How can we can enhance compassion and resist callousness? Through sharing and reflection. I believe strongly that intentionally sharing the challenges of dealing with illnesses and others’ vulnerability will make us better at supporting each other and ourselves.
In my view the alternative would be an existence of compartmentalization and functionality. We could survive, but work would become a place where we do our best to make the Machine work well. A system that primarily values efficiency and performance to “manage care” will eventually devalue the human needs of the caretakers, too, and believe that individual ethics and emotions should not interfere with efficiency. Efficient systems will tend to create callous persons.
The challenge facing health care is whether it is possible to resist callousness without compromising effectiveness. Can we continue to care, and still avoid burnout? Can we encounter illness and suffering with purposeful compassion instead of defensive detachment? Can we continue to work and grow, without losing our souls?
My answer to each of these is a qualified Yes.
My answer is qualified by realizing that one cannot do this alone – it can only be done within a supportive community. Such a community can realize that it deals with human suffering and loss – the ones that necessarily accrue with illnesses, accidents and aging. Frontline health care workers are inclined (or were at one time) to wish to relieve suffering. Where does such virtue originate, and why is it in danger always of being suppressed? Through reflection and sharing of ideas and experiences, I suspect we can re-discover that “professionalism” does not have to mean indifference to suffering.
This will also take willingness to examine one’s values and emotions, the sources of our ethics and behaviors. Change always begins within oneself. How much imperfection can we acknowledge; how much openness to change can we manage?
To counteract divisive forces, we need to proactively identify, defend and model forces that can bind us. I have proposed the following mission statement for the hospital community I work with. It is my starting place to envision how self-care and community and patient care are related.
5400 Mission Statement
Mission
- 5400 is a general medical unit of Rochester General Hospital providing professional and humane care to inpatients with complex medical issues that include acute and chronic pulmonary problems.
Vision
- Our technically excellent care will provide for
patient safety, disease management and cost-effectiveness.
- We will strive to provide patients, with their losses in health and security, with care that is technically excellent and humanely directed.
- We will model patient care that appreciates and
addresses the multidimensional nature of illness.
- Staff and providers will connect their science with their humanity.
- We will model professional behaviors not only in biomedical knowledge and skills, but also in collaboration, compassion and conscientiousness.
- We will support patients and their families with their psychosocial needs, even when we cannot restore their physical health or emotional well-being.
- Our leaders will advocate for a supportive
community.
- They will demonstrate ethical behavior, independence, proficiency and purposefulness in their actions.
- They will encourage work-life balance and personal and professional growth in staff.
- They will model the relationships and behaviors that they wish staff to exercise with patients
- They will insist that the institution do similarly.
- We will strive as individuals and as a community
to resist health care becoming a machine that reduces individuals (patients and
staff) to their functions.
- We hope for individuals to do better than to only adapt and survive, but to grow individually and to develop purposefully.
Goals
- Improve morale
- Improve staff recruitment and retention
- Improve interpersonal communication skills
- Improve communication in the electronic medical record
- Improve Patient Experience measures
- Improve Transition of Care measures
- Improve measurements of safety and quality
- Maintain fiscal responsibility
Values to Support
- Meaning: Patient care is a calling, a calling to provide assistance to fellow human beings confronting illness and aging.
- Trustworthiness: Health care providers seek excellence in their technical and humane skills to earn the trust of their patients and colleagues.
- Kindness: Kindness toward patients includes kindness toward oneself and colleagues.
- Communication: Real-world problems can only be addressed successfully through communication and collaboration.
- Personal integrity: Truth-seeking and relationship-building require courage to examine one’s feelings and values.
Aphorisms
- We seek Compassion that can stand in awe of what patients carry, rather than in judgment at how they carry it. (paraphrasing Gregory Boyle, SJ)
- Know patients, care for them, and ease their way.
- Love grows and pains shrink, through sharing.