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For decades medical schools and teaching hospitals focused on turning out superb technicians. Students and residents were expected to be well versed in the latest medical advances and knowledge about disease, but the advice they usually received on how to communicate with patients was to maintain emotional distance. As patients found out, good technicians didn’t necessarily make compassionate clinicians. Since then medicine has learned that compassion and communication skills should—and need to—matter. Studies have shown that compassionate care can lead to better patient outcomes and adherence to treatment regimens. And how doctors communicate to the rest of the care team also can affect patient outcomes, as well as work relationships and the culture of a health care system.
Charlotte Ashton visits NHS staff in Colchester, Essex, who are the first in the UK to receive compassion training. Can compassion get forgotten on a busy hospital ward? NHS staff in Colchester, Essex are the first in the UK to receive compassion training. During the course coach Andy Bradley explains which body language to avoid, how to listen properly, and why it is important to care for your colleagues. The scheme is a social enterprise, or a business with a primarily social purpose. Fifty-eight percent of social enterprises reported growth last year compared to 28% of small and medium-sized enterprises (SMEs).
f you are reading this post, then you likely work in long-term care. And if you do, the chances are good that your capacity for experiencing empathy is pretty advanced. After all, you interact, with some of the frailest individuals in society so you understand their emotional needs.
However, you might have a coworker who doesn't seem to “get it” yet. Whether they are new to LTC or seem to lack what scientists call the “empathy gene”, your colleague never seems to know just the right thing to say, even though they could be perfectly skilled, clinically speaking.
In a newly published study, researchers found the majority of medical residents surveyed experienced a decline in empathy over the course of the oft-used "long-call" shift. Fatigue and sleep deprivation are undisputed job descriptors for medical residents, but results from a new study indicate the common "long-call" shift may have adverse effects not only for residents, but also their patients.
A surprisingly consistent body of research exists indicating that conventional medical training actually reduces practitioner empathy. What is worse, the decline in empathy appears even more pronounced at the time that the curriculum shifts towards patient-care activities. In one study published in 2009 in the journal Academic Medicine entitled "The devil is in the third year: a longitudinal study of erosion of empathy in medical school," the authors conclude:
"It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential."
Until the past two decades, physicians (unlike other caregivers) have been skeptical about empathy, assuming that it would interfere with their clinical objectivity and effectiveness. This has shifted as research has shown that empathy plays a fundamental role in both diagnostic accuracy and treatment effectiveness. Repeated studies show that patients first give superficial clues about their histories until they sense empathy, and only then disclose anxiety-provoking information (as happened in the reported case). Such disclosure is crucial for making the correct diagnosis. Empathy is also important for establishing trust, and trust is a powerful determinant of adherence to treatment and thus effectiveness of care.2 Even when clinicians need to deliver bad news, their empathic engagement matters, empowering patients to take earlier steps in organizing treatment and self-care.... by Jodi Halpern, MD, PhD
It can be exhausting being compassionate and taking in other people's suffering on a full time basis. This condition is known as compassion fatigue. While first diagnosed in nurses caring for trauma victims back in the 1950s, it has come to attention again is the last couple of years, finally making the big time when just this week the Wall Street Journal published a story addressing how patient care is affected by caregivers who are in need of care themselves.
Researchers have only in recent years begun to study the effects of compassion fatigue, a form of burnout compounded by secondary traumatic stress. New programs are underway to help nurses cope with compassion fatigue, an occupational hazard for caregivers that also puts patients at risk of substandard care, today’s Informed Patient column reports. Though the intense emotional demands on nurses are as old as the profession itself, researchers have only in recent years begun to study the effects of compassion fatigue, a form of burnout compounded by secondary traumatic stress. According to a primer published last year by the American Nurses Association, compassion fatigue is “a combination of physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress.” By Laura Landro
A nurse refuses to help an ailing alcoholic who is upset to find a hospital detox unit closed. A hospital clerk brushes off a deceased woman’s grieving family as they try to pay her bills and claim her belongings. A charge nurse keeps the mother of gunshot victim from seeing her son, saying the emergency room is “too busy.” These harsh, real-life scenarios helped inspire Eve Ekman, a doctoral student in social welfare at the University of California, Berkeley, to study empathy burnout in the workplace, a condition expected to skyrocket this year due to the stress caused by the nation’s financial crisis.... Ekman hypothesizes that clinical empathy, instead of emotional distancing, can help alleviate job burnout and energize caregivers to act with compassion. Instead of being discouraged at claims of growing ‘compassion fatigue,’ which refers to the emotional numbing that caregivers can experience, she has found herself heartened by how many continue to demonstrate compassion in their jobs despite the daily suffering they encounter.
