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COMPASSION

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sugra julium

on 8 January 2016

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Transcript of COMPASSION

COMPASSION

Compassion
Literature – Compassion improves health outcomes
Providing compassionate care:
-Builds Trust
-Enables openness
-Facilitates disclosure of information
-Promotes effective diagnosis
-Clients are more likely to follow care plans
-Reduces patients anxiety

Supporting Hospital Staff to Provide Compassionate Care
Do Schwartz Center Rounds work in English hospitals?

Schwartz Center Rounds, “Rounds” is a multidisciplinary forum which brings together hospital staff to discuss the nonclinical, social and emotional aspects of caring for patients.

Objective:
To assess whether Rounds could transfer from the US to a UK setting; and whether UK Rounds would achieve a similar positive impact on individuals and teams, and hospital culture.

Our definition
6C's Document

The 6c’s is a strategy to address equality issues under the Equality Act 2010. These 6 core values have a strong affect on the staff and most importantly those who use the services. the 6C's have now become a national policy for all health care services to provide the best and positive experience of care.

The main aim of the 6C's policy is tackle issues in health care settings and the potential to transform care experience by promoting Equality within the provision.
- Making the 6C’S as part of everything we do.
- carrying out equal weight
-Leadership at every level to manage the 6C’s performance and supporting staff.
- Training and developing and reflection on the 6C’s.
-Creating the right culture for care.
-clear communication to ensure that strategy is understood and promoted within the workforce.
-Working and collaborating with others.
-Supporting staff health and wellbeing.

Results:
The findings show that in the two pilot trusts, Rounds are perceived by participants as a source of support and that their benefit may translate into benefits for patients and team working; and that Rounds have the potential to effect change in the hospital culture.

“Following attendance at Rounds, staff felt that they provided patients with more compassionate care”


Conclusion:
Rounds appear to transfer successfully from the US to the UK, and there is some evidence that they are having a similarly positive impact, but more research is needed.



Aims:

Attempt to define abstract concept
Consider Government policies regarding compassion
Examine how the presence/absence of compassion impacts and effects care provision, practice and health outcomes
Explore obstacles to compassion

6C’S; CARE, COMPASSION, COMPETENCE, COMMUNICATION, COMMITMENT, COURAGE.
The Strategy in work force.
Government directive – Compassionate Care
Can Compassion be taught?

Obstacles to Compassion
1) Lack of time
2) Documentation overload
3) Lack of support for staff
4) Work-life balance
5) Exhaustion
6) Conflicting work place expectations
7) Lack of recognition
8) Pressure to meet targets
9) Lack of self care - leads to compassion fatigue

“A lack of compassion towards oneself, is likely to work its way through to a lack of compassion towards patients". (Cornwall and Goodrich, 2009)


Compassion Costs
Nothing
Rebecca's story
“You can make the worst experience of someone’s life as good as is possible, by your caring compassion, empathy and listening…” (NHS Improving Quality 2014)

“...universal agreement that if you are not compassionate, you cannot say you are a midwife”
(Nolan, 2014)





Compassion not only improves patient outcomes but, a compassionate working environment can also cut costs: reducing staff turnover, sickness levels and staff absenteeism.

A "caring culture" in the workplace and a policy of open disclosure when errors do occur has led to a significant reduction in malpractice lawsuits in the US. (Post 2011, Youngson 2015)
“I gave birth to my son by an emergency C-section due to cord prolapse and decelerations of baby´s heart rate which was diagnosed when I was 10cm dilated. I had a lot of people coming in and out of the room telling me what to do but no one really explained what was going on which made me feel not only that I had no control or choice in the situation but also scared and confused. After giving birth I was transferred to the ward and because I was immobilised I had to ask for a jug of water from the midwife. However, she told me to get it myself. This made me feel unwanted and a burden …
...looking back I think it was a lack of time and understanding that made me feel that way also because the ward was very busy, midwives were probably over worked and stressed . Saying that, some midwives were very caring and understanding by taking into consideration how I was feeling and putting themselves in my shoes which made me feel much better.”



Is Compassion Innate?

• Oxytocin is produced when giving and receiving compassion. (Hefferon, 2013)

• When threatened, physiological changes prepare us for ‘fight or flight’, the emotion of compassion has the reverse reaction, to 'approach and soothe'. (Keltner et al, 2010)

• Compassion is a universal language through non-verbal expressions; a warm smile, touch of a hand.

