nammi, Nurse, General Practice, 09:57PM Jul 30, 2013
Diane M. Goodman
It had been a typical evening during my brief rotation as adjunct nursing faculty. I was at the bedside of a seriously ill med/surg patient with two (second-career) nursing students. I was mid-way through performing my usual toe massage to the patient, while explaining the intricacies of backpriming an infusion pump.
One of the students drew attention to my "free massage" (as she called it) during patient assessments. "Isn't that nice", she exclaimed. "You massage the patient without being aware of it". The patient, who had been dozing fitfully, immediately spoke up and begged that I continue. "Please", she implored, "it feels wonderful". Her comment, and the fact that my touch seemed unusual to the students led to a heated debriefing later. At issue were the topics of caring and compassion. Are they integral to being a "good" nurse? Are they one and the same? And most important of ALL, have they become optional in a field that is increasingly technical in scope?
As hospitals struggle to meet and maintain high standards (particularly related to patient satisfaction), they have begun to comprehend that patients want to feel cared FOR and cared ABOUT by providers.* Nurses themselves may have read studies involving dressing changes and professional technique. Surprisingly, patients believed the more competent nurses were the ones who smiled and appeared compassionate during the procedure, not necessarily those who exhibited breath-taking skill and precision.
Similar studies involving medical residents at Harvard Medical School discovered that patients verbalized feeling a greater sense of being cared for if the medical residents pulled up a chair and sat at the bedside, even if they spent less overall time with the patient than those who stood during a pain assessment.
These findings are even more relevant for 2013, as length of stay becomes shorter.
Has compassion become optional in healthcare? Are we expecting too much of nurses to consistently exhibit caring in addition to maintaining highly sophisticated skills? Or, is it an aspect of caregiving that is doled out in bits and pieces (or added askance when everything else is done, similar to end-of-shift charting)?
I hope not! As a nurse practitioner who has experienced the gift of being on "both sides" (patient AND provider), I would much prefer a lovely toe massage vs. the occasional eye roll or stern glance. I have been subjected to both when it was obvious I needed assist to the bathroom yet AGAIN, or worse, required that a call be placed to a physician for an alternate medication (God forbid!).
What are your thoughts on caring and compassion? Should the behavior be non-negotiable? One eye rolling nurse was enough for me as a patient. Between you and me, I sincerely hope she retired minutes after my discharge from that hospital.
Share your thoughts...and delve a little deeper into compassion. Is the behavior innate, acquired, or a meld of both? I'm on a quest.
*Burdett Trust of Nursing, 2006.