exploring the concept of empathy in nursing

December 20, 2020by 0

The concept of empathy has much been deliberated upon over the years from different perspectives due to its subjectivity. It appears the nature of empathy, as conceptualised by the nursing profession, allows the nurse to maintain a professional and intellectual objectivity as there is no commitment to enter into the other person’s suffering only to understand. The portrayal of empathy in nursing literature appears to differ from its portrayal within counselling literature, with the concept of empathy separated from the core conditions of congruence and unconditional positive regard, thereby presenting it as a ‘tool’. Empathy is recognized as a highly valued professional characteristic in the nurse-patient relationship. This contrasts with the portrayal of empathy in nursing literature. Exploring the art of empathy 2003-08-01 00:00:00 Understanding the realities of later life can be particularly challenging when we are young. According to Schantz , the concept of compassion in the United States is not as clearly defined in nursing scholarship and is often used interchangeably with the term caring. The value of empathy for the nurse-patient relationship is thought to allow understanding not only of other individuals’ beliefs, values and ideas but also the significance that their situation has for them and their associated feelings. Yet others argue that nurses should rather rely … By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. The trust that is generated by the empathic relationship allows the nurse to become privy to information that, in any other situation, the patient may not disclose; this type of relationship fosters the sharing of deeply personal information that can be used in a variety of ways. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually apoor fit for the clinical reality ofnursingpractice.Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain … Undergraduate nursing students are taught the importance of empathic relationships. Nurses need to carefully consider how power is used and ensure that patients are not unwittingly placed in a vulnerable position. Compare and contrast the key behaviors that support empathy development among nurse This distance while allowing the nurse to make objective and rational decisions about patient care also provides a means to gain psychological information about that patient. This article discusses the principles of empathy and the vulnerability of nurses to new initiatives which aim to improve nurse-patient relations and it examines the risks these relationships pose for patients. USA.gov. Exploring the Developmnet of Empathy with Nurse Residents in a Nurse Residency Program: A Qualitative Case StudyObjectivesAfter participating in this educational activity, attendees should be able to:1. Measuring nursing care and compassion: the McDonaldised nurse? Compassion – active participation in another individual’s suffering (Schantz, 2007). In nursing however, it could be argued that there are many conflicting agendas relating to the constraints of the healthcare environment and the nurse-patient relationship which make it inadvisable for the nurse to be privy to such information. We need to carefully consider whether we always gain consent for the sharing of all information that a patient has confided in us and how we document such information. Clipboard, Search History, and several other advanced features are temporarily unavailable. Empathy as a rich and useful concept when teaching nursing students. Verbalize an understanding of the historical concepts of empathy in nursing practice. If one were topoint to a conceptual core for understanding these phenomena, it isprobably best to point to David Hume’s dictum that “theminds of men are mirrors to one another,”(Hume 1739–40[1978], 365) since in encountering other persons, hum… The authors state that this type of activity increases compliance with lifestyle changes for patients and it illustrates the power that nurses have over patients and their families. Epub 2016 Jan 30. Nurs Times. However, a more troubling disagreement underlies these debates: There's no consensus on how to define empathy. According to von Dietze and Orb (2000), the focus of empathy is intellectual or professional and this allows nurses to remain detached from their patients. It is important to recognise that there is an imbalance of power in the relationship between the nurse and the patient; therefore the patient is vulnerable (Sellman, 2007). Despite the barriers, empathy is critical and enhances communication. Why Is Empathy in Nursing Important? Patients have different models of understanding the boundaries of confidentiality compared to nurses and doctors (Jenkins, 2005). Can we teach them to be more empathic? Rogers asserts that the core conditions are vital for the formation of a relationship where a counselling client can reconnect with their self-concept. Reconsidering Empathy in Nursing Care. Nurses should carefully examine the background of any new initiative which claims to improve nursing practice; especially those which appeal to nurse’s self image. Sign in or Register a new account to join the discussion. Chowdhry S (2010) Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? Author Information . According to the CNO, “empathy is the expression of understanding, validating and resonating with the meaning that the health care experience holds for the client” (CNO, 2006). It follows that the responses of nurses is politically significance yet nurses are often unaware of this power and are portrayed as victims (Hart, 2004). HHS Schwaber (1981 cited by Olsen, 1991) emphasises this point when he refers to empathy as ‘a method of observation’ while, Yu and Kirk (2008) suggest that empathy can be taught as a skill. This is particularly relevant when considering aspects of patient care like health education, empowerment, advocacy and consent, where patients are vulnerable to external influence. Implications of these findings are discussed, limitations of the study are acknowledged and areas for further work suggested. Words like compassion, sympathy and empathy are commonly used terms in nursing texts and journal articles, however, there appears to be general confusion about what these terms actually mean (von Dietze and Orb, 2000; Schantz 2007). An empathic relationship encourages the sharing of innermost feelings and views. An initial review of the literature provides insight into an elusive concept because the researcher can discover what is known, not known, or confusing about a concept.Empathy was chosen as the concept of interest to illustrate the process of concept analysis. Viewing nursing within the context of the political influences which govern its practice is helpful in gaining an understanding of the constraints and power relations that are omnipresent within the healthcare environment. 2. This causes confusion and ultimately results in the individual living out their lives by an external rather than internal locus of evaluation (Rogers, 1951). Empathy within the nursing relationship is de… Basic forms of communication. PMID: 21121451 Abstract This article examines the reasons why empathy and compassion have become so highly politicised. His research focused on the relationship between the client and the therapist rather than the process of therapy itself; placing the client at the centre (Rogers, 1951). Any new initiative designed to improve this relationship and therefore the patient’s perception of their care is potentially fraught with danger. It encourages those involved in the delivery of patient care to consider the implications of embracing new initiatives that are aimed at improving, measuring and monitoring levels of empathy or compassion within the nurse-patient relationship. Some authors have questioned the value of seeking to develop empathic nurse-patient relationships within busy acute healthcare settings due to the constraints of this environment (Wong, 2004). Why should an empathic nurse-patient relationship be a cause for concern? Empathy, sympathy and compassion also share elements with other forms of … COVID-19 is an emerging, rapidly evolving situation. Health communication theory and practice. How can we measure empathy? Sympathy - the verbal and non-verbal expression of sorrow or dismay (Morse et al, 1992). 2 Abstract: The aim of the current study was to explore the Arab nurses' conceptualization and utilization of empathy in the psychiatric setting in United Arab Emirates (UAE). This means that the individual does what they believe others would want them to do rather than following their own desires. Golis (1995) asserts that empathy is the ‘hook’ into another person’s emotions and that there is often an ulterior motive for wishing to gain this type of insight. 101026Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? Many argue that empathy is indispensable to effective nursing practice. Within nursing literature, empathy appears to be valued as a concept to be used alone rather than within a relationship containing all the core conditions. Stenhouse R, Ion R, Roxburgh M, Devitt PF, Smith SD.  |  An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. The nurse-patient relationship is far from equal and differs vastly from the counselling relationship where the counsellor seeks to help the client become their own expert. Empathy in nursing is defined as a human, professional, and caring trait in the process of communication with patients. The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. However, this li… Chowdhry, S. 2010. Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? Welsh universities have announced their intentions to measure and monitor nursing students on their ability to show compassion to their patients (Santry, 2010). High profile new initiatives to improve patient care that also improve the public relations need to be carefully examined. Used with the core conditions of congruence and unconditional positive regard and within in the boundaries of the counselling relationship (absolute confidentiality between the counsellor and client), the counsellor seeks not to influence the client but to provide them with the conditions that they require to listen to their inner voice. This means that we should clarify with our patients whether they wish to have their innermost feelings and personal logic documented or shared with the health care team. However, despite these concerns, a new discourse about nursing practice has emerged which includes the following questions: How empathic are nurses? It is important to understand the terms compassion, sympathy and empathy which are used interchangeably in nursing literature resulting in confusion and manipulation of these concepts in the healthcare environment. Nurse advocacy, patient empowerment, consent and confidentiality are discussed as examples of potential areas requiring careful consideration. The term empathy originates from the German word Einfühlung and was first used by Robert Vischer in 1873 to describe the projection of human feeling on to the natural world. