Define compassion, and service as it relates to your role as a medical assistant.

What does it mean to advance humanism in healthcare?  According to Arnold P. Gold Foundation advancing humanism in healthcare is characterized as, “a respectful and compassionate relationship between physicians, members of the healthcare team and their patients.”  A recent article  published January 26, 2019 in Modern Healthcare talks about the importance of having all members of the healthcare team constantly educated regarding how to utilize patient-communication-best-practices to ensure the best outcomes.  This title says it all, “Physician empathy a key driver of patient satisfaction”.  This article was published by Science Daily® and points out that sixty-five percent of patient satisfaction was attributed to physician empathy. Additional Gold Foundation studies have also recognized the impact empathy has on improving health outcomes and its significance in patient care.

What is Empathy?

Empathy is defined as, “the ability to understand and share the feelings of another.” It is the capacity to put one’s self in another’s shoes and feel what that person is going through and share their emotions and feelings. It is the recognition and validation of a patient’s fear, anxiety, pain, and worry. It is the ability to understand patients’ feelings and facilitate a more accurate diagnoses and more caring treatment.  Expressing patient empathy indeed advances humanism in healthcare – as a matter of fact — expressing empathy in healthcare is THE KEY INGREDIENT to enhancing the patient experience and patient encounter.

Both empathy and compassion in healthcare play vital roles in the patient experience and are key components of the physician-patient relationship. When a patient arrives to see their healthcare provider, the patient’s medical condition — whether it is a severe illness or injury, a chronic condition, or simply a routine check-up – will often manifest emotions such as anxiety, fear, and apprehension. Patients want to know they are receiving the very best care, and that is conveyed when their care team is empathetic and compassionate.

Why is Empathy Important?

Empathy extends far beyond a patient’s medical history, signs, and symptoms. It is more than a clinical diagnosis and treatment. Empathy encompasses a connection and an understanding that includes the mind, body, and soul.  Expressing empathy is highly effective and powerful, which builds patient trust, calms anxiety, and improves health outcomes.  Research has shown empathy and compassion to be associated with better adherence to medications, decreased malpractice cases, fewer mistakes, and increased patient satisfaction.  Expressing empathy, one patient at a time, advances humanism in healthcare.

When I first watched the video below, I was reminded, and blown-away, by the notion that the smallest expressions of empathy make huge lasting impressions.  Checkout the Cleveland Clinic’s, Delos “Toby” Cosgrove, MD, President and CEO, as he and his team demonstrate some special moments that exemplifies the power of empathy in healthcare. The video has become a viral sensation, with 4,437,714 views on YouTube, as of this writing. It may be viewed below:

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Written By: Darby Faubion BSN, RN

It is not uncommon to face difficult, often heartbreaking, situations as a nurse. Knowing what to say or how to respond is not always easy. Even the most experienced nurses can struggle at times. What happens when you don't know what to say to a patient or how to act when a loved one is given bad news? How can nurses show compassion in nursing practice while still maintaining composure and professionalism? Is that even possible? The good news is even though some days are easier than others, it is possible to learn ways to be more compassionate as a nurse. In this article, I will share why compassion in nursing is essential and offer 12 ways to show compassion in nursing practice.

What Does Compassion in Nursing Practice Exactly Mean?

The broad definition of compassion is “sympathetic pity or concern for the sufferings or misfortune of others." However, there is not a consensus for a single definition of compassion. Some scholars suggest compassion is part of a value system and emotion that may be influenced by culture or upbringing. Compassionate care in nursing goes beyond pity or concern. Being compassionate in nursing means developing trusting relationships with patients, alleviating suffering, listening with care, and going beyond what many people consider the "normal" role of a nurse.

Why is Compassion Important in Nursing Practice?

Compassion in nursing practice is more far-reaching than many people realize. A compassionate nurse is empathetic to the suffering of her patients and willing to go the extra mile when needed to improve patient morale and outcomes. Here are six reasons why compassion is so important in nursing practice.

1. Patients are more comfortable.

Compassionate nursing care brings patients comfort when they are ill or suffering from distress. The simplest acts of compassion can make patients feel more comfortable, making it easier to rest and recover.

