exploring the concept of empathy in nursing

A concept analysis of nurse-patient trust. This work has influenced the concept of patient-centred care which emerged from discourses of the ‘self’ in the 1960s. Empathy within the counselling relationship involves unconditional positive regard and congruence which essentially means that the focus is on enabling the individual to become self-directed; this is termed ‘Non-directive Counselling’ as there is no hidden agenda (Rogers, 1951). But is an empathic relationship altruistic? 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. What happens to information provided by the patient? Stenhouse R, Ion R, Roxburgh M, Devitt PF, Smith SD. 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. The focus on tasks is influenced by the medical model and sometimes this is referred to as ‘old nursing’. The findings revealed that empathy is not a single phenomenon. 2009 Aug;35(8):465-8. doi: 10.1136/jme.2008.028530. Empathy enhances patient-physician communication and trust, and therefore treatment effectiveness. Empathy has positive influence over the quality of relations between nurses and patients, as well as the quality of nursing care. Many new nursing initiatives originate from evidence based practice, this means that nurses are continually driving growth and change. 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. However, despite these concerns, a new discourse about nursing practice has emerged which includes the following questions: How empathic are nurses? Despite the barriers, empathy is critical and enhances communication. This is particularly relevant when considering aspects of patient care like health education, empowerment, advocacy and consent, where patients are vulnerable to external influence. 2010 Oct 26-Nov 1;106(42):22-5. Nowadays, empathy is considered as an effective skill for communication that is useful for both the health care worker and the … Engaging patients with empathy can lead to a better doctor/patient and nurse/patient relationship. Any new initiative designed to improve this relationship and therefore the patient’s perception of their care is potentially fraught with danger. 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). 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. 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. 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 means that there is an increased emphasis on person-centred care and on the quality of the nurse-patient relationship. 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. Empathy is recognized as a highly valued professional characteristic in the nurse-patient relationship. USA.gov. This contrasts with the portrayal of empathy in nursing literature. Yet others argue that nurses should rather rely … 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. This study is based on the data of a doctoral study exploring the nature of empathy on an oncology ward. 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. 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). 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). The concept of empathy has much been deliberated upon over the years from different perspectives due to its subjectivity. 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. Within the nurse-patient relationship empathy is conceptualised as having therapeutic value and as such is promoted to nurses as being desirable (McCabe, 2004). 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. A negative self concept is thought to arise from a highly critical environment which distances the individual from their ‘organismic self’. The discourse of ‘patient empowerment’ is a good example of how the best intentions for patients may be influenced by hidden agendas. To do this, I will be exploring the concept of empathy from a psychological perspective as well as the nursing perspective. 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). Empathy within the nursing relationship is de… Within the nurse-patient relationship empathy is conceptualised as having therapeutic value and as such is promoted to nurses as being desirable (McCabe, 2004). 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? 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. Why should an empathic nurse-patient relationship be a cause for concern? 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). This site needs JavaScript to work properly. Patients have different models of understanding the boundaries of confidentiality compared to nurses and doctors (Jenkins, 2005). Ultimately, this enables the client to become less judgemental of themselves, more congruent and empowered to find their own unique way forward through life’s problems. Effective communication is central to the provision of compassionate, high-quality nursing care in all… An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. This raised awareness of the importance of dignity and is accompanied by a number of tool kits that have been widely used in practice (DH, 2009). 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. 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. Moreover, compassion is thought to be an ‘altruistic expression’ and therefore involves a selfless concern for the welfare of others. 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. Empathy has also become a ‘tool’ which researchers are showing an interest in measuring (Yu and Kirk, 2008). Interest in this aspect of nursing practice is influenced by government agendas aimed at improving the image of the NHS. An empathic relationship encourages the sharing of innermost feelings and views. Comparisons between the counsellor-client and nurse-patient relationship are perhaps helpful to identify possible tensions. Empathy is considered to be at the heart of nursing as a part of caring. Within counselling literature, the self-concept is heavily influenced during our formative years by the attitudes of others. I will also be relating new information to improvement for future nursing practice. Sympathy - the verbal and non-verbal expression of sorrow or dismay (Morse et al, 1992). Patients trust nurses who are empathic towards them as they feel that the nurse cares about them (Määttä, 2006). Summary. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. This causes confusion and ultimately results in the individual living out their lives by an external rather than internal locus of evaluation (Rogers, 1951). 