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Keywords Empathy, Compassion, Nurse-patient relationship. The findings revealed that empathy is not a single phenomenon. Some of the ways that nurses influence their patients is demonstrated by Lawrence et al (2010) who identified that nurses and patients families select interventions aimed at ‘promoting, improving and sustaining behaviour’ following stroke. An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. This article examines the reasons why empathy and compassion have become so highly politicised and encourages those involved in the delivery of patient care to consider the implications of embracing new initiatives which are aimed at improving, measuring and monitoring levels empathy or compassion within the nurse-patient relationship. Empathy enhances patient-physician communication and trust, and therefore treatment effectiveness. Compassion involves an active participation in another individual’s suffering rather than simply identifying with it (von Dietze and Orb, 2000). An account of how the concept of basic empathy is relevant for nursing practice Empathy is a topic of continuous debate in the nursing literature. Personal system concepts from King’s general systems framework include perception, self, growth and development, body image, space, time, and learning. As the ‘expert’ professional with specialised knowledge, nurses have a considerable influence on their patients. The influence of government agendas on nursing is evident in the response to events at Stafford Hospital (Rose, 2010) and the inquiry into care provided by Mid Staffordshire NHS Trust (Department of Health, 2010). 2016 Apr;39:12-5. doi: 10.1016/j.nedt.2016.01.019. The focus on tasks is influenced by the medical model and sometimes this is referred to as ‘old nursing’. Empathy within the nursing relationship is defined as: a human trait; a professional state; a communication process; caring; and a special relationship (Yu and Kirk, 2008). In the counselling relationship, the deep empathic understanding is used to express a desire by the counsellor to fully identify and understand the other person’s experience as if it were their own. Interest in this aspect of nursing practice is influenced by government agendas aimed at improving the image of the NHS. Empathy is a topic of continuous debate in the nursing literature. Nursing Times; 106: 42, early online publication. Exploring the concept of empathy in nursing: can lead to abuse of patient trust. An increasing pressure is being put on health and social care providers to promote dignity in care. The problem with new initiatives to measure or monitor compassion or empathy is that both of these concepts are considered to be central to a nurse’s identity.  |  This site needs JavaScript to work properly. Effective communication is central to the provision of compassionate, high-quality nursing care in all… The concept of empathy lies amid much confusion. The professionalisation of nursing has helped to move it from instrumental rationality with its focus on procedures and routines (task orientation). Empathy has also become a ‘tool’ which researchers are showing an interest in measuring (Yu and Kirk, 2008). While this appears to be innocent enough; perhaps reflecting a desire to improve patient care, closer examination reveals that compassion appears to have become a commodity or a product of the healthcare system (Por, 2008). Many argue that empathy is indispensable to effective nursing practice. Engaging patients with empathy can lead to a better doctor/patient and nurse/patient relationship. Empathy model most often used in nursing is based on the relations in the communication process. In contrast to nurse training, counsellors undergo a lengthy period of personal development; this enables them to recognise and take ownership of their personal prejudices and ensures that they do not influence the individual’s frame of reference (Sanders, 2002). England: Open university press. By NT Contributor, Empathy is often promoted as being desirable but any new initiative to improve care should be carefully considered to ensure it does not put patients at risk, Sue Chowdhry PGCert - TQFE, BN, HNC Counselling, RGN, EN, NNEB, is lecturer in healthcare and counselling at Adam Smith College, Kirkcaldy. But before nurses  jump on this particular bandwagon and sign up to have their levels of empathy measured, perhaps they need to carefully consider, who is investing in this particular discourse and who will gain from it. This does not suggest that nurses deliberately exploit their patients but the environment that they work in makes demands on how this information is used and raises the question: What do we do with personal information? Author Sue Chowdhry 1 Affiliation 1 Adam Smith College, Kirkcaldy. 2 However, as with many holistic concepts and …  |  J Med Ethics. Nursing times 160(42), pp. Public opinion and media attention becomes the key drivers for government policy relating to health care; as the government in an effort to avoid embarrassment reacts to critical reports (Hart, 2004). Helping nurses reconnect with their compassion. Within counselling literature, the self-concept is heavily influenced during our formative years by the attitudes of others. By listening and communicating we can understand and guide our patients. However, the boundaries of the counselling relationship vary from that of the nurse-patient relationship; it is these distinct differences that have implications for patients. Nurses have a duty of care towards their patients and this means that great care is needed in areas where the nurse may use the trust established by an empathic relationship to influence a patient. A scan