Empathy and Compassion in Care

Nursing is more than a profession. As nursing students, we hear this frequently, but what does it really mean? Nursing as a profession means we are able to competently do skills within our scope of practice and document them accordingly. However, we couldn’t call ourselves nurses without the ability to be compassionate and empathetic towards our patients. Empathy can be expressed as “a feeling, portrayed non-verbally, and includes thoughts and emotions related to understanding patients’ situations” (Yegdich 1999). Being able to step into a patient’s shoes, and not only know, but truly understand how they are feeling is a critical skill for nurses in order to create strong patient-nurse relationships. In contrast to empathy, compassion is not understanding patient situations, it is more of the feeling of sympathy towards a patient and wanting to help them because of their situation (Winch 2014). With both empathy and compassion, the occupation of nursing becomes more than just a profession, it’s a calling. 

Watson’s Caritive Factors

            Jean Watson formulated a theory of human care which was based on 10 caritive factors used by nurses when delivering healthcare to patients. These included: “(1) the formation of a humanistic-altruistic system of values, (2) the instillation of faith-hope, (3) the cultivation of sensitivity to one’s self and to others, (4) the development of a helping-trust relationship, (5) the promotion and acceptance of the expression of positive and negative feelings, (6) the systematic use of the scientific problem-solving method for decision making, (7) the promotion of interpersonal teaching-learning, (8) the provision for a supportive, protective and corrective mental, physical, sociocultural, and spiritual environment, (9) assistance with the gratification of human needs and (10) the allowance for existential-phenomenological forces” (Mullins 1993).

Empathy and Compassion are the foundation for these factors. Compassion and empathy are traits built into the nurse who then uses these factors to give quality care to their patients. Take for example the fourth factor that Watson created which is the development of a helping-trust relationship (Watson 2020). Compassion and empathy are the base to developing relationships with patients. If the patient feels that the nurse truly cares for them, they are more likely to open up which may help to develop a better care plan. Another example is the ninth factor which is meeting the needs of the patient. By giving compassionate care to their patients, the nurse will know what their patient needs and meet them to the best of their ability.

Clinical Reflection

            Due to the pandemic, our clinical rotation this semester was cut short. Although I saw a lot of compassionate and empathetic care throughout the 5 weeks that I was at the hospital, I didn’t have a situation that stood out to me. However, I have been working as a certified nursing assistant (CNA) for almost four years and have definitely seen a lot of examples of compassion and empathy in my experience as a CNA. The situation that I experienced, and the one that stands out to me the most, is when I was working on the memory-care unit this past summer during quarantine. I had a patient who was very family oriented, and before the pandemic, she saw her family almost every day. Due to the virus, we couldn’t allow visitors in our facility in order to protect our patients from getting sick. After a few weeks of not seeing her family I noticed a change in my patients’ attitude and behaviors. After having a therapeutic conversation with her, I narrowed down the causes to this change and figured out that she severely missed her family and was starting to feel lonely. Being a very family-oriented person myself, I used empathy to step into her shoes and understand how she felt after not seeing her family for weeks. I wanted to help her through this hard time because I felt sympathetic towards her situation.  I worked with my director to get her family on a zoom call, and put it on the TV so she would be able to hear and see her family better. After this zoom call, I noticed a positive change in her attitude and behavior. She was happier and our relationship grew closer because I used empathy and compassion to understand her situation, and what I could do as her CNA to help. This definitely positively affected my patient outcome because although she lives in a long-term care facility, she lives a better quality of life knowing that she is not alone, and her family continued to think of her during quarantine even though they could not see each other in person.

            Through my experiences as a CNA, I have also seen instances in which care was provided without compassion or empathy. I had a co-worker who was not a very compassionate person, therefore she couldn’t provide the best care for her patients. This situation also happened on the memory care floor that I was working on and it was during an overnight shift. One of my patients had walked down the hall to the nurse’s station where me and my coworker were. She was very confused and disoriented. She didn’t know where she was, where her family was or who we were. My co-worker looked at me, rolled her eyes and said, “she does this every night” and didn’t do anything to respond to the patient. I was shocked that she did this and I walked over to the patient, held her hand and said “why don’t we go back to your room to talk, and I can make you some hot cocoa?” the patient seemed very relieved to have someone respond to her with compassion and a caring response. I made her some hot cocoa and we went back to her room and talked for over an hour. After our therapeutic conversation, I could see from her body language that she felt much better because I used compassion and empathy to understand her situation and care for her accordingly. My response definitely helped ease her anxiety and allowed her to go back to bed with peace of mind, however if I had not done that and was not compassionate, she would be wandering with anxiety which could pose multiple safety risks.

The future

After these experiences, I realize that it is not difficult to provide compassionate and empathetic care which is proven to positively effect patient attitude, behavior and outcomes. In the future I want to work harder to provide better care for my patients, especially as I move up to become a registered nurse. I need to make sure that even if I am not receiving the same attitudes from my patients as I am giving them, I still need to provide them with the best care that I can. One thing I would have done differently in the situation with my co-worker who was not compassionate, would be to professionally mention to her that her response to the patient didn’t help the situation. Even if she does get anxious and confused every night, we still need to be providing compassionate and empathetic care by understanding her situation and how to help her. In order to incorporate caring behaviors into my clinical care, I need to be more compassionate and empathetic towards my patients by stepping into their shoes and consider what their needs are. I am inspired to keep working towards my goal of providing better care and am determined to develop better patient relationships through compassion and empathy.

References

Mullins, I. C. (1993). Watson’s caritive factors in relation to care needs indicated by AIDS patients (Order No. 10663487). Available from ProQuest One Academic. (1986944156). Retrieved from https://une.idm.oclc.org/login?url=https://www-proquest-com.une.idm.oclc.org/docview/1986944156?accountid=12756

Watson, J. (2020). Theory of human caring. SAGE Publications Ltd. doi:10.4135/9781529727562 Retrieved from https://sk.sagepub.com/video/jean-watsons-theory-of-human-caring

Winch, S., Henderson, A. J., Kay, M., Burridge, L. H., Livesay, G. J., & Sinnott, M. J. (2014). Understanding compassion literacy in nursing through a clinical compassion cafe.

Yegdich, T. (1999), On the phenomenology of empathy in nursing: empathy or sympathy?. 

Journal of Advanced Nursing, 30: 83-93.