As a nursing student in my third year, I find myself constantly juxtaposing between knowledge and experience. Until this semester, my process of assimilation consisted mainly of textbooks, lecture halls and the internet. Subsequent to my sophomore year, I sensed that I was not thriving in this environment. My grade point average was not poor, but I became fatigued of relentlessly accumulating knowledge by these methods. When I finally stepped foot in my first clinical last month, I realized what had been missing in the prior years. During the orientation at the rehabilitation facility where I was to experience real patient care for the first time, I was asked why I decided to become a nurse. I responded with a concise reply: I want to help people. I want to alleviate any pain or discomfort one might experience and provide support during the healing process. I later learned in my Integrating Experience course that this desire is regarded as compassion. This trait is defined by psychiatrist and academic, Harvey Max Chochinov as “a deep awareness of the suffering of another coupled with the wish to relieve it” (2007).
Compassion often goes hand-in-hand with empathy, which is “the ability to recognize, understand, and share the thoughts and feelings of another person… It involves experiencing another person’s point of view, rather than just one’s own, and enables prosocial behaviors that come from within” (Empathy, 2020). Though these two words are often used interchangeably, they are evidently not synonymous. Developing empathy is crucial for establishing relationships and behaving compassionately. From my perspective, compassion is taking empathy a step further by developing the desire to relieve the suffering another individual is experiencing, rather than just sharing that individual’s thoughts or feelings. Bearing that in mind, conveying both empathy and compassion in care is not only encouraged, but imperative. According to the novel, The Compassionate Mind: A New Approach to Life’s Challenges, empathy and “compassion [unite] people in difficult times and [are] a foundation to building human relationships which can promote both physical and mental health” (Gilbert, 2010). Putting these sentiments into practice will empower the nurse to provide the best care possible.
Jean Watson is a renowned nursing professor, nurse theorist and author who reflected this postulation in her work, Human Caring Science, which incorporates ten Carative Factors, or the ten most significant guidelines for expressing care in action. Watson not only included empathy and compassion in the ten factors, but established these characteristics as their foundation. As a student nurse, I recognize that by following this set of guidelines in practice, I will be able to provide a nurturing, peaceful, and trusting environment in which the patient will be able to heal and maintain their dignity during distressing times. This ability will allow me to drastically change client outcomes for the better. Understanding someone’s feelings will enable me to better understand what they need in order to recover.
I recognized this while on the unit at the rehabilitation facility. On the first Thursday I was assigned clinical, I entered the unit with my thoughts consumed with the possibility of assisting with the placement of a PICC line or helping a nurse with wound care. I was so exhilarated by the idea of seeing things I had never seen before and experiencing something new. It didn’t really cross my mind that these patients were real people had an entire life I had no idea about. That is, until I entered my first patient’s room. He was an older man, lying in the bed closest to the window. He looked very pale and tired. He didn’t talk much as I took his vital signs, but smiled softly every time I said something humorous. After I finished, I thanked him and headed out back into the hallway to assist the other nurses. I had many other interactions similar to this throughout my shift, each patient different. All the while, becoming more comfortable and having conversations with all different people about their families, occupations and interests. I realized that the catheterizations and medication administration were not nearly as important to me as getting to know the patients and assisting them with minimal measures, just to increase comfort and put a smile on their face. This illustrated Watson’s ninth carative factor: Assisting with basic needs, with an intentional caring consciousness, administering ‘human care essentials,’ which potentiate alignment of mind-body-spirit, wholeness in all aspects of care.
At one point, when many of the patients were in physical therapy, a nurse asked if I wanted to assist with a catheterization. The same excitement I had experienced when I first arrived came flooding back. The nurse and I gathered supplies and we entered the room of the first patient I saw that day. The catheterization process did not go smoothly. The patient was in a great deal of pain. Eventually the R.N. realized that a different technique may be better, and she stepped out for a moment to procure the proper supplies. I stood next to the man, who wore a disconsolate expression. At one point, he turned to me and said in a coarse voice, “I am so discouraged. I just want to go home,” and tears filled his eyes. I took his hand in mine and I told him that truthfully, I was very new to this setting, just like him. I said that I honestly believed he was in the best hands and I told him that I wouldn’t leave him until the procedure was over and he felt better. The nurse came in and together, we were able to perform the catheterization with minimal pain. I told the nurse that I could clean up and she assessed the patient and left the room.
The man and I were silent for a few minutes and then I asked who the flowers were from on his side table. He started to tell me all about his wife and how she visited every day. After a while, this man and I were talking and laughing and he realized he was feeling better. I was elated. Although, I wished that I was able to continue to check in on this patient for the rest of the time that he was at the facility. This is the one thing I would have done differently if it were an option. Eventually, when I become a nurse, I will be able to send patients home with a sense that they will be physically and emotionally strong and motivated to continue to heal.
When I returned home that evening, I thought about that one patient considerably. I assisted with a medical skill I had only practiced in labs, and that I never expected to experience during my first clinical. Yet, I was so much more grateful for the opportunity to make this man laugh and smile, after he had such a long and painful day. What I showed to this man was empathy and compassion, and it did stimulate a determination and livelihood in this man that I never expected to see after that first time I stepped foot in his room to check his vital signs. At the end of the day, being a nurse requires the ability to understand what a person is going through and how to help them, both physically and emotionally, just as much as this profession requires the skills and knowledge you learn from lectures and textbooks.
References
Bramley, L., & Matiti, M. (2014). How does it really feel to be in my shoes? Patients’ experiences of compassion within nursing care and their perceptions of developing compassionate nurses. Journal of Clinical Nursing, 23(19-20), 2790-2799. doi:10.1111/jocn.12537
Chochinov, H.M. (2007) Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care. British Medical Journal 335, 184–187.
Empathy. (2020). Retrieved November 16, 2020, from https://www.psychologytoday.com/us/basics/empathy
Gilbert, P. (2010) The Compassionate Mind: A New Approach to Life’s Challenges. Constable, London.
Wagner, A. L. (2010). Core Concepts of Jean Watson’s Theory of Human Caring and Caring Science [PDF]. Oklahoma City, OK: Watson Caring Science Institute.