of the recent nursing literature reveals a renewed interest in the concept of empathy, with explorations of the origins of the concept, methods for teaching empathic behavior, ways to apply empathy during nursing care, and, of course, in this era of evidence-based practice, scales and observational methods for measuring empathy. New initiatives which are influenced by politico-economic drivers and involve the measurement of skills or attitudes may lead to unwanted and possibly unvalidated competency indicators. Then I will discuss how this concept applies to my care scenario and how it relates to professional caring in nursing. The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Nurses may not be aware of these demands or may feel powerless to do anything about them. Skelton (1994) argues that seeking to empower the patient is motivated by the desire to make them conform to the wishes of the nurse (the expert), while encouraging the patient to think that it was their idea. The empathy concept of Edith Stein, philosopher and follower of Edmund Husserl's phenomenology, goes beyond these conflicting views and offers a more complex interpretation, with relevance for both healthcare and nursing education. 2010 Oct 26-Nov 1;106(42):22-5. Research indicates that empathy, a quality regarded as fundamentally important to nursing practice, is a teachable skill.Because empathic nurse-patient relationships are particularly important in the care of the terminally ill, this has direct relevance to the professional development of palliative care nurses. Propositions for each concept in the personal system were explicated and a theory of nursing empathy was developed. The concept of empathy lies amid much confusion This analysis addresses that confusion using Walker and Avant's model of concept analysis, and looks at what empathy is is it trait or state, is it dynamic or static, and how is it recognized and measured' Implications of these findings are discussed, limitations of the study are acknowledged and areas for further work suggested Understanding what influences these new initiatives is important as it can help to identify those with vested interests in their success. This is a stark reminder of the imbalance of power and paternalistic nature of the healthcare environment. Interest in the role of empathy within the nurse patient-relationship has been growing over the past few decades (Yu and Kirk, 2008) and is often considered to be a crucial component of quality care (Reynolds et al, 1999). 100 years: Centenary of the nursing register, 2020: International Year of the Nurse and Midwife, Nursing Times Workforce Summit and Awards, Stafford Hospital caused ‘unimaginable suffering’. Areas where particular caution is required relate to situations where the patient may be influenced by the nurse or the needs of the wider healthcare environment and these include, advocacy, patient empowerment, consent and confidentiality. Within the nurse-patient relationship empathy is conceptualised as having therapeutic value and as such is promoted to nurses as being desirable (McCabe, 2004). In psychology and counselling literature it is used to ‘explain how we discover that other people have selves’ (Wispé, 1987) and was popularised by the psychologist Carl Rogers. Empathy, as initially described by Rogers, reflected a deep desire to understand and enter into the experience of another human being may become in healthcare a method of gaining trust and obtaining information. Empathy, sympathy and compassion are defined and conceptualised in many different ways in the literature and the terms are used interchangeably in research reports and in everyday speech. Studies have been undertaken to explore the concept of empathy among nursing students, but there have been no investigations in Jordan or in the Arab world. This article examines the reasons why empathy and compassion have become so highly politicised. More specifically, empathy forms part of the ‘core conditions’ along with congruence (being genuine and transparent) and unconditional positive regard (being non-judgemental) (Rogers, 1951). In short, insight is gained into the mind and thinking of the patient. Some of the influences on the such discussion include: government policy, the requirements of statutory nursing regulatory bodies and recent initiatives which promote the ‘centrality of compassion in nursing’ (Cornwell and Goodrich, 2009). Empathy has positive influence over the quality of relations between nurses and patients, as well as the quality of nursing care. Empathy is a complex, multidimensional concept that has moral, cognitive, emotive and behavioural components. Empathy helps nurses build a trusting connection with those in their care by focusing on the patient's point of view. Definitions are outlined in Box 1. This suggests there may be inherent problems with the empathic relationship in this setting. The empathic understanding of patients by nurses has the potential to put the patient at risk. This work has influenced the concept of patient-centred care which emerged from discourses of the ‘self’ in the 1960s. Empathy in nursing is a newer concept, which started to be recognised as part of the nursing profession and an important part of the nurse-patient relationship and communication skills in the 1950s. Moreover, compassion is thought to be an ‘altruistic expression’ and therefore involves a selfless concern for the welfare of others. A negative self concept is thought to arise from a highly critical environment which distances the individual from their ‘organismic self’. ‘New nursing’ focuses on the individuality of the patient; person-centred care and has sought to counteract the effects of the medical model (with its associated depersonalisation) (Salvage, 1990). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. ‘Employers must do their utmost to support their nursing staff’, 24 October, 2010 Many new nursing initiatives originate from evidence based practice, this means that nurses are continually driving growth and change. Summary. However, an examination of the origins of the term empathy is important if it is to be critiqued and accepted as part of nursing practice. Comparisons between the counsellor-client and nurse-patient relationship are perhaps helpful to identify possible tensions. 22-25 Some of the latest initiatives aimed at improving the patient’s experience include teaching nurses to be more empathic (Yu and Kirk, 2008). This article proposes a new holistic conceptualization of empathy for nursing practice that allows different aspects of the literature to be understood. This means that the role of nurse as patient advocate is a concern; claims have been made that nurses are still grappling with ethical dilemmas of this role due to conflicts of loyalty between the needs or wishes of the patient and the employer (Martin, 1998). A concept analysis of nurse-patient trust. This analysis addresses that confusion using Walker and Avant's model of concept analysis, and looks at what empathy is: is it trait or state, is it dynamic or static, and how is it recognized and measured? The Social Care Institute for Excellence, in partnership with the Department of Health, developed a practice guide for promoting dignity in health and social care settings (SCIE, 2006). This article examines the reasons why empathy and compassion have become so highly politicised and encourages those involved in the delivery of patient care to consider the … It is not just health care providers who are attempting to commercialise compassion and empathy; those receiving health care now view themselves as consumers, and rather than passively accepting care provision, are actively questioning the care that they receive (McQueen, 2000). Visit our. Sympathy is the verbal and non-verbal expression of sorrow or dismay (Morse et al, 1992). But is an empathic relationship altruistic? 2009 Aug;35(8):465-8. doi: 10.1136/jme.2008.028530. Section Editor(s): Donnelly, Gloria F. PhD, RN, FAAN, FCPP; Editor-in-Chief. Schantz also noted that nursing research in the United States uses the terms compassion, sympathy, empathy, and … What happens to information provided by the patient? However, it is worth remembering that the patient is also a commodity of the healthcare market and as such, is subjected to constant surveillance and is constructed in terms of measures such as pain, clinical trajectory, and audit rating (Richman and Mercer, 2004)This means that notions of both compassion and empathy in nursing care are highly political with a politico-economic agenda rather than an altruistic one. Therapeutic empathy is a well-established Western psychiatric concept identified as a quality central to establishing the nurse-patient relationship. This study is based on the data of a doctoral study exploring the nature of empathy on an oncology ward. To begin the dissection of the identified concept of interest, the CNS researcher must begin with the meaning to nursing. Medical Nursing: (11th edition) London: Harcourt Publishers limited Berry, D. 2007. Within the nurse-patient relationship empathy is conceptualised as having therapeutic value and as such is promoted to nurses as being desirable (McCabe, 2004). Br J Nurs. Please enable it to take advantage of the complete set of features! 2009 Jan 8-21;18(1):46-51. doi: 10.12968/bjon.2009.18.1.32091. The economics and management of the healthcare system changes the perception that nurses and doctors have of their patients for example, when health care resources are limited, health professionals may perceive patients who take up more resources as being more demanding (Stearns, 1991). Nurse Educ Today. Some of the latest initiatives aimed at improving the patient’s experience include teaching nurses to be more empathic (Yu and Kirk, 2008). I will also be relating new information to improvement for future nursing practice. This area perhaps merits further research including: nurses perception of empathy and its value; the way that the empathic relationship impacts on the patient’s decision making process; and the effects of an empathic nurse-patient relationship on the patient’s self concept. They are likely to be the product of discourses which appear attractive to the professions self concept, but have hidden agendas or dynamics that are not apparently obvious; the practice-discourse of the empathic nurse-patient relationship is an illustration of this. 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For UK health professionals only The roundtable discussion and this associated article…, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. Were explicated and a theory of nursing care asserts that the core are... Not be aware of these demands or may feel powerless to do anything about them this... Information relating to their work with their clients in order that they can maintain their clients in order they. It relates to professional caring in nursing models of understanding the realities of later life can be challenging... Art of empathy in nursing suffering ( Schantz, 2007 ) concerns, new! Compare and contrast the key behaviors that support empathy development among nurse Despite the barriers empathy! 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