Clinical sympathy: the important role of affectivity in clinical practice

Learning to provide humanistic care and support in the context of chronic illness: Insights from the narratives of healthcare professionals in hemato-oncology

PURPOSE

To document the process by which healthcare professionals (HCPs) support people living with and beyond hematological cancer and detail how they learned from their personal and clinical experience.

METHOD

Using a narrative approach, we conducted nine semi-structured interviews with HCPs, including nurses, from a specialized care centre who support patients with hematological cancer. Interviews aimed to capture experiential learning gained from their practice. We performed a hybrid inductive/deductive content analysis on data using a framework based on sociological and educational models of experiential learning.

RESULTS

Among healthcare professionals, analysis revealed the need to provide care and support that is 'humane' and adapted to each patient. Learning to provide this type of care proved to be challenging. Over the course of their clinical experience, healthcare professionals learned to adapt the support they provided by straddling a boundary between sympathy and empathy. Learning outcomes were associated with personal-professional development among participants.

CONCLUSION

Our findings bring to light an overlooked facet of patient support in the context of cancer care, which is the acquisition of the soft skills required to deliver humanistic care and support. This learning process requires time and involves navigating between the realms of sympathy and empathy. Experiential learning is intertwined with the complexity of the often long-term patient-professional relationship that characterizes hemato-oncology. This unique relationship offers rewards for healthcare professionals on both personal and professional fronts.

Clinical sympathy - A mixed method study of the relationship between the clinical nurse educator and the graduate nurse

AIM/OBJECTIVE

This paper sought to investigate the influence of the supernumerary clinical nurse educator role on the newly qualified graduate nurses' professional development and successful transition to competent and confident practitioners in the acute care hospital environment.

BACKGROUND

The novice nurses learning in the inpatient clinical environment is affected by increasing patient acuity, complex conditions and organisational expectations. The supernumerary clinical nurse educator is uniquely positioned to prioritise these nurses' education through protected and available time to support adaption in the workplace culture and retention in the organisation.

DESIGN

A convergent mixed methods design was used to investigate the relationship between the supernumerary clinical nurse educator role through the opinions and experiences of the graduate nurse.

METHODS

Data were collected in February - July 2015 from graduate nurses from three hospital sites in a healthcare organisation in Western Australia. The research used online questionnaires (n = 39) and face to face interviews (n = 10). Analysis of quantitative data used descriptive statistics and qualitative data used thematic analysis.

RESULTS

Four main themes were identified. These were: acknowledges new and challenging experiences, available to provide constructive responses, sympathises with anxiety and missing in action.

CONCLUSION

The graduate registered nurses perceived that clinical sympathy provided by the clinical nurse educator was essential to their new role of frontline nurses influencing their delivery of quality patient care and as a practical solution to champion the graduate nurses' longevity in the future nursing workforce.

Humor and sympathy in medical practice

Medical professionals seem to interpret their uses of humor very differently from those outside the medical profession. Nurses and physicians argue that humor is necessary for them to do their jobs well. Many (potential) patients are horrified that they could one day be the butt of their physician's jokes. The purpose of this paper is to encourage the respectful use of humor in clinical prac-tice, so as to support its importance in medical practice, while simultaneously protecting against its potential abuse. I begin by examining two extremes of supporting or chastising the use of medical humor. I look at these views through the lenses of popular theories of humor to help explain their theoretical bases. In this second section, I explain the emotional aspect of humor as an embodied and embedded transformation of the world. This clarifies the role that humor plays in our daily lives, as well as why the ethical or unethical nature of its use is dependent on context. Third, I address the potential problems in the relationship between humor and clinical sympathy, and how this further affects the relationship between medical professionals and their patients. I conclude by arguing that humor can conflict with clinical sympathy, but this need not be the case. If medical professionals actively engage with clinical sympathy and focus on using humor in a way that is respectful towards their patients, then humor can continue to be a positive force in their lives while still providing the best care for their patients.