Cultivating Compassion in Nursing
The society of the developed world has been experiencing a culture shift. We are more productive than ever, with technology that we joked about as science fiction only 30 years ago. We are connected all the time through our cell phones and the internet, enabling us to spread ideas and stay in contact in ways we never thought possible. This advancement applies to medicine as well. Research continues to help people live longer and healthier lives. Yet with every technological or scientific development we make, we must not forget the impact of emotional connection. Compassion must not be underestimated as a crucial nursing skill to improve patient outcomes. As nurses, we must continue to cultivate compassion, taking measures to avoid compassion fatigue while aiming to communicate empathy to patients and their families. Here I aim to emphasize defining compassion with the importance of both humility and taking action; and thereafter give the experiences which shaped this perspective in my own career and the ways I hope to move forward with the deepest compassion in my future career as a nurse.
Compassion is commonly defined with words and phrases such as “caring for others,” “sympathy,” and “kindness and understanding”. In the nursing field, compassion is most often touted as paramount to the profession, and I am a firm believer in this message. But the definition of compassion in nursing should be elaborated on greatly, emphasizing not just the importance of being able to feel compassion for our patients, but more importantly that we act on those feelings. Compassion fatigue, or the “combination of physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress,” (Lombardo & Eyre, 2011, p.1) has come into light in more recent generations of nurses, and “self-care” has been taught as an important skill. The growing concern for this problem might leave students and new graduates confused about where the balance lies between compassion that compels us to work as hard as we can, and avoiding compassion fatigue through the practice of self-care. I believe that in light of the negative effects that compassion fatigue can have on patient outcomes, a true, detailed definition of compassion in terms of the nursing field encompasses sympathy, concern, and understanding for the well-being of patients, being compelled and having the initiative to take action towards helping that person, and doing everything in your power to improve the outcome of that person’s situation. On an individual basis, this might seem to eliminate the condition for self-care, but from a big-picture perspective, the ability to care for patients best comes as an emotionally healthy, stable nurse.
Fulfilling this vision for being both compassionate and emotionally healthy requires certain actions be taken to maintain the capacity for interpersonal skills, empathy, and mental stability. In order to do everything in our power to improve the outcome of patients day after day, a certain level of self-awareness and humility to recognize one’s own limits must be practiced. In my experience, this might mean recognizing when I am failing to fully rest because I am taking the emotional load of my workplace home with me, and taking measures to combat this with recovery measures. Another example of this self-awareness could be as simple as placing importance on maintaining a healthy, energizing diet and exercise regimen. Through these action items, serving both patient-care and self-care purposes, we can be experience true, sustainable compassion in nursing.
My most in-depth experience in health care is with the unique patient population I spent time with at the US Department of Veterans’ Affairs (VA) hospital in Seattle. As a clinical research coordinator, I didn’t see many critically ill patients, but many of our research participants suffered from moderate to severe PTSD, and social and emotional stressors that ultimately affected their physical health more than the patients often recognized. An analysis of veterans returning from Iraq and Afghanistan showed that 76% of participants suffered from mood swings, 74% with anxiety, and 66% with depression, all of which are associated with post-concussive syndrome, the most common condition of this era of combat veterans. Seventy-one percent suffered from headaches and 66% with excessive fatigue (Lew et. Al., 2007). These ailments make it difficult for these veterans to do things such as maintain employment and perform daily tasks such as cooking and cleaning. Their family support is of utmost importance yet these problems also negatively affect their relationships.
For all these reasons, veterans are in particular need for compassionate care. Most of them have undergone many traumatic experiences and have trouble adjusting to non-military society once they leave service. They often have to begin new careers while struggling with PTSD episodes and abruptly transitioning from the unique culture of military deployment to new routines such as family life or going to college. As they pursue care at the VA, many system barriers face them in trying to attain the benefits they need and the process can be quite daunting. Like most other experiences anyone may have had in government settings, there are certain inefficiencies in administration at the VA. In addition, there is stigma associated with veterans attaining VA benefits, that they might be lying about symptoms or experiences to take advantage of the system. Individual barriers in providing care to veterans might be that unless one is a veteran themselves, it can be hard to relate to the experiences that these patients have. Relating neither practically nor emotionally can make it difficult to be sensitive towards their situation. This can, however, be improved through experience. One gesture I learned to make was the simple act of asking the patient’s preference about the door to the room. Many veterans strongly preferred sitting so they could face the door or to have the door cracked slightly, both due to PTSD. Sensitivity towards unfamiliar cultures can improve the learning curve in caring for different populations.
With consideration of the definition of compassion that I elaborated on earlier, compassionate care in nursing can greatly affect patient outcomes by improving listening to the patient’s situation and being responsive in a way that affects change and improvement. It opens up communication lines between the patient and provider. By hearing about how the patient individually experiences his or her condition, the most effective care plan can be formulated. The patient often knows the most about his or her condition and how best to cope with it. Taking patients seriously is an effective practice in patient-centered care, and is central to demonstrating compassion. Compassionate care allows the provider to learn the most about the patient and therefore make the most informed treatment plan decisions (van der Cingel, 2014). I believe that compassion is the mortar that holds the rest of nursing theory together, binding the technical skills, medical knowledge, and communication up in order to provide care and treatment.
In an increasingly fast-paced, transactional society, it can be second-nature to let that transition into our nursing care. But by showing patients that we connect with them on an emotional level through the power of compassion, we will improve patient outcomes and improve the quality of care in our workplace. In contrast to the artificial connections we make today through technology and social media, true compassion can be experienced by both patients and nurses through implementing care on both sides, learning about the unique intricacies of the populations we care for, and never failing to listen and learn from who we encounter.