• The initial development of compassion begins as children through parenting, environment and socialising.


 -Trust and intimacy are required for compassion to flourish.
 
-Having a good role model – peers, other members of a multidisciplinary team.

-Learning to be a better person daily. Learning from experiences – use reflection tools. (Wear and Zarconi, 2007)
 

-Imagination plays a key role – putting yourself into someone else’s ‘shoes’. Learn through experiences.

-It is not ‘doing unto others as you would have done to yourself’ as every person and situation is different. It is putting yourself into their shoes and understanding all the variables in their situation. (Pence 1983)
 

-Actively listening deeply and being present. Non-speaking communication – nodding of the head, eye contact, ‘hmm’, ‘ahh’. Body orientation, eye contact, voice tone and rhythm. (Kelley and Kelley, 2013)

-Wanting to make a difference - Help people
-Students are screened during interview process for compassion – roleplay, scenarios. (Busuttil, 2013)
"Compassion is deeply rooted in human nature; it has a biological basis in the brain and body…And when experienced, compassion overwhelms selfish concerns and motivates altruistic behaviour". (Keltner, 2004)
Sugra Julium, Miriam Lopes
Cindy Laing, Ruth Leach
Megan Fitzsimmons, Felicity Duarte
Jane Lockhart, Victoria Larlham
(Goodrich, 2012)
Sabine´s experience of lack of compassion lead to fear to go through that same situation again with her second child. She refused a VBAC and opted for an elective section.
Rebecca's Story
"During my labour I felt fear and a lack of control. I was told to stay on my left side which felt unnatural and nobody explained why. My midwife was hardly in the room. I felt like an inconvenience and nuisance. As a first time mum I was scared and nothing was explained to me."
introduce woman to environment
chance to ask questions
help her feel confident and reassured
build rapport
don't stand above her - down to eye level
eye contact
hold her hand
show respect, empathy and support
Dictionary definition: (Oxford English dictionary)

Sympathetic pity and concern for the sufferings
or misfortune of others

Example; the victim should be treated with compassion.

Origin ‘suffer with’.
Greenfield et al 1988, Di Matteo 1994, Lown, b 1996, Epstien et al 2005, Sequist et al 2008, Del Canale et al 2012, Barsade and O'Neil, Stewart et al 2000, Post 2011.
Busuttil R (2013) Compassion: nature or nurture? International Journal of Urological Nursing. 7. (2). pp 59-60.

Kelley KJ, Kelley MF (2013) Teaching empathy and other compassion-based communication skills. Journal for Nurses in Professional Development. 29. pp 321–324.

Pence, G (1983) Can compassion be taught? Journal of Medical Ethics. 9. pp189-191.

Wear D, Zarconi J (2007) Can Compassion be taught? Let’s ask our students. Journal of General Internal Medicine, 23 (7) pp 948-953.

Elmire, R., Schmied, V. and Wilkes, L. (2010) 'Women's perceptions and experiences of traumatic birth: a meta-ethnography', Journal of Advanced Nursing, 66(10), pp. 2142-2153.

Harris, R. and Ayres, S. (2012) 'What makes labour and birth traumatic? A survey of intrapartum 'hotspots'', Psych and Health, 27(10), pp. 1166-1177.

Hunter, L. (2015) 'Being with woman: claiming midwifery space', The Practicing Midwife, 18(3), pp. 20-22.

Knapp, R. (2015) 'Where there was love...Compassionate midwifery as protection against trauma', The Practicing Midwife, 18(3), pp. 17-19.

Nolan, M. and Oliver, F. (2014) 'Examining compassion and resilience through various lenses', The Practicing Midwife, 17(8), pp. 20-23.

Department of Health (2012) Compassion in Practice: Nursing, Midwifery and Care Staff. Our Vision and Strategy. The Stationary Office. London.

Compassion Fatigue Awareness Project (2015) What is Compassion Fa-tigue? Available at: http://www.compassionfatigue.org/pages/compassionfatigue.html (Accessed: 22 September, 2015)

Cornwall, J. and Goodrich, J. (2009) 'Exploring how to enable compassionate care in hospital to improve patient experience' Nursing Times. 105 (15).

