses (yes – I am old enough to remember the enrolled nurse programme), and also knew the consultants very well and what made them tick – including how they took their coffee and what their favourite biscuits were.

That ward sister was inspirational. She was a true leader who ran her ward very well and had the respect of all those who worked there. She had great systems and processes set up to ensure the patients got the high quality care they should, ensured learners got the all the experience they needed in a supportive way, found time to develop her own team, and was fully committed to her ward.

All of this seemed to be done without any effort and she had the respect of all the staff who worked there: nurses (qualified and student), auxiliaries, domestics, ward clerk, medical students and medical staff.

All of the staff who made up the team were leaders in their own way, including the students: it may have been doing the night-time drinks round (with cocoa or ovaltine made with frothy hot milk), or ensuring Mr Smith got his dressing changed on time, but all these bits added up to the efficient running of the ward, which delivered high quality care.

Looking at the 6 Cs, I believe the first ward I worked on very easily ticked all those boxes – can you say this now for the area you work on? Some of you will say yes but I bet a lot of you say no. Why is that? Is it because not everyone takes on the responsibility of being a leader? Surely now that we have technology and first-class medicines, dressings and supplies available to help us, this gives us more time to care, develop professionally and be there for our colleagues, patients/families and the organisation you work for?

If we are to take on the strategy from the CNO and embrace the 6 Cs we will certainly need some of the courage she talks about. 'Go back to basics,' I hear many people cry, or get rid of the paperwork, or perhaps start to respect each other again. However we address the 6 Cs, we have to make decisions that will ensure all the patients we see/have influence over (for those who may not be direct care givers) are given the best possible care that they deserve.

I urge you all to look at the strategy, even if it is just the 6 Cs, and look at your practice and evaluate how you work and look to change six things, one for each of the Cs – however small the changes may be.

England's chief nursing officer, Jane Cummings, is the first to admit that the Mid Staffordshire hospital scandal and other care failings have rocked both public confidence and staff morale in nursing."It was very clear that nursing was getting a bit of a bad name and it felt like the profession was being quite beleaguered and criticised," says Cummings. "Nurses felt frustrated about that, but we also knew that we had evidence from Mid Staffs, from the first report, that actually care had been bad. Nobody in this country can say that care is brilliant all of the time."

In response, Cummings used her new role at the National Commissioning Board, the body that now runs the NHS in England following the radical reorganisation of the health service earlier this year, to devise a strategy designed to set a strong direction for nursing, and to improve patient care."I wanted to see something that both addressed the need for leadership and direction, and what we can practically do that will improve the care we give," she says.

The six CsBuilt around the six Cs – care, compassion, competence, communication, courage and commitment – her "compassion in practice" plan sounds a bit motherhood and apple pie, but Cummings insists there is substance behind the fine words.