Friday, 18 December 2015

Should Doctors and Nurses Be Compassionate?

This was the question on Radio 4’s programme Beyond Belief, earlier this year. Anna Smajdor, a medical ethics lecturer at the University of East Anglia, put the point across that it is not necessary within the role of the health care professional to provide compassion for their patients. Anna says,
“we find it very difficult to know or control what people are feeling”, explaining that it “would be nice if every time I went to the hospital, the doctor or nurse would love me as much as my mother does, but do I have the right to expect or demand that? I don’t think I do. Compassion is about what people feel for you, and you cannot demand that people provide you with an emotion as part of your due…in the health service I think that’s going too far”
I couldn’t imagine providing care for my patients without giving compassion. It’s not in my personality to shut off my human side, and I believe that is the case for most people.
Many years ago I looked after a young man who sadly died. He was from another country. His parents, who were acrimoniously separated, were informed just as they boarded the plane to see their son in our hospital, that their only child had died. They had to endure a several-hours flight in the worst of circumstances, to arrive in a country where they could not speak the language, to confirm the identity of their child to the police. To say that this was an horrific experience for anyone was an understatement.
His mother broke down when she saw her son. Her wailing, grief-stricken cries cut deeply into everyone who heard her. Unable to communicate with her, all we could do was offer her our arms and our shoulders to share her anguish, the crevices of our necks warm and wet with grief. This mother and her estranged husband, consumed with grief and the horror of their situation, did the only thing they could in that moment: they lashed out at each other. Even in another language, we could feel the conveyance of hatred, anger, shock and bitterness in their voices. But there was little any of us could do. We didn’t understand what they were saying. As a 23 year-old new-ish nurse, I  lacked the experience to deal with this as a professional, but I felt every ounce of their pain.
Later, as I sat with the mother and father in the relatives room of the mortuary, a police officer asked them a few identifying questions. They were able to answer through an interpreter who we had managed to find, although at the time we could only find an inexperienced nurse on another ward, who was clearly traumatised by the details, because she was getting the full impact of the parents’ grief.
The officer handed the mother a clear plastic bag, containing her son’s large, leather-strapped watch, his wallet with a few foreign notes mingled in with the British £10 notes, and his passport. I felt this to be so impersonal that the property was handed to her in this way. She broke down again as she took the bag from the officer. I saw her son’s passport photo, and I too began to cry. He looked so different in his photograph, so handsome and the same age as my younger brother. It was the most intense, sad and loneliest place I have ever visited as a nurse. Grief following death is an all-consuming, exhaustive and potentially destructive place to be. To professionally help a patient or relative in any situation without the connection of humanity, compassion and care is impossible, in my eyes.
Here is where mindfulness can assist the professional in dealing with these kinds of situations. As nurses, we see the most vulnerable people deal with the most challenging of situations in the strongest ways they know how. We support them through these experiences in the most sensitive, compassionate manner and with fortitude, in the ways we are taught, the ways we are shown, and in the ways we would want to be treated if we were ever to find ourselves in the similar circumstances we are exposed to in our work. This is the key to being able to do our job. I know that on days when I have been rushed off my feet, when help is thin on the ground and I haven’t been able to give my best care to my patients, I go home feeling that I have failed to do my job effectively, and I know many friends and colleagues who feel the same. But mindfully working through these situations, by making that meaningful connection with patients and their relatives can make a big difference both in the delivery of care and the way the healthcare professional feels when they leave work.
It is okay to empathise with the relative about how difficult they are finding their grief.  “I know how hard you are finding this, and I feel how overwhelmed you are, this is tough but I am here to help you.”  Sometimes it’s not about finding the most effective way to provide care, but it is about making the emotional connection in a mindful way.

As I said goodbye to the mother and father of the chap I had cared for, all I could do to convey my empathy to them was to place one hand on my heart, and hold the mother’s hand, with the other. I know we couldn’t verbally communicate, but I know that she felt what I meant, and I felt the understanding between us. I hope that my compassion was felt and understood. The health service is made whole by compassion, and to deny anybody that in their time of need would be to deny their humanity.

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