The decisions by medical schools to encourage what patients call "bedside manner" is a welcome advancement. But the effort should go farther, to reach practicing physicians so that they too can learn how empathy and effective communication can lead to better patient care and to protection from lawsuits. Rosenbaum's article [reprinted from The New York Times] shows the size of the task. When the existing medical culture lauds aloofness and demeans empathy and effective communication, the result is dangerous to patient and physician.
Purpose: Motivational Interviewing (MI) is used to help patients change their behaviors. We sought to determine if physician use of specific MI techniques increases patient satisfaction with the physician and perceived autonomy. Conclusions: When physicians used reflective statements, patients were more likely to perceive high autonomy support. When physicians were empathic, patients were more likely to report high satisfaction with the physician. These results suggest that physician training in MI techniques could potentially improve patient perceptions and outcomes.
There is an evidence-based scientific foundation for studying empathy as an important factor in patients’ health. They followed 891 diabetic patients for 3 years and conclusively showed that physicians’ empathy itself resulted in a 40-50% improvement in the measured results. Finally, in their concluding remarks, the researchers acknowledged any limitations to their methodology, but stated that their results do provide sufficient evidence warranting replication of this line of investigation at other institutions and with a variety of diseases. I became a convert. There is an evidence-based scientific foundation for studying empathy as an important factor in patients’ health.
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Doctors care. Most care deeply about their patients. “But patients don’t always know that,” said James Tulsky, director of the Duke University Center for Palliative Care. “That’s because when patients express distress or concern to their doctors, the physicians are unlikely to respond appropriately to that concern.” The doctors do have empathy, Tulsky said, but they generally don’t have the means to express it. But they can learn those means, according to researchers at Duke. Read more: The Herald-Sun - Duke researchers find doctors can learn empathy By Neil Offen img http://bit.ly/dP1O76
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Compassion fatigue develops when we give, give, give to those in need and neglect to care for ourselves. Compassion fatigue grows out of a constant exposure to hurting people, when we ourselves might be hurting. Compassion fatigue captures those who allow themselves to be entranced/jaded by the crazy things of this world. Symptoms might include: crass/dark joking, cold interactions with patients or even a lack of compassion for the true emergent situations.
Harvard Medical School's Department of Continuing Education offers complete CME course listings and online registration. The objective of this course is to explore how principles and practices of meditation, especially acceptance and compassion, can be integrated into patient care and support the therapist's own wellbeing. As a result of attending this course, you will be able to: define compassion as a psychological skill; identify conditions to support or hinder compassion in psychotherapy; describe the neurobiological processes of awareness and acceptance; trace the historical roots of compassion mind training; cultivate a compassionate response to suffering; and implement self-compassion as an antidote to compassion fatigue.
All Certified Nursing Assistants with Advocate Home Care Services are required to go through ASiST (Aging Simulation Sensitivity Training). "So, where your mother is saying, 'oh, my hands hurt, I can't do this.' You're going to say, 'OK, I understand'," Advocate Home Care Patient Care Coordinator Linda Rivard said. "As simple as it is for us, they can't do this."
PURPOSE: To determine whether vicarious empathy (i.e., to have a visceral empathic response, versus role-playing empathy) decreases, and whether students choosing specialties with greater patient contact maintain vicarious empathy better than do students choosing specialties with less patient contact.