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Nurses need to think carefully about how they use information gained as a result. Measuring nursing care and compassion: the McDonaldised nurse? Similar concerns are are raised by von Dietze and Orb (2000),  warning us that nurses do not make judgements in a vacuum and will always be influenced by ‘particular values and dynamics around patient care’. Section Editor(s): Donnelly, Gloria F. PhD, RN, FAAN, FCPP; Editor-in-Chief. Sympathy is the verbal and non-verbal expression of sorrow or dismay (Morse et al, 1992). 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. Why Is Empathy in Nursing Important? Some of the latest initiatives aimed at improving the patient’s experience include teaching nurses to be more empathic (Yu and Kirk, 2008). 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. Keywords Empathy, Compassion, Nurse-patient relationship. 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? However, this li… 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). Empathy helps nurses build a trusting connection with those in their care by focusing on the patient's point of view. In the UK, compassion, and patient-centred care have gained increased prominence and this has lead to renewed discussion and debate about what constitutes good nursing care. Empathy is usually considered as the capability to put oneself in a situation to understand the emotions, feelings of other people. Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? 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). 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. Core conditions are considered to be of equal importance as they are all required to allow an individual to reconnect with their ‘true self’ and move forward in their lives in their own individual way. 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 … 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). Reconsidering Empathy in Nursing Care. England: Open university press. The concept of empathy lies amid much confusion. 2 However, as with many holistic concepts and … Empathy – allows understanding not only of other’s beliefs, values and ideas but also the significance that their situation has for them and their associated feelings (Rogers, 1951). COVID-19 is an emerging, rapidly evolving situation. Author Sue Chowdhry 1 Affiliation 1 Adam Smith College, Kirkcaldy. Nurses need to carefully consider how power is used and ensure that patients are not unwittingly placed in a vulnerable position. 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. Author Information . The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Empathy in nursing is defined as a human, professional, and caring trait in the process of communication with patients. Many argue that empathy is indispensable to effective nursing practice. This is a stark reminder of the imbalance of power and paternalistic nature of the healthcare environment. ‘Employers must do their utmost to support their nursing staff’, 24 October, 2010 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. Exploring the concept of empathy in nursing: can lead to abuse of patient trust.  |  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. Basic forms of communication. 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. 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. Then I will discuss how this concept applies to my care scenario and how it relates to professional caring in nursing. 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. 101026Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? Compare and contrast the key behaviors that support empathy development among nurse NLM Undergraduate nursing students are taught the importance of empathic relationships. 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. 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. Empathy is a complex, multidimensional concept that has moral, cognitive, emotive and behavioural components. Rogers asserts that the core conditions are vital for the formation of a relationship where a counselling client can reconnect with their self-concept. Power is a central influence in nursing practice and this means that nurses should be encouraged to seek an understanding of the way that it operates in the social context that they work in. Counsellors rarely document detailed personal information relating to their work with their clients in order that they can maintain their clients’ privacy. 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/. This means that politics directly influences nursing practice; with government agendas, influenced by public opinion making headline news. 1 This conceptual and semantic confusion has practical implications for clinical practice, research and medical education. 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. 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). 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 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). Therapeutic empathy is a well-established Western psychiatric concept identified as a quality central to establishing the nurse-patient relationship. Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? By listening and communicating we can understand and guide our patients. 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. Chowdhry, S. 2010. Visit our. Exploring the concept of empathy in aesthetic nursing Brackenbury, J Journal of Aesthetic Nursing | Vol 5 | No 7 | September 2016 | pp 349–353 Abstract Empathy is a complex, multidimensional concept that has moral, cognitive, emotive and behavioural components. This article examines the reasons why empathy and compassion have become so highly politicised. Propositions for each concept in the personal system were explicated and a theory of nursing empathy was developed. Can we teach them to be more empathic? Some of the latest initiatives aimed at improving the patient’s experience include teaching nurses to be more empathic (Yu and Kirk, 2008). This suggests there may be inherent problems with the empathic relationship in this setting. Before the psychologist Edward Titchener (1867–1927) introducedthe term “empathy” in 1909 into the English language asthe translation of the German term “Einfühlung” (or“feeling into”), “sympathy”was the termcommonly used to refer to empathy-related phenomena. This article proposes a new holistic conceptualization of empathy for nursing practice that allows different aspects of the literature to be understood. 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. Understanding what influences these new initiatives is important as it can help to identify those with vested interests in their success. 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. 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Will also be relating new information to improvement for future nursing practice is influenced by government agendas at...

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