Patients as Teaching Partners: the Impact on Empathy
Stephanie Anderson will never forget the orientation for her role as an emergency services assistant (ESA) in the Emergency Department.
“A peer and I both sat down with the family member of a patient, who shared what it was like to have her mother treated in the ED years ago,” said Anderson. “She remembers that no one acknowledged her as she stood alone, watching her mother be resuscitated.”
Dena Salzberg, a member of the ED Patient/Family Advisory Council, shared this personal experience with newly hired ESAs as part of a nurse-driven initiative to help staff better understand the perspective of patients and families who are receiving emergent care.
“When something happens, we are all rushing around, but someone needs to also look for a patient’s family and see what they need,” said Anderson. “It has made me think about my job differently. I make sure I’m always asking people if they need something or have any questions.”
This outcome is exactly what long-time ED nurse Andrew Dundin, MSN, RN, CEN, hoped for when he proposed the training program for new ESAs.
“There’s a good amount of research on empathy, and if it is properly cultivated among staff and demonstrated to patients and families, there are positive outcomes,” said Dundin, who launched the program on a pilot basis for his capstone project in graduate school. “Empathy helps to establish trust, which enables patients to be more forthcoming about what’s going on in their lives. The more we understand their circumstances, the more we can help them and engage them in their care.”
The voluntary program included communication-skills training, discussion with patient/family teaching partners and roundtable learning, where ESAs spent time sharing their teaching partners’ stories and discussing lessons learned.
“The patient teaching partners’ stories demonstrate how our actions or inactions can make patients feel unheard or judged, for example,” said Dundin. “Staff also learn things we can do that mean the world to patients, such as providing a warm blanket, ensuring that the patient has access to their call bell or updating them. Because of the volume and velocity in the ED, we need to train people to think this way. Otherwise, the little things that mean something to patients and families may get lost.”
Salzberg agreed. “I stress how important it is for staff to comfort someone when possible, talk to them or offer to adjust the lights or curtains. The hardest thing for a patient is just lying on a stretcher and not knowing how long they will be there or what the status of their test results or labs are,” she said. “And staff should remember there’s also a family member who is an extension of the patient and needs support.”
Anderson had this in mind recently when she saw the parents of a patient who was being prepared for a procedure. “I could tell the family didn’t really know what was happening, and I approached them to inform them what the procedure was and ask if they had any questions,” Anderson said. “I don’t always have the answers, but I can quickly let a nurse or attending know that the family needs an update, and that makes a difference.”
The program has seen positive results and is now part of orientation for all ESAs. “We found that there was a statistically significant increase in their score on a scale of empathy after completing the program,” said Dundin. “In addition, I heard from many participants, including the staff and teachers, that they really enjoyed this experience.”
Anderson, a nursing student at Northeastern University, said the program taught lessons she’ll carry throughout her career. “Understanding the patient and family perspective has changed how I do things,” she said. “Every person you meet has different values, priorities and needs, and it’s important to take a few minutes to simply ask how someone is doing and what they need.”
7.5Number of points by which participants’ mean score increased on the Jefferson Scale of Empathy – a validated tool developed by Jefferson University in Philadelphia – after the program, demonstrating its positive impact on empathy.