Empathy – the human connection to patient care.
Seeing the person in the patient.
Could a greater miracle take place than for us to look through each other’s eyes just for instant?
Henry David Thoreau (1817 – 1862)
In 2008 a report by was published by the Kings Fund under the title “Seeing the person in the patient” (1) reviewing stories of patients treated in the UK hospitals from their own personal perspectives. These stories gave a great deal of insight into how our behaviour as healthcare professionals may be perceived by patients and the effect it has upon their treatment, for better or worse. However, this PRIME international newsletter is not considering such a written article, even though its 72 pages are well worth reading. Instead, I would like us to spend four minutes looking at a YouTube video from the Cleveland Clinic, a leading US hospital situated in Cleveland Ohio.
I would like to thank PRIME nurse tutor Jo Blaker for drawing our attention to this video presentation (see below) which we would commend to everyone in the caring professions, whether qualified or still a student. In a few minutes, we learn to think of the story behind the facial expression not only of patients but also of fellow team members. All too often, in the hectic world of medical care, we think only of the professional task in hand. But we can learn so much by just looking into the eyes of our patients and through the complex neurology of human empathy understand something of their situation in an instant – an instant that can save a great deal of misunderstanding in the subsequent consultation.
One great lesson someone taught me is that the two cardinal moments of a consultation are when a patient enters the room and when they leave it. I took it to heart. I stopped reading through the notes as Mrs Smith or Mr Jones came in, gesturing them to take a seat – instead I looked up as the door handle turned and greeted them with a smile– but most importantly I saw how they came in – anxious and hesitant or maybe embarrassed or maybe looking as if they had good news to share – or some deep sorrow. Such information helped so much the subsequent time together, and far from lengthening the time of many consultations actually reduced them. Then as the person stands up to leave the room, so often we are tempted to turn to the computer keyboard to type in the details – but take a moment to see how they leave – do they pause before turning the handle? Do they look back wistfully? This usually meant they had something important to share that they had not revealed, or my advice had not satisfied them. A simple “is there something else?” could often put right in a few seconds something that would otherwise have caused hours of anxiety for the patient, a soured relationship or even a serious undisclosed symptom.
The follow-up five minute video from Cleveland (see below) takes the story further with patients’ accounts of their reaction to what had been said or not said, along the lines of the Kings Fund report.
So maybe we could make a more conscious effort to look into the eyes of our patients and see something of their journey. We must of course be careful not to jump to conclusions too quickly, and in some cultures we have to be careful of too direct a gaze, but it is remarkable just how much our inner being can relate to another human being. Some people avoid such relationship under the guise of “professional distance”. When I trained 50 years ago I was told we must become hardened to our patients’ pain otherwise we would burn out. However, the privilege afforded to us in the caring professions of deep relationship with other human beings, even if only for a few minutes, is something that I treasured during my years of practice. We will come to the issue of how to avoid burnout in a future issue, but meanwhile let’s treasure the privilege of being able to look into each other’s eyes.
1. Seeing the person in the patient , Joanna Goodrich and Jocelyn Cornwell Kings Fund publication 2008