April 20, 2016

By: Kati Kleber, BSN, RN, CCRN

Empathy for each other: The foundation of a healthy unit culture

It wasn’t until about three years into my career that I was able to differentiate between sympathy and empathy.  It was kind of like figuring out the difference between hospice and palliative care.  At first, they seem like the same thing, but they are actually incredibly different.

While sympathy is essentially feeling bad for someone, empathy is feeling bad with someone.  Empathy is about connection and support without an agenda; just being emotionally present with him or her as they walk through pain and suffering.

Once I understood how to empathize with my patients and their loved ones, I immediately began implementing it at work; critical care patients and loved ones need it quite a bit!  However, I began to realize how essential it is to apply this to each other as nurses.

Nursing is tough

Nursing is a really challenging career for many different reasons, and it is important that we recognize that we have the ability to support each other and make this constantly challenging career easier – much easier.

How much easier is a tough shift with the right coworkers?  How much easier is dealing with a challenging patient and family when you know your coworkers have got your back?  How much easier is a BSN-completion course when you are taking it with a friend?  How much easier is it when you are having trouble balancing being a mom of a sick kid, nurse, and wife when one of your coworkers has had similar experiences and knows how it feels?

Practical support

Empathy is an essential aspect of practical support.  Many believe that empathizing with someone requires a big, life-altering situation.  However, that could not be farther from the truth.  Empathy is necessary in many daily, practical moments.

That moment when your coworker comes to you and tells you that they gave the wrong dose of labetalol, when they are on the verge of tears because a physician just chewed them out, when the new graduate can’t figure out time management and prioritization, when they come into work overwhelmed about what’s going on at home.  Those instances are essential; the way we react when someone comes to us as their trusted coworker will tell them that they are either supported or not.  If someone feels supported, they feel empowered.  They feel valued.  They feel cared for.

How to empathize

If you’ve been there before, remember what it feels like.  Try to put yourself in their shoes and remember those feelings; feel with them.  Don’t try to fix it for them, just be there for them.  Even just a, “that’s happened to me before, you’ll get through this,” or relating this circumstance to a mistake made in the past.  This brings us back to reality.  It lets us know the world is not over, that we can deal with this situation, and someone has our back.  During these times, it is very easy for us to get caught up in our own head and emotions and suddenly we’re making a mountain out of a molehill and taking what could have been a teachable situation and turning it into shame that will last as long as we feel we deserve it.

What we stand to gain

We do not want our coworkers living in fear of reprimand every time a mistake is made or a situation could have been handled better.  This leads to people not being honest about the mistakes they have made because they want to avoid this discipline and judgment.  As you can imagine, this creates a dangerous environment for both nurses and their patients.

Little moment after little moment of frustration, self-doubt, discouragement, etc. without support over time will create a very disengaged and dissatisfied nurse and therefore unit.  If we want to cultivate a supportive and positive unit culture, we must seize each of these little moments.  We must swoop in and support and encourage each other so that we do not dread these instances, rather we view them as either learning opportunities or times when we need encouragement.

Please note, this does not include situations that require progressive discipline from management and severely compromise patient safety. Those must be dealt with promptly and appropriately.

We want to foster a culture of safe, supportive accountability.  The foundation of this culture is honesty.  To encourage honesty, we must treat each other with respect, empathy, and support when discouraging things happen and when teaching and accountability need to occur.  While management does provide some of this in various instances, where it really matters is when it comes from our boots-on-the-ground coworkers.  Promoting and modeling this professional vulnerability by providing practical empathy to others and being honest with our needs will encourage others to do the same.

Support others when they come to you, empathize with them.  Be honest about the mistakes you have made and when you need support yourself.  It is up to us – the nurses at the bedside – to cultivate this environment.  Management and administration cannot create this for us; we must take accountability and encourage this not only for our patients, but also for ourselves.

For more information about empathy, check out Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead by Dr. Brene Brown and this video (https://www.youtube.com/watch?v=1Evwgu369Jw) which illustrates the difference between sympathy and empathy.

KATI KLEBER, BSN, RN, CCRN, is a nationally certified critical care nurse in the Neurosciences Intensive Care Unit at Novant Health Presbyterian Medical Center in Charlotte, North Carolina. A veteran author and blogger on top nursing trends, Kati has been recognized by Charlotte Business Journal as “2015 Nurse of the Year” and is a recipient of the Great 100 Nurses of North Carolina award. Kati has also been a featured source across a number of media outlets, including CNN, The Dr. Oz Show, U.S. News, The TODAY Show, and many more.

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