Guest blog by Beth Boynton, RN, MS
Before trying to answer this question I need to differentiate between my use of the terms ‘consumer’ and ‘patient’. I’d like to use the term ‘consumer’ to include all of us who may receive health care service and ‘patient’ to include those who are actively being treated at any given moment. The need to make this distinction will become clearer as we consider the topic.
It seems obvious that collaboration between healthcare professionals, consumers, and patients is our best hope for fixing problems like making care safer, kinder, and more cost-effective. Yet in order for this to happen, healthcare professionals must try to understand what patients need and want in terms of their care so that we can provide the best care, patients should speak up as best they can to tell us, and consumers need to understand as much as they can about how our healthcare system works (or doesn’t work) so that efforts to change will be based on solid ground.
While patient-centered care is an approach that is helping gear clinicians to listen to, respect, and empower patients, I wonder how we might reach out to consumers to invite them to learn more about the work that nurses, doctors, and other healthcare professionals do, how it affects us, and consider how they might be supportive. Empathy for healthcare providers seems important in the pursuit of collaborative care and the dismantling of the old ‘us and them’ paradigm.
Yet, there is a big caveat to this and it presents a paradox that leads me to write and hopefully inspire discussion about it. When consumers are patients it is the job of healthcare professionals to take care of them. Not the other way around. There is an inherent dependency involved in the relationship and it does not seem right for nurses and doctors to expect patients and families to be empathic about their challenges when patients are sick and/or vulnerable. On the other hand, not making room for empathy may interfere with truth finding and problem-solving that we could be working on together.
For example, healthcare employers often tell nurses via customer service training that they should never tell patients that the organization is short-staffed. Nurses are running around from urgent task to urgent task. Patients and families have reasonable requests and sometimes urgent needs that go unattended for too long. Instead of providing more staff there are memos to discourage overtime and care providers are given critical evaluations for lack of time management skills. Workarounds are never openly advised, but there is not enough time or staff to do things properly. Shortcuts become taboo to talk about, common, and unsafe. It is frustrating, sometimes extremely frustrating and I don’t know any colleagues who feel good about making patients wait for pain medication, leaving work for the next shift, or forgetting to give a critical antibiotic.
I have two thoughts about this conundrum. One is that patients and consumers deserve to know the truth. This way they are empowered to help or get their care elsewhere. In fact, I’ve often thought that organizations facing budget constraints should work with a consumer group to come up with a plan of how family members, volunteers, and even administrative leaders might help during a nurse staffing shortage. Nurse Assistant training is only 6-8 weeks and could be a prerequisite for working in a hospital or nursing home. That way there would always be help available and things that get delayed would not include patient care. Alternatively, hospitals and nursing homes could just be honest. “We welcome you and there is a bed, but you should probably bring someone with you to help the nurses and nurse assistants because we had someone call in sick for duty.”
The other thought is that at some point consumers should know how such conditions affect the people they are entrusting their care to and the health care systems they depend on. Burnout, substance abuse, and even suicide are tragic and interrelated problems that healthcare professionals face. And maybe empathizing with the frustrated nurse or doctor isn’t appropriate when being cared for, but maybe simple efforts such as getting to know neighborhood nurses and doctors on a deeper level would help. Conversations outside the clinical environment between consumers and healthcare professionals that help discover emotional or physical stressors may create doors for authentic and co-creative problem solving might help.
I don’t have an exact answer to this question about empathy, but I do believe that we all deserve and maybe even need it. Honesty should be a priority and seeking answers will somehow help us to move forward toward a collaborative vision of healthcare that is safer and more compassionate. What thoughts do you have?
Beth Boynton RN, MS is a national speaker, consultant, and the author of “Confident Voices: The Nurses’ Guide to Improving Communication and Creating Positive Workplaces”. She specializes in communication, collaboration, & emotional intelligence for healthcare professionals and organizations and is trained in the Professor Watson Curriculum for Medical Improv through Northwestern University Feinberg School of Medicine. Her video, “Interruption Awareness: A Nursing Minute for Patient Safety” and blog, “Confident Voices in Healthcare” have drawn audiences from all over the world. She is currently writing a core text on communication for nursing students with F.A. Davis Publishing Co which is tentatively scheduled for publication in the Spring of 2015. Her complete CV is online.