METHOD: The Balanced Emotional Empathy Scale was administered at the beginning of each academic year at the University of Arkansas for Medical Sciences for four classes, 2001-2004. Students also reported their gender and specialty choice. Specialty choice was classified as core (internal medicine, family medicine, obstetrics-gynecology, pediatrics, and psychiatry) or noncore (all other specialties).
we hear a lot about how doctors are supposed to have empathy for patients, but should patients have empathy for doctors? My guess is that almost no one has ever even thought about this. I can’t say that I did before reading Patrick Barkus’ letter to The Wall Street Journal: … Do patients empathize with doctors? This is a question one seldom hears asked, and it seems symmetry would demand that it at least be considered. Without the hint of an equivalency between patient and doctor it is doubtful that empathy exists as much more than an abstraction and rarely on a one-to-one basis. A further point. One could argue that physicians reluctance to discipline each other is a sign of real-world empathy in practice. A reluctance often criticized but rarely praised. … img http://bit.ly/dP1O76
Just inside the entrance to Pasqua Hospital, colourful panels adorn the walls; gold, silver and bronze casts of hands reach out towards the room. On Tuesday evening, those hands were stretched towards those who were there to celebrate the unveiling of the huge, 20-footlong mural. Titled the Oneness Compassion Mosaic, it was created by 300 Regina Qu'Appelle Health Region patients, family members, volunteers, health care staff, students and members of the community over the space of almost two years. "Their trust was incredible," said Bonnie Chapman, the artist in residence who conceptualized, facilitated and curated the project. BY EMMA GRANEY
Modern medical technology helps patients recover faster than any other time in history. However, the human interaction between patient and care giver is still the essential foundation of healing. I'm Here is a personal narrative from the patient s perspective. Filled with practical advice, packed with humor and overflowing with appreciation, Marcus Engel encourages health care professionals to practice compassionate communications in all its forms.
Hospitals are fighting compassion fatigue—a mix of emotional stress and burnout—amid a shortage of nurses and concerns about patient care. Compassion fatigue is a combination of secondary traumatic stress from witnessing the suffering of others and burnout. It can lead nurses to feel sadness and despair that impair their health and well-being. Hospitals are tackling the problem amid a worsening shortage of nurses and concerns that patients may suffer. Compassion fatigue can reduce nurses' empathy and lead them to dread or even avoid certain patients, raising the risk of substandard care.
Patient experience has emerged as a dynamic issue for healthcare CEOs, physicians, and industry leaders. No provider can afford to offer anything less than the best clinical, physical and emotional experience to patients and families. As patients become savvier, they judge healthcare providers not only on clinical outcomes, but also on their ability to be compassionate and deliver excellent, patient-centered care. Multidisciplinary Conference The Patient Experience: Empathy and Innovation Summit is a three-day, multidisciplinary conference devoted to exploring patient experience as a key differentiator essential to the future of healthcare delivery. Click here to see the agenda from the May 22-24, 2011 Summit. The Summit will feature expert panel discussions about the national patient experience movement, providing participants from all disciplines the opportunity to identify shared challenges and inspire innovative solutions to help transform the patient experience and elevate customer satisfaction as a competitive differentiator.
We are now planning, organizing and launching a one year online international conference on the question of,
'How Can We Build a Culture of Empathy and Compassion?'
The conference consists of an ongoing series of online Panel Discussions with empathy and compassion experts from all fields and walks of life. The panels take place using Skype group video conferencing and are recorded and placed on Youtube for viewing at any time.
Location: Online on Skype and YouTube Date: A one year 'rolling' conference starting November 1, 2011 and ending Oct 2, 2012 Vision: We envision a global culture of empathy and compassion, in a world where people experience the joy of being connected to each other and interconnected with all life.
The doctors in this study, published last week in the Annals of Internal Medicine, learned empathy - from a computer. That's right, a computer. Researchers at Duke University in the US developed a computer program that teaches what cancer specialists learn when they take courses on empathy. Researchers audiotaped between four and eight encounters between the cancer doctors and their patients - people with advanced cancer. Those recorded sessions were submitted throughout the study period to monitor empathic responses and - in the case of the doctors who received special training in the empathic response - provide tips on how to improve.
A questionnaire assessing students’ satisfaction with, and opinions on, empathy training, as well as barriers to training, was distributed during the last quarter of the year.
RESULTS: Of 188 eligible participants, 157 (84%) responded. Approximately one-half of the respondents said empathy could be taught. Eighty-one percent of respondents felt that their empathy had increased or stayed the same during their training. When asked about barriers for learning empathy, the majority of respondents chose time pressure and lack of good role models.
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