Empathy

Patient Empathy Because You Care

Empathy vs. vs Sympathy

ƒ Empathy ƒ understanding of another another’s s feelings ƒ the ability to identify with and understand another person’s person s feelings or difficulties ƒ attribution of feelings to an object ƒ the transfer of your own feelings and emotions to an object such as a painting ƒ emphasizes understanding

Empathy p y vs. Sympathy y p y ƒ Sympathy ƒ capacity to share feelings ƒ the ability to enter into, understand, or share somebody else’s feelings ƒ the feeling or expression of pity or sorrow for th pain the i or distress di t off somebody b d else l ƒ the inclination to think or feel the same as somebody else ƒ emphasizes sharing of another persons feelings and experiences

Empathy vs. vs Sympathy ƒ If the friend uses sympathy sympathy, y p y, y, she might g think,, for example: He is remembering his father with pain. Poor Roger. If the friend decides to verbalize her thoughts, she might say to the grieving man words such as: "II feel your pain." ƒ If the friend uses empathy empathy,, she might think, for example: He is remembering his father with pain and also the pleasure of his love for him. If the friend decides to verbalize her thoughts thoughts, she might say to the grieving man words such as: "I feel your pain and also your great love for your father." http://www.empathy-and-listening-skills.info/index.htm

Empathy vs. vs Sympathy ƒ If the friend added "I'm I m sorry for your loss, loss," this statement would also be characteristic of sympathy, but not of empathy. The person using empathy would share the grieving man's emotional pain, but not necessarily feel sorry for or pity it hi him. Of course, one can use both b th sympathy and empathy, empathy, for example: "I feel your pain and also your great love for your father. I'm sorry for your loss." http://www.empathy-and-listening-skills.info/index.htm

The Challenge ƒ Most challenging are those patients who are dying. dying ƒ Avoid using the label “Terminally ill” ƒ Is I a doubledouble d bl -edged d d sword d ƒ Further removes dying persons from other’s caring ƒ They now belong to a “group” that carries negative assumptions. ƒ Not constant time (some may die sooner than others) ƒ Pg 312

The Challenge ƒ Dying is a personal event ƒ Patients P ti t go through th h a process ƒ Ask the questions, “what does this mean to the ƒ ƒ ƒ ƒ ƒ

patient?” ti t?” How do we gain an understanding of death? East E t vs. West W t Great stories of myth and in culture. (Pg. 313) Influence of religion Differences in how kids react vs. adults.

The Grieving g Process Craig, Essentials of Sonography and Patient Care Care,, 2006

ƒ Elisabeth KublerKubler-Ross worked extensively with dying patients ƒ Stages of death ƒ ƒ ƒ ƒ ƒ

Stage 11- denial and isolation Stage St 2- anger 2Stage 33- bargaining Stage 44- depression Stage 55- acceptance

The Grieving Process ƒ Not always a smooth path ƒ Some do not experience each stage ƒ Other Oth may go th through h more th than one att a time ƒ Some move back and forth ƒ The ppain never ggoes awayy

Denial and Isolation ƒ Occurs in all patients ƒ Characterized by the “No, not meme-it must be a ƒ ƒ ƒ ƒ

mistake” attitude Some diagnostic error has been made Refusal to believe creates a buffer of protection from shocking news that is too difficult to handle. Mood ood sswings gs o of high g hopes opes then e despa despairs s Make excuses and reasons for their loss or illness.

Anger ƒ The “why why me” me stage ƒ Difficulty for everyone to deal with because the tendency to displace anger in all directions. ƒ Unreasonable demands, criticism, dissatisfaction ƒ Ways of expressing the loss of control ƒ Not a good time to use humor, allow them to “act act out” out

Bargaining ƒ Starting to accept condition ƒ “bargain” with God to postpone the inevitable ƒ Want to be rewarded for good behavior ƒ Desperately try alternative or “quack” therapies ƒ Allow them to talk about these

Depression ƒ Realize the reality of their loss ƒ Overwhelming sadness and sorrow ƒ Looses interest in their surroundings surroundings, silent silent, withdrawn ƒ Allow them to express sorrow and feel sad sad. ƒ Encouraging reassurance does not help; cheerfulness c ee u ess only o y distracts d s ac s them e ƒ Be willing to sit quietly, encourage them to talk about feelings g

Acceptance ƒ At peace and thinking more clearly ƒ “the the calm before the storm” storm ƒ May not believe they will die, they want to talk ƒ ƒ ƒ ƒ ƒ

about it and ask questions Not a joyful stage Controlled with intense feelings g absent Believe things can get better. Hope p helps p to maintain during g suffering g You may not know answers to questions, resist the temptation to change the subject or tell the patient ti t nott to t worry.

Special Challenges of Inpatients ƒ Confinement disrupting patient’s life ƒ Institutionalized life ƒ At home: loneliness, strife, boredom ƒ Physical comforts of institutions institutions, beds beds, rearrangement of furniture, environmental issues ƒ Psychological comforts, being n familiar surroundings ƒ Sense of well being ƒ The “at home” routine ƒ Companionship (pets, weekly visitor/friend) ƒ Loss of privacy

Diffi l i iin the Difficulties h P Patient i IInteraction i ƒ Survey asked nursing students to ID major “dislikes” related to working with patients/the type of patients students disliked

Patients to Dislike ƒ Feel bad and complain after everything ƒ ƒ ƒ ƒ

has been done for them Patients who are not clean Patients who will not do what the professionals ask them to, will not cooperate and not obey rules Patients that are extremely demanding Patients who can help themselves yet expect the care provider to do everything.

Paying Attention! The health professional who manipulates objects in everyday life is in danger of manipulating the patient in the same impersonal manner. Put what is important before what is urgent

Paying Attention ƒ Little things make a difference too! ƒ Attention to personal details, however mundane that are important to the patient is an effective way of showing them they matter. matter

Things To Do and Practice 1. Avoid labeling, especially as a means of reducing your frustration and anger. 2. Caring is as important as other interventions 3. Don Don’tt have unrealistic expectations of your power as a health care professional to force compliance p 4. Don’t expect to change aspects of the patient’s situation beyond p y yyour control

Things To Do and Practice 5 Take care of your emotional well 5. well--being “even the therapist needs therapy” 6 Work to change social and institutional 6. conditions or attitudes that lead to devaluing behavior by professionals 7. Interaction with an aggressive patient: make k sure exitit iis possible ibl ffor b both, th check h k body language and tone of voice

Things To Do and Practice 8 Affirm policies and practices that 8. encourage respect for everyone while assuring physical and emotional safety safety. 9. Recognize your limitations