2. Compassionate nursing practices improve patient outcomes.

Compassion in nursing can ease a patient mentally and emotionally, which helps them heal and improves overall health outcomes.

3. Compassion in nursing practice extends beyond patient care, affecting interprofessional relationships.

Nursing is a rewarding profession, but it can also be stressful. Nurses who take the time to exercise acts of compassion toward patients, coworkers, and peers often experience less stress and have better work relationships.

4. Compassionate nursing helps strengthen nurse-patient relationships.

Patients experiencing illness, injuries, or disease, and their loved ones, often feel anxious and afraid. Nurses who demonstrate compassion in their care are instrumental in strengthening the bond between nurses and patients, which can help improve patient outcomes.

6 Key Skills A Nurse Must-Have for Delivering Compassionate Care

1. Resilience:

Nurses who participate in activities to explore others' perspectives and their personal values become capable of maintaining resilience. Resilience makes it possible to harness emotions and intentionally pursue compassionate practices.

2. Excellent Communication:

Therapeutic communication is an excellent tool for demonstrating compassion in nursing. Nurses who learn how to effectively communicate with patients and their loved ones can have a significant impact on their patients’ well-being and play an integral role in improving patient outcomes.

3. Emotional Intelligence:

Nurses with high emotional intelligence typically find it easier to handle interpersonal relationships with patients and coworkers. When you develop an awareness of your emotions and the emotions of others, you can provide more compassionate nursing care.

4. Confidence:

Nurses who are confident in their abilities and feel like what they do matters feel comfortable showing compassion. Confident nurses create caring environments within healthcare organizations conducive to improved nurse-patient relationships and patient outcomes.

5. Cultural Awareness:

One of the most important but often underappreciated classes nursing students take is Cultural Competencies. As a nursing instructor, I strongly advise learning to understand and appreciate the diversity of cultures represented within patient populations. Nurses who take the time to get to know their patients and approach care with compassionate consideration of their cultural beliefs and preferences can augment positive nurse-patient relationships.

6. Critical Thinking:

When you think of compassionate care in nursing, critical thinking may not be the first thing to come to mind. However, nurses who demonstrate the ability to solve problems quickly and think critically find ways to deliver compassionate nursing care to patients and their families. Patients who receive care from nurses they feel are capable of making critical decisions often leave positive reviews when asked about patient satisfaction and care.

HOW CAN NURSES SHOW COMPASSION IN NURSING PRACTICE?

Compassion in nursing does not have to be complicated. I believe nurses who pause long enough to think about what they would want from a nurse if they were the patient find it easier to exercise compassion for those in their care. In this section, I want to share some of my personal experiences as a nurse and will also present some examples of situations where compassion makes a difference for patients. As you read each one, imagine two scenarios: First, you are the patient. In the second, you are the nurse. (For the sake of patient privacy, no real patient or family member’s names will be used in my examples.)

1. Listen to what your patients and their loved ones say (and what they do not say).

The simple act of listening to your patients or their families can mean the difference between a good day and a bad day for them. You may have several patients who all want your time. Skilled nurses can show compassion in nursing by learning to provide high-quality care to each patient and making each one feel significant.

For Example:

I learned one of my first lessons of compassion in nursing practice while still in nursing school. I was assigned to a patient named Mr. Jones, who several nursing assistants and nurses said was “a mean, grumpy old man.” Being eager to show my instructors and classmates that I could handle even the worse patient, I knocked on his door and stepped inside. The water pitcher he threw at me missed my head but soaked my uniform. To say I was shocked would be a gross understatement. It took more than a few minutes to get my composure and brave going through his door again, but I did. With a bit of coaxing and telling jokes that he did not laugh at, I was eventually able to give him a complete bed bath, a fresh shave, and get him into a pair of clean pajamas. Before I left my clinical assignment, Mr. Jones thanked me for everything I had done that day. He said something I have never forgotten: “I figured since I'm gonna die, I may as well go out with a bang, and I didn't care whose feelings I hurt along the way. No one cared to ask how I feel about dying. Not till you.”