Goodrich, J. (2012) 'Supporting hospital staff to provide compassionate care: Do Schwartz Center Rounds work in English hospitals?' JR Soc Med. 105. pp. 117–122.
Department of Health (2012) Compassion in Practice: Nursing, Midwifery and Care Staff. Our Vision and Strategy. The Stationary Office. London.

Compassion Fatigue Awareness Project (2015) What is Compassion Fa-tigue? Available at: http://www.compassionfatigue.org/pages/compassionfatigue.html (Accessed: 22 September, 2015)

Cornwall, J. and Goodrich, J. (2009) 'Exploring how to enable compassionate care in hospital to improve patient experience' Nursing Times. 105 (15).

Goodrich, J. (2012) 'Supporting hospital staff to provide compassionate care: Do Schwartz Center Rounds work in English hospitals?' JR Soc Med. 105. pp. 117–122.




Epstein, R.M., Franks, P., Shield, C.G., Meldrum, S.C., Miller, K.N., Campbell, T.L., Fiscella, K., (2005) ‘Patient-Centered Communication and Diagnostic Testing’. Annals of Family Medicine, 3 (5) p.415-421. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466928/ (Accessed: 22 September 2015).

Del Canale, S., Louis, D.Z., Maio, V., Wang, X,. Rossi, G., Hojat, M., and Joseph S. Gonnella, J.S. (2012) ’The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy’, Academic Medicine, 87(9)

DiMatteo, M.R. (1994). ‘Enhancing patient adherence to medical recommendations’. Journal of the American Medical Association 271, p79-83

Greenfield, S., Kaplan, H.S., Ware, J.E., Yano, E.M. and Frank, H.J. (1988). ‘Patients’ participation in medicalcare: effects of blood sugar control and quality of life in diabetes’. Journal of General Internal Medicine 3 (5), p 448-457

Hefferon, Kate. (2013) Positive Psychology and The Body: The Somatopsychic Side to Flourishing. New York, NY: Open University Press.
K
eltner, D. (2004)’The Compassionate Instinct’
Available at: http://greatergood.berkeley.edu/article/item/the_compassionate_instinct. (Accessed: 23 September 2015)

Keltner, D. (2012) ’The Compassionate Species’.
Available at: http://greatergood.berkeley.edu/article/item/the_compassionate_species (Accessed: 27 September 2015)
Lown, B. (1996)‘The Art of Healing’. New York: Ballantine Books
NHS Improving Quality (2014) A review of support available for loss in early and late pregnancy
Available at: http://www.nhsiq.nhs.uk/resource-search/publications/pregnancy-loss.aspx (Accessed 19 September 2015).
Nursing Times (2011) Ethical and Compassionate Nursing: Ensuring compassionate care in hospital, Available at: http://www.nursingtimes.net/Journals/2011/08/24/j/y/s/NT-Ethical--Compassionate-Care.pdf (Accessed: 21 September 2015)
Sequist, T.D., Schneider, E.C., Anastario, M., Odigie,E.G., Marchall, R., Rogers, W.H. and Safran, D.G. (2008). ‘Quality monitoring of physicians: linking patients’experiences of care to clinical quality and outcomes’. Journal of General Internal Medicine 23 (11), p1784-1790
Stephen, G. (2011) ‘Compassionate care enhancement: benefits and outcomes’ The International Journal of Person Centered Medicine, 1(4) p808-813
NHS England, Copy right and you: our culture of compassionate care
The 6C’s defined (2014) Available at: http://www.nhsemployers.org/campaigns/care-makers/about-care-makers/the-6cs-defined (Accessed:10/09/2014)
Schofield.B, Concept Analysis-Compassion in nursing University of Huddersfield. Available at: https://www.rcn.org.uk/__data/assets/pdf_file/.../Research2012Mo16.pdf
NHS England / Nursing Directorate, (2014), Compassion in practice; Two years on, Leeds, Beal.


Studies and reports such as ‘ 2 years on’, is a study which shows how working under the 6C’s strategy is being used and promoted in a health care setting. Compassion is one of the key aims for the ‘3 year vision’ suggested by midwifes, Jane Cummings, the Chief Nursing Officer for England (CNO) at the NHS Commissioning Board, and Viv Bennett, Director of Nursing at the Department of Health
Government directives such as Compassion in practice: 2 years on have aimed to:
-ensure health care is improved and this should be supported by appropriate technology.
- identify how changes can be introduced to improve nurses and midwifes care sector considering skills and knowledge (embedded in the 6C’s).
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