How empathy skills can change nursing
Shifting perspectives
He clearly sees empathy as encouraging caring and supportive actions. We will act differently if we think about and understand others’ lives from their perspective. Krznaric contrasts empathy with sympathy, which goes little further than feeling sorry for someone. For example, one might have feelings of sympathy towards scenes of
starvation on the television news, but these feelings will not necessarily lead us to act. Nursing is an active profession. This focus on action places empathy at the heart of nursing practice. It is the nurse’s passion for people that drives him or her to pursue a nursing career, yet having empathy is not always easy. Patients can sometimes engage in behaviours we find difficult to understand. We judge. And we all do it, knowingly or not. Take, for example, someone who is using heroin and whose life appears self-destructive (see box). Sometimes labels are convenient and easy ways to explain away a life that we don’t understand. Those are the occasions when
24 november 12 :: vol 29 no 11 :: 2014
making connections beyond the comfortable and superficial becomes especially important if we are to be caring. Stepping into someone else’s shoes is not straightforward. Only that person has trod the path of his or her life with all its twists and turns. We have to recognise the way an individual’s
SUMMARY
Empathy is the basis of a revolution. That is the idea put forward in a recent bestselling book by the philosopher Roman Krznaric. In his book, Empathy: A Handbook for Revolution, Krznaric sets out why he believes people and society benefit from trying to understand others’ lives. He argues that people are fundamentally social beings and suggests that we can find solace in the connections and relationships made possible by developing empathetic understanding. We are excited at these ideas and believe they are also the basis of a revolution in nurse education and practice. Krznaric suggests that empathy is ‘the art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions.’
ALAMY
Want to do the best for your patients? Then step into their shoes, say nursing lecturers Iain Atherton and Richard Kyle
Empathetic understanding could be the basis of a revolution in nurse education and practice, freeing nurses from a reliance on stereotypical labels that mask the complex realities of patients’ lives. Authors Iain Atherton and Richard Kyle are lecturers in nursing in the School of nursing, midwifery and health at the University of Stirling’s Highland Campus, Inverness
NURSING STANDARD
choices and circumstances are interconnected. Actions such as drug use may be coping mechanisms following traumatic life events. We have previously encouraged nurses to think about how they have been shaped by their own biogeography (features, September 17, and tinyurl.com/oteljno). Being a nurse is not entirely down to choices you have made. Those choices have been constrained and enabled by the contexts of your life. If we ourselves have not been fully in control of our lives, then neither have our patients. Thinking reflexively about our own situation helps us to accept how context influences the lives of others.
Individualised care
This is not to say we just accept the actions of others. We might come to understand why it is people started or continue to take drugs, but that is not the same as just accepting their drug use uncritically. We may know the story of their life that brought them to their drug use, but still work towards their drug-free future, because we are aware of the damaging health and social impacts of prolonged addiction. We may understand the importance of the patient’s
friendship networks, but still attempt to encourage new relationships, because we know that these social connections provide access to drugs. Empathetic understanding can provide a basis for shared discussion about how challenges might be approached. The end result may not be that the patient is able to stop taking drugs. However, the sense of empathy increased through continual conversation can at least forge a trusting therapeutic relationship that is of considerable value in itself.
simplifications. Worse, they can often be erroneous. Developing empathy through conversations can allay our own anxieties and help us to connect with our patients – as messy, contradictory individuals. Just like us. Doing so can enrich our nursing lives. Empathy can rejuvenate our sense of purpose as nurses.