2. Show genuine interest.

Sometimes all it takes to demonstrate compassion in nursing is to let your patients know you care is by being interested in things that matter to them. You do not have to know every detail about a person to show interest and make them feel valued. Showing genuine interest in knowing what is important to your patients can make a significant difference in the nurse-patient relationship.

For Example:

Ms. Britt was a resident in the nursing home where I used to work. She loved cats! Ms. Britt had pictures of cats on her walls, pillows with cats on them, a cat lamp, cat shirts, cat socks. Every time she got a card in the mail, or someone brought her a gift, chances were good that it would have a cat on it somewhere. It wasn't until my shift ended and I sat down with her one day that Ms. Britt showed me some picture albums she had brought from home. They were filled with... you guessed it! Cats! What I didn't know before then was Ms. Britt had a cat rescue at her house before she had a stroke and had to move to the nursing home. She had taken an old barn on her property and turned it into a safe place for stray cats to find warmth and food. She missed them so much! The hour or so I spent visiting with her and listening to her stories made her so happy. I don't think she realized how glad it made me, too.

3. Learn to express empathy when appropriate.

Empathy is the ability to relate to someone else's emotions because of shared experiences. Nurses sometimes feel uncomfortable sharing their feelings with patients because they fear getting too attached or transparent. However, it is possible to express genuine understanding based on your previous experiences without sharing too much. Patients can feel vulnerable, leading them to lash out at others or withdraw. Nurses who express empathy are uniquely positioned to help their patients understand they are not alone, which can relieve anxiety and feelings of despair. Showing empathy is one of the most powerful ways to demonstrate compassion in nursing and build strong nurse-patient relationships.

For Example:

My sister died when she was thirty-five years old. She was two years younger than me and the sweetest person you could ever meet. To this day, her death is the one thing I grieve more than anything else I have experienced. For years, I carried the sadness and anger of her loss with me. There were days it consumed me. I held onto the grief and sadness as if it were the only thing I had left of my sister. It was not until Mr. Jerry, a lifelong friend of my family, lost his brother that I realized I could use my experience to help someone else instead of using it as a reason to stay hurt and bitter. The fact that I lost my sister meant I could look at Mr. Jerry and tell him that, although the days ahead were going to be difficult, he would make it. I was able to encourage him and tell him it was okay to grieve, but he did not have to let his grief own him. Showing empathy does not mean you have to bear your deepest, darkest secrets to strangers. It is, however, the ability to relate to them on a level that others may not be able to do. Expressing empathy shows your patients and their loved ones that there is someone who has been through their experiences and has survived them. Your willingness to be open with your clients can give them the strength to face the illness or loss they are experiencing.

4. Acknowledge your patient’s feelings.

Imagine being a patient whose health is failing and who feels like no one cares about what you’re going through. Taking the time to listen to your patients and acknowledge their thoughts and feelings is one of the greatest acts of compassion you can show. Although you may have experienced the same situation your patient now faces, the simplest change in a word can make your statements seem less abrasive and create an atmosphere for healthy conversation. Try to remember to use statements like "I understand" instead of "I know."

For Example:

Mr. Jones has been diagnosed with colon cancer. When his doctor tells him he recommends surgery to remove the diseased portion of his colon and create a colostomy, Mr. Jones is devastated. One way to demonstrate compassion to Mr. Jones is to say, “I understand how scared you must be. If you want to talk, I would be happy to sit with you for a while." In a situation like this, your patient may be angry, and that's normal. Simply offering to be there if he needs you can make a huge difference in how he processes the information and handles things moving forward.

5. Be patient.

When you have had a hectic day at work, and every call light that is pressed seems to be coming from your patient's rooms, it can be frustrating. You may feel like there are not enough hours in the day to tend to everyone who needs your attention. When you feel overwhelmed, it can become easy to rush through patient care. You may not realize your tone of voice changes when you are stressed. Your patients and their loved ones will notice, though.

