For health professionals, understanding a patient’s perspective and acting with compassion can transform an interaction, particularly when patients are vulnerable or seriously ill. Empathy is also vital in relationships between colleagues, as they support and encourage each other. We spoke to four people working in the NHS about what empathy means to them and the role it plays in health and social care.
Understanding all the facets of a situation
Karen Brown is an end of life nurse at Great Western Hospital NHS Foundation Trust in Swindon. She is working on a project improving care for patients who have heart failure using the Patient- and Family-Centred Care (PFCC) approach and methodology.
‘Everybody involved in the project is doing some patient shadowing to help them see things from the patient’s perspective. In a busy acute setting, it can sometimes be difficult to do that. Having the space and time to step back and witness the effect interactions can have on patients and family has been really important.
‘For the cardiac physiologists, for example, it opened their eyes to what patients understand and take on board. They saw that even if you think you’ve talked something through, what actually lands with the patient can be a very small proportion of that information. It became clear that some patients who were coming in to have their cardiac devices turned off didn't understand that they wouldn't die at that point, so not really understanding the meaning of deactivation. The clinic has been redesigned to allow more time for appointments, and they’re working to ensure patients understand the devices better when they are put in.
‘My role is staff-facing, rather than patient-facing, and for me empathy is about trying to understand all of the different facets that staff, patients, or families bring to a situation. So many elements come together to make up how you feel and your emotional response to things. For me it’s about trying to take a wide view and understand all those different elements in order truly to work with people, and to support them in what they would like to achieve.’
The key to a shared decision-making approach
Dr Pipin Singh is a GP. He was part of a medication review project that worked in 20 care homes across North Tyneside. The structured review process introduced as part of the project had an overwhelmingly positive impact by helping care home residents and their families to make decisions about medication and significantly reduced unnecessary prescribing.
‘Empathy is an extremely important part of my job as a GP. It’s important to be able to relate to people, to try to put yourself in their shoes. By understanding their experience and feelings, you can put together a plan to treat them as a whole person. Empathy is the key to a shared decision-making approach. Patients are more likely to be on board if there’s empathy from the person providing the care.
‘Empathy and compassion were a huge part of the medication review project. Listening to the patients’ and relatives’ stories was so important. I remember a patient who didn’t have the capacity to make a decision about whether to carry on taking certain drugs and her daughter stepped up. We listened to her thoughts about how she didn’t want her Mum to spend the next few years drowsy because of the medication. It was very important to understand her point of view in order to make a decision about the medication. That, to me, was an empathic approach to care.’
I’ve been there myself
Josie Mavromatis is a care navigator for Pathway. She works with homeless people in London hospitals, helping them to feel safe enough to stay in hospital, undergo treatment, and share their stories, so that she and her colleagues can link them into appropriate support and accommodation.
‘When someone with no fixed abode comes into hospital, they are referred to our team, the homeless team. Each case is different; we take their history and go from there. I've been homeless and because I've been there myself, I can really empathise with homeless patients. If someone is shouting or difficult to deal with, I don't take it personally.
Years ago, when I was on the streets, I went into A&E and I needed to be put on a drip. I remember a nurse grabbing my arm and saying, ‘people like you, wasting our resources’. It made me not use services for such a long time. I had pneumonia and I remember saying “I don’t want to go to hospital, I’d rather be on the streets”. If that nurse had been a bit more empathetic, I might not have become so ill. Now I work in a hospital I can see the difference it makes to someone if they come in and know that the people in A&E want to help.’
Patients are not objects, and nurses are not robots
Frances Riley is ward sister for an acute general medicine ward in John Radcliffe Hospital in Oxford. She is part of a project working on improving end-of-life care on the ward, focused on four areas: earlier recognition that patients are approaching end of life, prioritising comfort, understanding the needs of family members, and improving use of end-of-life care medication.
‘I think empathy is closely linked with compassion and dignity and it’s a fundamental part of our job. It’s about seeing each patient as an individual. Patients are not objects, and nurses are not robots – it’s about personal interaction. To be a good nurse, you need to have more than technical skills. There’s got to be empathy there to make it a positive hospital experience for patients and families.
‘It's important to support each other and be empathetic to colleagues as well as patients. I think we debrief with each other and that’s important, because you do sometimes take it home with you, you can’t leave everything at work.
‘I think empathy is important to quality improvement work too. Our project has allowed us to see things from the perspective of a patient or family member, rather than just how we see things as health care professionals.’