Showing Compassion Toward Palliative Care Colleagues

Betty R. Ferrell, PhD, RN

Disclosures

June 05, 2018

Communication in Palliative Care

An approach that conveys compassion for both the physician and the patient is most likely to lead to the best care. In contrast, accusing the physician of inflicting harm or going over the physician's head by contacting his or her superiors will lead to further division and poor communication. And although an ethics consult may be needed at a future point in time, the first approach would be to try to foster compassionate communication between clinicians.

Recognition is growing in palliative care and throughout healthcare that we need to improve communication between clinicians and patients, and pay more attention to compassion. To date, little attention has been focused on practicing compassionate responses.

The case of Dr R and Molly is not unlike many cases in which personal experiences and emotions may be influencing professional behavior. The nurse is correct in recognizing that Molly and her family need honest information in order to make decisions about her care and her death, but this goal will be best achieved if the staff can come to a shared understanding and find ways to support each other in what will probably be very difficult care ahead as Molly declines further.

The term "compassion" means "to suffer together." Dr Ronald Epstein, a leading physician and author of the book Attending: Medicine, Mindfulness, and Humanity, wrote that he shares the pain of his patients. It is not the same pain; nevertheless, he suffers with them, as the boundaries between clinician and patient become blurred.[1] This dual compassion leads to action to reduce suffering. It also gives healthcare professionals the sense of purpose that sustains careers over time.[1] Action is a key component of compassion, and in Molly's case, the clinical team must show compassion toward Dr R as she cares for Molly in her decline.

Failure to recognize our colleagues as people who also have experienced loss and suffer with patients can create distance and conflict.[2,3,4,5] Compassion and communication can support our colleagues, who often bear a tremendous burden in caring for seriously ill patients.[6]

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