For Example:

Mr. Randy was a patient on the Med-Surg floor who constantly pressed the call light requesting someone to come to his room. While it is nice to feel needed, busy nurses cannot stay at the bedside of one patient for their entire shift. When I was assigned to be Mr. Randy’s nurse, I soon realized the frustration that other nurses who had cared for him previously felt. One afternoon when his wife visited, she told me she knew he must be confused because she spent every day with him at the assisted living facility where he now resides. However, the hospital was uncomfortable and had nowhere for her to rest. Realizing how confused Mr. Randy must be because he was in a different place without his wife, I spoke with the nursing assistant assigned to him and asked her to check on him more frequently, and I did the same. Together, we were able to alleviate some of Mr. Randy’s anxiety about being alone which led to him not pressing his call light, constantly distracting us from the care of other clients.

6. Respect your patient’s need for privacy.

One of the most frustrating things about being a patient in a healthcare facility is the lack of privacy many patients experience. Being mindful of your patient’s need for privacy is an excellent way to show compassion in nursing.

For Example:

Imagine, if you will, you are assigned to care for Mrs. Temple. Mrs. Temple is an author who has lived alone since her husband died eight years ago. Despite your efforts to make her feel comfortable and let her know you are there for her, Mrs. Temple seems perturbed every time you go to her room. One of the CNAs tells you she heard Mrs. Temple say, "People won't go away. I can't get a moment's peace." While it could be easy to feel like your efforts are unappreciated, the compassionate nurse recognizes Mrs. Temple is accustomed to being alone and likes her privacy. The most appropriate nursing action, in this case, is to assure her that you are available if she needs anything, be sure Mrs. Temple knows how to use the call light if she needs assistance and offer her privacy.

7. Take the time to explain treatment plans and answer questions.

When several patients require your attention, it can become easy to rush through assignments such as passing meds, providing wound care, or administering treatments. Being compassionate in nursing means realizing although you may have several patients, your patients only have one nurse. They are often afraid and need someone to take the time to comfort them.

For Example:

Suppose you have eight patients during your assigned shift. Six patients are alert, oriented, and can feed and dress themselves. One patient is alert, responsive, and has a loved one at her bedside. Your other patient is alone and anxious. This patient's physician has just written an order for a full-body scan and blood work. With eight patients you are responsible for, it could be easy to call the lab and radiology to notify them of the doctor's orders and leave it up to them to tell your patient what is going on. Although eight patients are your responsibility, a compassionate nurse understands that one patient has a greater need for individual attention, even to notify him of the doctor's orders and what to expect. Taking the time to explain to your patient about upcoming tests, what they are looking for, and offering to notify a friend or loved one can relieve some of his anxiety, positively impacting his health outcome.

8. Get to know your patients.

It can become easy to rush through the day and see patients as names on charts or patient numbers instead of individuals. Unfortunately, with a nationwide shortage of nurses, the lack of personal interaction with clients happens more frequently. Compassionate care in nursing practice sometimes means slowing down, being patient, and getting to know your patient. Showing an interest in your patients is one of the fastest ways to strengthen nurse-patient relationships, which promotes positive patient outcomes.

For Example:

Mr. Robert was one of my patients in the nursing home. When I first met him, Mr. Robert would not leave his room. He ate meals in his room, watched television, and read every day. He usually only spoke when spoken to or prompted by questions. When I first began caring for him, I didn't know that Mr. Robert was a retired physician. When I found out he was a doctor, I was excited. I arranged my daily med pass to make him the last patient I saw. I took Mr. Robert's medicine to him and asked to sit with him each day. I made it a point to think of a new question for him each day, something about his work experiences and life. It took a while for him to open up to me, but in time, he did. Before he passed away, Mr. Robert had begun to take daily walks with me down the nursing home halls. He sat in the dining room for meals and even gave me "advice" on being a better nurse.

9. Be present.

Studies indicate doctors listen to their patients for an average of 15 seconds during one encounter. Nurses are left with the responsibility of standing in the gap and being an ear for patients who are lonely and afraid. Being present means more than offering your physical presence in the room. To truly be present for your patients, look them in the eye, and respond when appropriate. Listen intently, and don't let your thoughts wander elsewhere, as patients will notice if you are not paying attention or seem disinterested.

