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 Cs of caring have been developed by Simone Roach
(2002) in response to this question (p.43). These six Cs 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
Man

The Cocky Man

Posture

Comfortably erect

Slouching or too erect

Eyes

Look right into her eyes

Shifting around - not into her

eyes

Hands

Relaxed, at the sides,

on table, etc.

Constantly touching
something or himself

Speech

Relaxed, slow and

specific.

Strained, tense, choppy, fast

and too loud or soft

Talks About

Her, others and things

in general

Himself

Face

Pleasant, easy
expression

Facial "ticks" or odd

expressions

A Plan

Has one!

Doesnt think he needs one

CONFIDENCE
1) Dress and groom yourself well.
Dress better than the best-dressed person you expect to meet. If you dont, youll feel inferior
subconsciously which will manifest itself as nervousness outwardly. Also, make sure youre properly
groomed. You do this for the obvious reasons just stated, but even more important - if youre 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! Shell 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 wont have to worry about this on top of
everything else.
2) Build it up from inside.
Confidence is very difficult to fake, so youre 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 doesnt know the difference between
reality and the things you tell yourself - if you do it with conviction. Of course, youre 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 - hes 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 youve 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 youre doing here is programming your mind for success. Youre 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! Dont 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 persons 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 dont dwell!) and, if you find that youre gestures become erratic or large, play them down. Focus on
the calm confidence youre trying to show.
4) Hold a drink in your LEFT hand!

First, holding a drink (even if its 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) Dont 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 mouth
And a hundred other signals - any one or two of which are enough to set off red flags in her head. Further,
it gives you "smokers 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 dont keep the nicotine level high enough in your blood
stream, youre 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 youre 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 doesnt 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.
Youd be surprised how great a "conversationalist" you become by letting the other person do all the
talking!
Obviously, you cant go on and on without saying something, but dont 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 doesnt 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, wouldnt it be easier to speak in public about something you already
know well rather than about something you dont? And, wouldnt it be even easier if you had hours of
practice beforehand? Of course! You can practice these confidence-building techniques anytime and
youll 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 - 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 thats 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 Cs
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 Cs. These
6 Cs 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 Cs
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 feedback
Competence a high level of competence is required to deliver appropriate care, recognise a deteriorating
situation, challenge poor practice or decision making of others
Communication good communication involves better listening and shared decision making no decision
about me without me and making every contact count
Courage 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 working
Commitment 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 Cs
Built 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.