Next steps
We have drawn on Krznaric’s book in this article and an excellent next step would be to read that book. Krznaric
WE WILL ACT DIFFERENTLY IF WE THINK ABOUT AND UNDERSTAND OTHERS’ LIVES FROM THEIR PERSPECTIVE Empathy is about stepping beyond stereotypes that over-simplify and sometimes completely mask complicated lives. Think about all the labels we risk drawing on daily. What do they convey? Every handover includes details of patients’ names, dates of birth and condition. Hearing that someone in our care is in their nineties may conjure up an image of an individual who is frail and dependent. And learning that he or she is ‘an asthmatic’ may make us think of someone wheezing and reaching out for an inhaler. But these are
makes various suggestions about what the empathy revolution entails, including reading books or watching films that encourage empathy (go to www.empathylibrary.com) and having conversations with others and asking questions about their lives. Keep talking – to each other, to patients and to their families. Find out about their life story and the places that have and continue to shape it and them. Developing empathy is an active process. It can be exciting and rewarding, and revolutionise your practice NS
GETTING TO KNOW THE REAL ‘JUNKIE JACK’ Sue, a nurse, had just found out that she would be looking after a young man called Jack. He had a long history of hospital admissions that had resulted from his heroin use. Sue had never looked after him previously and had little experience of caring for people with such an addiction. His reputation in the community as ‘Jack the Junkie’, however, preceded him, something of which Sue was well aware. She felt some apprehension. She made a point of finding out about Jack’s life and the places important to him: his biogeography. It was a busy ward but opportunities arose to speak with him, for example when administering his IV antibiotics. In so doing she found out about Jack the person rather than the ‘junkie’. She learned about his parents, his brothers and sisters. She also learned about his numerous attempts to stop using drugs. These were made difficult by his constantly coming into contact with people taking heroin and other drugs. He had become homeless and the need for a place to sleep often led him to rely on others for a bed and companionship. But these acquaintances also encouraged his drug use. The intertwined biography and geography of his life, made moving away from drugs extraordinarily difficult. Over time and through conversation Sue came to feel a connection with Jack. That isn’t to say she accepted his drug use as inevitable or acceptable. But she did come to know him as Jack the person complete with all his quirks and contradictions. She felt much more comfortable sitting down talking with him, and, in time, even came to enjoying seeing him. As such, she was in a better position to care for and about him, and work with him for his future.
NURSING STANDARD
november 12 :: vol 29 no 11 :: 2014 25
Shifting perspectives
He clearly sees empathy as encouraging caring and supportive actions. We will act differently if we think about and understand others’ lives from their perspective. Krznaric contrasts empathy with sympathy, which goes little further than feeling sorry for someone. For example, one might have feelings of sympathy towards scenes of
starvation on the television news, but these feelings will not necessarily lead us to act. Nursing is an active profession. This focus on action places empathy at the heart of nursing practice. It is the nurse’s passion for people that drives him or her to pursue a nursing career, yet having empathy is not always easy. Patients can sometimes engage in behaviours we find difficult to understand. We judge. And we all do it, knowingly or not. Take, for example, someone who is using heroin and whose life appears self-destructive (see box). Sometimes labels are convenient and easy ways to explain away a life that we don’t understand. Those are the occasions when
24 november 12 :: vol 29 no 11 :: 2014
making connections beyond the comfortable and superficial becomes especially important if we are to be caring. Stepping into someone else’s shoes is not straightforward. Only that person has trod the path of his or her life with all its twists and turns. We have to recognise the way an individual’s
SUMMARY
Empathy is the basis of a revolution. That is the idea put forward in a recent bestselling book by the philosopher Roman Krznaric. In his book, Empathy: A Handbook for Revolution, Krznaric sets out why he believes people and society benefit from trying to understand others’ lives. He argues that people are fundamentally social beings and suggests that we can find solace in the connections and relationships made possible by developing empathetic understanding. We are excited at these ideas and believe they are also the basis of a revolution in nurse education and practice. Krznaric suggests that empathy is ‘the art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions.’