For Example:

Mrs. Collins was a widow with two grown children who lived in other states. Her primary care provider made rounds at the nursing home where she lived once each month to check on his patients. On more than one occasion, I found Mrs. Collins sitting alone in her room crying. Although I administered her medications and checked her blood sugar daily, the days when I took the time to sit with her for a few minutes had the most profound effect on her. Those moments seemed to bring a sense of happiness to her loneliness, if only for a while. Sometimes our hectic schedules make us feel like we don't have extra time to give to patients, but you may be surprised the difference five or ten minutes of your time can make in someone else's day.

10. Be aware of moments that require high levels of compassion.

Compassion in nursing practice means being alert to patient situations and doing what you can to make difficult situations more comfortable. Nurses know when their clients will be given the news of a poor prognosis or when loved ones must face difficult decisions about care. Your attitude about the patient's situation can set the atmosphere for how they or their loved ones will respond. Take the time to gather your thoughts and composure before entering their room or initiating difficult conversations.

For Example:

Perhaps one of the most difficult situations I faced as a nurse was when I accompanied an obstetrician to deliver the news to an expectant mother and father that there was no fetal heartbeat. Because the pregnancy was so close to term, the decision was made that the mother would deliver the baby. I don't think I have ever felt as helpless as a woman or a nurse as I did at that moment. Holding the hand of a woman who was giving it her all to bring a baby into this world who would never cry or smile or laugh at her took every ounce of composure I could gather. I had to realize that, as heartbreaking as the situation was to watch, I was there to serve that mother and her family. I had to be a rock of steadfast compassion and strength for them in a moment where they felt there was none. Being aware of moments that require a high level of compassion can be difficult, but it can also make all the difference in the world to your hurting patients and their loved ones.

11. Even if you can’t empathize with your patient, you can sympathize.

When you express sympathy, you demonstrate a desire to see your patients free from pain, suffering, and fear. Sympathy is an expression of hope that your patients can overcome their illness or disease or that they can endure the experience with as little discomfort as possible. Not everyone has experienced a life-altering injury, terminal illness, or disease. So, while you may not have a personal experience with one of these situations, you can have a genuine concern for your patients and their loved ones during their most difficult times.

For Example:

Mr. Walters came to the hospital every day to see his wife. He sat with her from the time visiting hours began until they ended. He fed her, brushed her hair, and helped her change her hospital gown as much as he could. Mrs. Walters was quiet when her husband was there but had episodes of crying and anxiety after her husband left each evening. I learned Mr. and Mrs. Walters had been married for nearly fifty years.

On the other hand, I had never been married and had never experienced the bond they shared. Because I took the time to try and understand their unique relationship and bond, I was able to appreciate their need for being together and offer them privacy during Mr. Walters’ visits. That simple act of compassion helped improve Mrs. Walters’ mood and helped ease her anxiety.

12. Take care of yourself.

It is not uncommon for nurses to become so involved with work and providing for the needs of patients that they overlook their own needs. It is difficult to show compassion when you are exhausted physically and mentally. I always encouraged my nursing students to remember it is impossible to care well for others if you do not first care for yourself.

For Example:

One of my first jobs as a nurse was at a nursing home near my home. Because the facility was so close to where I lived, I was often the first nurse called if someone else couldn't make their shift or the staff was short-handed. I did not mind being the go-to person because I loved my job. After a while, I began to feel physically and emotionally exhausted. It seemed like every cold or virus that came around affected me, which was unusual as I usually did not get ill easily. When I realized how much time I was spending at work and neglecting my health and responsibilities, I had to make some changes...for me. I talked with my nursing supervisor, expressed my gratitude for her confidence in me, and explained that, although I would be willing to help when needed, I also needed to take care of myself.

What Causes Compassion Fatigue in Nursing Practice?

