10/13/2017. Transformational Care. Objectives. The Role of the Empathic Nurse

Transcription

1 Transformational Care The Role of the Empathic Nurse Mary Coughlin MS, NNP, RNC-E President and Founder Caring Essentials Collaborative Boston, MA Objectives Upon completion of the learning session participants will: The learner will describe the difference between empathy and sympathy The learner will discover the biological correlates of empathy in the patient and self 1

2 Whether physician, therapist, social worker, or nurse, we engage in healing relationships with our patients and their families during a time of extreme vulnerability, sadness, and fear. (Coughlin 2016) As their lives unfold, our consciousness, our intentionality, our presence, makes a difference for better or for worse (Watson, 2003) Caring Essentials Collaborative A View from the Edge Creating a Culture of Caring As a patient, I was privy to failures that I d been blind to as a clinician. There were disturbing deficits in communication, uncoordinated care, and occasionally an apparently complete absence of empathy. I recognized myself in every failure. Awdish

3 Bearing Witness When we are unable to be present or turn away from the lived reality of our patients we fail our moral responsibility and undermine quality care and patient safety Coughlin 2016; Naef Caring Essentials Collaborative Defining Moments an event that typifies or determines all subsequent related occurrences 2016 Caring Essentials Collaborative 3

4 Maybe this one moment, with this one person is the very reason we are here on earth at this time Jean Watson Intensive Caring 2016 Caring Essentials Collaborative Activity Interpersonal Reactivity Index Davis

5 I often have tender, concerned feelings for people less fortunate than me. (EC) I sometimes find it difficult to see things from the "other guy's" point of view. (PT) (-) Sometimes I don't feel very sorry for other people when they are having problems. (EC) (-) I try to look at everybody's side of a disagreement before I make a decision. (PT) When I see someone being taken advantage of, I feel kind of protective towards them. (EC) I sometimes try to understand my friends better by imagining how things look from their perspective. (PT) Other people's misfortunes do not usually disturb me a great deal. (EC) (-) A (Doesn t describe me at all) B C D E (Describes me very well) A (Doesn t describe me at all) If I'm sure I'm right about something, I don't waste much time listening to other people's arguments. (PT) (-) When I see someone being treated unfairly, I sometimes don't feel very much pity for them. (EC) (-) I am often quite touched by things that I see happen. (EC) I believe that there are two sides to every question and try to look at them both. (PT) I would describe myself as a pretty soft-hearted person. (EC) When I'm upset at someone, I usually try to "put myself in his shoes" for a while. (PT) Before criticizing somebody, I try to imagine how I would feel if I were in their place. (PT) B C D E (Describes me very well) Nightingale Legacy The nurse is responsible for creating and maintaining an environment conducive to the healing process. Compassion Commitment to patient safety Diligent & thoughtful hospital administration Teamwork Nightingale

6 Sakallaris et al 2015 Components of a Transpersonal Healing Environment Internal Environment Healing Intention Personal Wholeness A conscious and benevolent mental activity (thought) purposefully directed toward health, wellbeing, healing, or highest good for one s self or another. Healing intention is manifest in the care setting in various ways, including setting intentions, prayer, and assessing patient hopes and expectations for healing and incorporating those hopes into the plan of care. The congruence of mind, body, and spirit, experienced through relationship with self and others, resulting in completeness and wellbeing. Mind-body-spirit congruence is enhanced through mind-body practices and interventions and attending to spirituality. Sakallaris et al 2015 Activity 6

7 Why Should we Care? The nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected. The nurse demonstrates professional values such as respectfulness, responsiveness, compassion, trustworthiness and integrity. The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. The nurse strives to foster and maintain a practice culture promoting ethical behavior and open dialogue. ICN Code of Ethics, 2012 The Power of Vulnerability Most people believe vulnerability is weakness. But really, vulnerability is courage. We must ask ourselves are we willing to show up and be seen? - Brené Brown 7

8 Three elements of Self Compassion Self-kindness vs. Selfjudgment. Self-compassionate people recognize that being imperfect, failing, and experiencing life difficulties is inevitable, so they tend to be gentle with themselves when confronted with painful experiences rather than getting angry when life falls short of set ideals. Common humanity vs. Isolation Self-compassion involves recognizing that suffering and personal inadequacy is part of the shared human experience something that we all go through rather than being something that happens to me alone. Mindfulness vs. Overidentification Mindfulness is a nonjudgmental, receptive mind state in which one observes thoughts and feelings as they are, without trying to suppress or deny them. At the same time, mindfulness requires that we not be overidentified with thoughts and feelings, so that we are caught up and swept away by negative reactivity. Neff 2011 Gather your ATTENTION Recall your INTENTION Attune Consider Engage / End Halifax

9 -Dr. Seuss References Awdish, R.L.A. (2017). A view from the edge creating a culture of caring. New England Journal of Medicine, 376(1), 7-9. Coughlin, M. (2014). Transformative Nursing in the NICU. New York, NY.: Springer Publishing Company. Halifax, J. (2014). G.R.A.C.E. for nurses: cultivating compassion in nurse / patient interactions. Journal of Nursing Education, 4(1), References Neff, K. (2011). Self-Compassion: The Proven Power of Being Kind to Yourself. New York, NY: William Morrow Publishers. Sakallaris, B.R., et al. (2015). Optimal healing environments. Global Advances in Health & Medicine, 4(3), Watson, J. (2009). Caring as the essence an science of nursing and health care. O Mundo da Saœde S o Paulo, 33(2),

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