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The power of those small acts of kindness


This blog was originally published on the NHS Leadership Academy website in 2014.

'Remember there’s no such thing as a small act of kindness. Every act creates a ripple with no logical end.'

Scott Adams, artist and cartoonist

My father was dying. He was lying in bed in a coma. He had been there like this for the past five days. My mother, brother and I had spent those past five days taking it in turns to sit with him 24 hours a day. On the morning of the sixth day I was returning to my dad’s bedside, it was 7.00am and as I came down the corridor I heard a voice coming from my dad’s room. Someone was chatting away and as I stood outside the door I could just see a woman cleaning the room. As I watched and listened I heard her telling dad what a beautiful day it was going to be and what the gardens were looking like outside of his window. She continued to talk, explaining what she was doing, how his family was, and as she leant across to dust the side table she stopped momentarily and gently touched his shoulder as she adjusted his blanket.

'I walked away from the scene needing just to find some space for myself to sit with what I had witnessed and fully appreciate it.'

In that moment I was overwhelmed, deeply touched and taken aback by the quality of compassion and care I saw coming from this woman in her simple, mindful and deeply respectful approach to her work. I walked away from the scene needing just to find some space for myself to sit with what I had witnessed and fully appreciate it.

Afterwards I found the cleaner, Lisa, and thanked her for the care she was administering. I asked her where she learnt how to do that and she told me that she always approached her work this way. She thought about each person as if they were a member of her own family. She imagined how important it was in those final days for the families and their loved one to be able to say goodbye to each other in an environment that was ‘clean, tidy and presentable’. She said she felt ‘honoured and privileged’ to be doing this work and making a small difference to the lives around her.

She told me that when she first arrived to work at the organisation her manager had asked her into her office. The manager explained that she was critical and integral to the achievement of the team and organisation’s vision. She explained what the purpose and vision of the organisation was, the values that underpinned their work and asked Lisa to reflect on how she needed to work both individually and as part of a team in order to support the achievement of that vision. The manager reinforced that everyone in the team depended on the quality of the work and presence of each other. No one member of the team was more important than any other whether that was the doctor, nurse, manager, cleaner or kitchen staff. They were all partners in achieving their goals and the organisation’s vision. On a moment-to-moment basis what they did – and how they were made a qualitative difference to the people around them and could very well be the last experience a family or their loved one had before they passed on.

'It was obvious that she acted as a role model and a beacon of good practice and her sense of unassuming and assured self-leadership pervaded the culture.'

What I discovered in talking with Lisa was that her approach to her work was also guided by her connection with her sense of inner leadership. The humbleness and quiet authenticity she brought to everything she did reflected her values that were so important in influencing the choices and decisions she made.  Whether she was dusting the table, filling the water jug or cleaning up a spillage, everything was treated with the same importance and care, revealing her deep commitment to her own personal sense of purpose and the vision that guided her work. This presence she brought to her work was communicated to other newer members of the cleaning team. It was obvious that she acted as a role model and a beacon of good practice and her sense of unassuming and assured self-leadership pervaded the culture. And all of this had been nurtured and supported by a manager modelling the same quiet confidence in her own leadership style and presence.

What this manager and her team had created was the kind of culture that was naturally populated with those small acts of kindness and compassion that really do make a difference. This meant that when my father died three hours after Lisa had left his room we knew he had died being genuinely loved and cared for by everyone around him.

If we are to work towards patient-centred care and if the patient experience is to be the final arbiter of everything we do in the NHS then patient engagement needs to be built on the kind of relationships modelled by Lisa and her fellow team members. I believe that as we face the pressures, stresses, uncertainty and complexity of life in today’s NHS we could learn a lot by looking at what this group of staff did: how they built the kind of collaborative relationships and partnerships between themselves, the patients and their families. Watching this team work together, lead themselves and lead each other has taught me as a patient leader some immensely valuable lessons about leadership. In particular the importance of seeing compassion, care and love as an integral and essential part of being an effective leader and not a sign of weakness. Finally I have learnt that simple authentic acts of kindness can have such a powerful influence throughout the system, spreading out, influencing and supporting the deliverance of the ‘hard’ outcomes, deliverables and targets that guide the work we do together.

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