While showing compassion in nursing practice is essential to positive patient outcomes, nurses must learn to recognize when their acts of kindness and compassion begin to take a toll on their physical or emotional wellness. The term compassion fatigue refers to the state of mental or physical exhaustion caused by one's inability to cope with their everyday environment or the compounded effects of daily stresses. Compassion fatigue has often been described as the price one pays for caring for others. When nurses begin to experience physical and emotional changes because of an inability to rest and recharge, they experience compassion fatigue.

5 Tips to Prevent Compassion Fatigue in Nursing Practice

Effective nursing requires being mentally and physically sharp. It is easier to promote health and wellness than overcome illness, stress, or fatigue. As a nurse, you know the importance of providing compassion in nursing care. You must also know how to prevent compassion fatigue and care for yourself to be the best nurse possible. Here are a few tips to help prevent compassion fatigue in nursing practice.

1. Set emotional boundaries.

Quality nursing care requires emotional involvement. Showing empathy and compassion strengthens nurse-patient relationships and promotes positive patient outcomes. However, nurses must understand their limits and set boundaries not to exceed what they can handle. Setting emotional boundaries in nursing requires you to stay compassionate toward your patients while establishing an awareness of the personal emotional space between you and your patients. You can offer support without being so emotionally involved that you lose sight of yourself or your well-being.

2. Practice self-awareness.

Compassion fatigue occurs when the impact of secondary trauma becomes overwhelming. To effectively address this and prevent CF, nurses must become self-aware. Self-awareness will allow you to recognize your thoughts and feelings and identify changes in stress levels. You can develop a sense of self-awareness by journaling, talking with others, mediation, and getting involved in support activities with friends and peers.

3. Establish a healthy work-life balance.

The prevention of compassion fatigue requires a commitment to your own well-being. While caring for your patients is essential, at the end of the day, you need to go home and care for yourself. By creating a healthy work-life balance, you will gain renewed energy and a fresh perspective when addressing patient care, improving the quality of life for you and your patients.

4. Implement active coping mechanisms.

How you choose to cope with stressful situations can significantly affect whether you develop compassion fatigue. Coping measures such as social support, humor, and taking control of your schedule and time will positively impact your emotional well-being.

5. Develop a support system.

Social support can help minimize the risk of developing compassion fatigue. Establish a network of friends and coworkers who positively influence your life. Choose people who are encouraging, outgoing, and whose personality is energizing, as you need someone to strengthen you, not add to your stress.

Useful Resources to Develop Compassion in Nursing Practice

Several resources prompt awareness and teach measures to help improve compassion in nursing practice. The following are some popular YouTube videos, podcasts, and books about nursing compassion you may find helpful.

YouTube Videos

• Compassion in Action- A Patient’s Perspective: Hear a patient’s story about how compassionate care influenced his journey through illness and recovery
• Compassion, Dignity, and Respect in Healthcare: Dr. Hiro Tanaka (Orthopaedic Surgeon at Aneurin Bevan University Health Board) and other team members and patients discuss how compassion in healthcare impacts patient outcomes.
• Caring with Compassion Supporting Patients and Families in a Crisis: In this video, healthcare professionals can learn strategies to address essential human needs and promote recovery from stress and adversity.

Podcasts

• Compassion and Courage- Conversations in Healthcare
• A Nurse’s Perspective- Compassion is Key

Books

• Compassionomics, the Revolutionary Scientific Evidence that Caring Makes a Difference: Physician-scientists offer data demonstrating that compassion could be the best drug available for patients.
• The Antidote to Suffering: This book addresses the dimensions of nursing care and the impact of compassion on both patients and nurses.
• The Mindful Nurse: In this book, nurses learn the skills necessary to cope with nursing challenges and promote compassion in nursing practice.

My Final Thoughts

If you are a nurse who wants to provide high-quality patient care, you understand the importance of being compassionate. It is normal to ask, "How can nurses show compassion in nursing practice?” In this article, you learned 12 ways to show compassion in nursing practice and found resources to help improve your ability to show compassion and prevent compassion fatigue.

What is the meaning of compassion in healthcare?

What is an example of compassion in healthcare?

Why is it important to have compassion in the medical field?

What are three 3 positive aspects of compassion or compassionate care?