ALAMY
Want to do the best for your patients? Then step into their shoes, say nursing lecturers Iain Atherton and Richard Kyle
Empathetic understanding could be the basis of a revolution in nurse education and practice, freeing nurses from a reliance on stereotypical labels that mask the complex realities of patients’ lives. Authors Iain Atherton and Richard Kyle are lecturers in nursing in the School of nursing, midwifery and health at the University of Stirling’s Highland Campus, Inverness
NURSING STANDARD
choices and circumstances are interconnected. Actions such as drug use may be coping mechanisms following traumatic life events. We have previously encouraged nurses to think about how they have been shaped by their own biogeography (features, September 17, and tinyurl.com/oteljno). Being a nurse is not entirely down to choices you have made. Those choices have been constrained and enabled by the contexts of your life. If we ourselves have not been fully in control of our lives, then neither have our patients. Thinking reflexively about our own situation helps us to accept how context influences the lives of others.
Individualised care
This is not to say we just accept the actions of others. We might come to understand why it is people started or continue to take drugs, but that is not the same as just accepting their drug use uncritically. We may know the story of their life that brought them to their drug use, but still work towards their drug-free future, because we are aware of the damaging health and social impacts of prolonged addiction. We may understand the importance of the patient’s
friendship networks, but still attempt to encourage new relationships, because we know that these social connections provide access to drugs. Empathetic understanding can provide a basis for shared discussion about how challenges might be approached. The end result may not be that the patient is able to stop taking drugs. However, the sense of empathy increased through continual conversation can at least forge a trusting therapeutic relationship that is of considerable value in itself.
simplifications. Worse, they can often be erroneous. Developing empathy through conversations can allay our own anxieties and help us to connect with our patients – as messy, contradictory individuals. Just like us. Doing so can enrich our nursing lives. Empathy can rejuvenate our sense of purpose as nurses.
Next steps
We have drawn on Krznaric’s book in this article and an excellent next step would be to read that book. Krznaric
WE WILL ACT DIFFERENTLY IF WE THINK ABOUT AND UNDERSTAND OTHERS’ LIVES FROM THEIR PERSPECTIVE Empathy is about stepping beyond stereotypes that over-simplify and sometimes completely mask complicated lives. Think about all the labels we risk drawing on daily. What do they convey? Every handover includes details of patients’ names, dates of birth and condition. Hearing that someone in our care is in their nineties may conjure up an image of an individual who is frail and dependent. And learning that he or she is ‘an asthmatic’ may make us think of someone wheezing and reaching out for an inhaler. But these are
makes various suggestions about what the empathy revolution entails, including reading books or watching films that encourage empathy (go to www.empathylibrary.com) and having conversations with others and asking questions about their lives. Keep talking – to each other, to patients and to their families. Find out about their life story and the places that have and continue to shape it and them. Developing empathy is an active process. It can be exciting and rewarding, and revolutionise your practice NS
GETTING TO KNOW THE REAL ‘JUNKIE JACK’ Sue, a nurse, had just found out that she would be looking after a young man called Jack. He had a long history of hospital admissions that had resulted from his heroin use. Sue had never looked after him previously and had little experience of caring for people with such an addiction. His reputation in the community as ‘Jack the Junkie’, however, preceded him, something of which Sue was well aware. She felt some apprehension. She made a point of finding out about Jack’s life and the places important to him: his biogeography. It was a busy ward but opportunities arose to speak with him, for example when administering his IV antibiotics. In so doing she found out about Jack the person rather than the ‘junkie’. She learned about his parents, his brothers and sisters. She also learned about his numerous attempts to stop using drugs. These were made difficult by his constantly coming into contact with people taking heroin and other drugs. He had become homeless and the need for a place to sleep often led him to rely on others for a bed and companionship. But these acquaintances also encouraged his drug use. The intertwined biography and geography of his life, made moving away from drugs extraordinarily difficult. Over time and through conversation Sue came to feel a connection with Jack. That isn’t to say she accepted his drug use as inevitable or acceptable. But she did come to know him as Jack the person complete with all his quirks and contradictions. She felt much more comfortable sitting down talking with him, and, in time, even came to enjoying seeing him. As such, she was in a better position to care for and about him, and work with him for his future.
NURSING STANDARD
november 12 :: vol 29 no 11 :: 2014 25
