Question

Wilkinson et al. Volume 1, Chapter 2, pp. 39-42 ("What is Caring?")

1. How are skills in caring and compassion developed? How do nurses provide, show, and demonstrate caring and compassion? Why might these skills be harder and harder to achieve in today’s healthcare settings? How can a healthcare professional respond to patients with a caring response, when the setting they work in may devalue it? I'm with first two questions but I have a hard time looking at others question. please can answers be typed

Answer 1

Why might these skills be harder and harder to achieve in today’s healthcare settings?

Compassion starts with good basic care and can be demonstrated in very practical ways, e.g. ensuring a patient’s feeding needs are addressed, that pain is managed and that the patient is helped to the toilet as needed. It can be equated with providing both dignity and respect.

Compassion goes beyond this, to encompass empathy, respect, a recognition of the uniqueness of another individual and willingness to enter into a relationship in which not only the knowledge but the intuitions, strengths, and emotions of both patient and [caregiver] can be fully engaged’.

Compassion should not necessarily be seen as being sweet and nice. It includes honesty and may require courage. In short, for healthcare professionals, compassion means seeing the person in the patient at all times and at all points of care.

when staff may have entered the healthcare profession with high ideals, abundant stores of compassion and a strong motivation to treat patients as they themselves would want to be treated, But lapses in compassionate care may occur. The main reason may involve the natural defences we develop in reaction to trauma. In care settings, staff experience regular, frequent or in some cases continuous exposure to human beings in varying states of pain and distress. Sometimes the defence takes the form of inappropriate joking; sometimes it manifests itself in numbing, a distancing reaction and withdrawal from being compassionate.
Staff who do not find effective ways of coping may be more susceptible to stress and burnout. Self-reported stress of health service staff in general is considerably greater than that of the general working population.
Stress and depression is evidenced by high self-criticism, and a lack of compassion towards oneself is likely to work its way through to a lack of compassion towards patients.
Stress and burnout have their origins in different sources, some of them individual,
some of them situational:

• Individual factors: Age and experience, Self-esteem levels,Personal resilience,Job satisfaction.
• Situational factors: Regular exposure to pain and distress, Conflicting information about what the organisation expects from staff or what is valued in the organisation, Poor feedback systems or lack of recognition or praise for individual acts of compassion and care, Lack of time and simultaneous pressure to meet targets.

Compassion, too, can become problematic for staff in settings where displays of emotion are treated as a failure to maintain an appropriate professional distance or authority. Though not necessarily unique to any one profession, this is particularly relevant to those in roles that place a high value on professional detachment. Such attitudes are more commonly associated with doctors but perhaps increasingly prevalent in nursing.