Shootout: what penalties say about life

Football is a global language and the shootout is the end to Shakespearian tragedy.

Simon Burton-Jones

Simon is Bishop of Tonbridge in the Diocese of Rochester. He writes regularly round social, cultural and political issues.

England v Columbia: 2018 World Cup shootout.

It is hard to pity entitled, overpaid footballers. Until, that is, it comes down to penalties after extra time. Even when you do not care who wins, the drama of the penalty shootout is so intense and all-consuming that every heart rate quickens.

Is there a more exquisite form of sporting torture?

Sport is laden with cliché, and the refrain, ‘it’s come down to the lottery of penalties’ is an established part of the lexicon. But is it just the spin of the roulette? That you can’t prepare effectively for the cauldron of the stadium?

Not according to Geir Jordet, it isn’t. The Norwegian Professor of Psychology and Football is on a mission to convince the world there is lots you can do to get ready and those that don’t are more likely to fail.

There is skill involved in taking a penalty, an ability that can be honed with practice. Individual players can be trained to take their time (but not too long), to establish a routine that helps them take control of the situation, to take careful breaths, and to focus. They can be helped with blocking out the trash talk of opponents, especially goalkeepers, who subtly try to get under their skin in the seconds leading up to a penalty. Extensive research can be carried out by data-rich backroom staff to help with preparation. And behind all this is the recognition that taking a penalty is a team effort, not an individual one.

This latter observation feels especially counter intuitive. There is nothing more lonely than the appearance of one man or woman taking the long walk from the centre circle to the penalty spot. But teams can support one another with words of encouragement and touch. Not just in the grasping of each other’s shoulders in the centre circle, but in reaching out to those who both score and miss. One reason Geir Jordet advises that the manager should choose penalty takers rather than look for volunteers is that they then can take full responsibility for the outcome. It is hard to believe there are still times when a manager looks around at players after extra time, hoping to see in the eyes who is up to the task. These duties should be sorted out in advance, with back-up plans for when players are injured or substituted.

Deciding war between opposing tribes based on an individual contest was quite common in the ancient world – effectively moving to the penalty shootout before the game, to save the effort.

Jordet, in his stimulating book Pressure: Lessons From The Psychology Of The Penalty Shoot Out says that anxiety is normal and should be embraced. Greater openness round mental wellbeing is allowing the modern professional to admit this. Erling Haarland, one of the world’s most accomplished goal scorers, has shared the fear he regularly feels round taking a penalty; it is hard to imagine a player from the 1970s saying the same.

Missing a penalty in the shootout is inevitable; the only way it can conclude. And statistics show that the world’s greatest players, like Lionel Messi, are not notably better at converting penalties than others. On average, the best players have around an eighty percent success rate (which, significantly, is one missed penalty out of five in a shootout). As in other professions, the best results are achieved by creating systems and cultures that can adapt quickly and honestly to errors and learn from them without humiliating those who fail.

Reading the book cast my mind back to the archetypal shootout between David and Goliath. Deciding war between opposing tribes based on an individual contest was quite common in the ancient world – effectively moving to the penalty shootout before the game, to save the effort. Perhaps David should have lost it, and not just because of his size. Beforehand, he had a serious bust up with his side and those who did not see him as a team player. Then Goliath trash talked him like Emi Martinez is famed for with Aston Villa and Argentina. And finally, he ran up to take his shot very quickly, without much reflection. But then again, Geir Jordet would be the first to point out that preparing badly for a contest does not mean you can’t win it – just that you are less likely to.

Football is a global language and the penalty shootout is like the cataclysmic end to a Shakespearian tragedy. English fans are long suffering audiences of this trauma – from Italia 90 to Wembley 2021, via the 1996 Euros when football was coming home until a last minute wrong turning. But many other nations have under-achieved at penalties, like Holland and Spain and, more recently, France. Roberto Baggio of Italy missed the decisive penalty in the first World Cup Final to go to penalties in 1994. He says of it:

‘I failed that time. Period. And it affected me for years. It was the worst moment of my career. I still dream about it.’.

The personal stakes are as high, if not higher, than the nation’s.

We are left with the feeling that hugely divergent outcomes can emerge from the smallest and most random of causes. The human tendency is then to rationalise the outcome in ways that make it seem inevitable. Geir Jordet is aware of this in football, but in other walks of life, we continue to build up wobbly cases on shallow evidence as a way of warding off anxiety or the fear that others will think we are clueless if we admit to the existence of chance. Most people are right less than eighty percent of the time; something we might hold in mind when the next England players make that solitary walk to the penalty spot.

Article

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.