Empathy: The key to end of life care
Introduction
In the United States, the most significant part of health-care professionals is represented by nurses. Currently, 3.6 million nurses are practicing to provide complete patient-centered care to the patients. Nurses are a crucial part of the health care team who is required to ensure the provision of safe and effective care for the global population. In a health care facility, nurses are those professionals that spend more time with patients and their families as compared to other professionals. With expert nursing care, they can reduce the distress and burdens of those patients who are facing death; nurses can support the patients and their families from all perspectives such as physically, socially, emotionally, and spiritually. Though most nurses are exceptional in performing their duties related to end of life care, there are those who lack optimal levels of compassion and seem to express less than desired empathy during end of life care. Empathy is a paramount quality that must be possessed by all nurses.
“Empathy means the capability to comprehend and share the sentiments of another. In other words, to put yourself in another person’s shoes so that you may have some understanding of what they may be experiencing. Emotions run high when a person is dying, and families look toward the primary caregiver for support and empathy. Empathy provides an avenue for awareness and validation of a patient’s fear or angst; this also applies to their loved ones and families. Understanding the patient and their family’s concerns can facilitate an appropriate plan of care.”
Gagan (1983) defines empathy as:
“The ability to perceive the meanings and feelings of another person and to communicate that feeling to the other.”
The critical difference between the above two definitions is the “ability to communicate” all those feelings that you are seeing and hearing (about a person specifically the patient or their family in this case) to whom you are talking to. From the perspective and conclusions of different studies, the following qualities or practices are essential to have to show empathy towards families during end of life care:
COMMUNICATE: By curbing your own avoidance, provide open, honest, and complete information in the end-of-life discussions. Ask the family if they need anything, initially, they may want to be alone, and that’s okay. However, by conveying that you are available if they need anything will help ease their mind.
EMPATHIZE: Grieving comes in many forms, and everyone grieves differently. Allow them time and space to grieve. Do not be judgmental, and do not infringe on this time.
SUPPORT UNCONDITIONALLY: Provide time and space for the family to feel welcomed. Provide chairs, tables, or refreshments. Provide spiritual support as desired. If approached for a hug, hug back; lend a shoulder to cry on, more importantly, take the time to listen. Allow them to vent and or express their feelings. Remember that it is their time and not yours.
LISTEN: Sometimes, listening is the best thing you can do; listening effectively is another step that could help in comforting the patients and their family at the end of life care, listen to what the patient wants and wishes at that time.
PROVIDE THEM WITH SPACE: Space allows them to deal with the loss of their loved one in their own way. Provide comfort as desired; however, do not overwhelm them with your presence. Let them grieve at their own pace; they must be given the autonomy to make their own personal journey.
BE CALM: This action speaks louder than words. The patient and family rely on you, the health care professional. The nurse must remain calm and take the helm.
BE AVAILABLE: Even though it is essential to give space for grieving, it is just as important to let families know that you are close by. Please don’t make the family hunt you down to address their needs. Let them know how to reach you should they need anything.
HEALTHCARE PROVIDER ROLE: Provide compassionate, empathetic, and unconditionally care to the patient and their family.
AVOID CLICHÉ REMARKS: The last thing a person wants to hear some cliché saying about their loved one’s death, such as “They are in a better place now” or “They will not suffer anymore.”
NON-VERBAL COMMUNICATION: End-of-life care can also be strengthened by practicing this technique; it can be an appropriate sitting style, an appropriate touch, smile, an attentive look, or even a body posture. Avoid defensive body language.
AWARENESS OF OWN EMOTIONS: It’s another key in strengthening the end-of-life care. It would be best if you captured the ability to be reflective and thoughtful about what could be said to lessen the pain and burdens in the perspective situations while being extra-aware of other’s emotional state. The nurse must be brave while listening to another person’s sorrow, anxiety, and to be there to offer strength and braveness of a professional character.
COMPASSION: You need to be brave and compassionate in your feelings, skills, thoughts, and words to relieve suffering; you need to possess the ability to be open to the sufferings of others and to provide factual information while not avoiding the discussion on dying. A professional is required to face his or her own fears while providing end-of-life care services.
DIGNITY: Dignity is the most crucial element in professional services; it’s the ability to value and respect the patient for his or her own sake. It’s another step in strengthening the practice referencing to the end-of-life care. Dignity is also inter-linked with honesty and courage, the ability to honor the personhood of a person as a patient, and all of their specific needs, including the capability to answer all of their questions without dodging or avoiding the use of the word “dying.” The most commonly asked questions in the clinical end-of-life practice are mostly future-oriented such as “What will happen to me?” Nurses are frequently asked to answer this question with an honest and respectful answer without striking or dodging the question.
ACTING QUICKLY: With all other qualities and practices, you need to be capable or practiced enough to act quickly; the end-of-life care can become an urgent situation. Where there would be no time for you to be prepared to show empathy or compassion towards the families and patients as there might be an end-of-life trigger that brings on sudden death. Here, your responsibility is to identify those triggers to your relevant professional team members so that they perform the appropriate treatment and, in other cases, to offer empathy, compassion, and support should an emergent situation occur.
CONCLUSION
Nurses can offer the best end of life care services, but they need to practice all the above features and steps to strengthen their end-of-life care services. We, as nurses, are required to be capable enough, to tell the truth with kindness, to answer all the questions of patients and families with honest and respectful answers, to understand their feelings and emotions and to offer strength and braveness while keeping in check our own emotions, to act quickly in urgent situations while staying calm and collective and to provide adequate space and time to allow families to adjust with their situation while making them aware with your presence.
References
https://bmjopenquality.bmj.com/content/8/2/e000669
http://rcnendoflife.org.uk/my-role/
https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics/endoflife-positionstatement.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618053/
https://www.huffpost.com/entry/why-empathy-empowers-pati_b_783138
