Empathy

I am currently in my third and final clinical externship, and it is proving to be the most difficult of my placements.  I am at an inpatient rehab facility that is beautifully kept, and I have a wonderful supervisor.  The work is very interesting, and I am finding ways to apply my classroom knowledge more than ever.  I have grown fond of my patients and really enjoy the opportunities to educate them and help rehabilitate them to their prior levels of function.  The hours are long, and I am always in motion.  Lunch usually consists of grabbing a few bites of a granola bar or other portable, snack size food between patients or while writing reports.  I honestly don't mind being this busy.  It feels very productive and makes the day go by fast.  Despite all of the positives, I have found myself very emotional and often on the verge of tears.  I have been struggling with insomnia and an elevated level of stress.  Why?  I think I have finally put my finger on it.  As wonderful as the facility is, and as competent as the staff are, there is still something missing that I think is commonly lacking in medical facilities.  Empathy.

Empathy, according to Dictionary.com, is a noun meaning "the intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another".  It is often incorrectly confused as sympathy, which is broadly defined as understanding the feelings of another.  Empathy  goes beyond understanding.  It requires one to imagine themselves in another's predicament, to feel what they feel.  I believe that showing empathy requires less talking and more listening, more doing.  Empathy does not judge.  I don't know if empathy can be taught or if it just is innate in some individuals.  Either way, it exists within me.  Some might think this is burdensome, but I believe it is a blessing.  It will hopefully allow me to connect with my clients in a way that will aid in becoming a competent and effective clinician.  What a wonderful characteristic to possess in a medical setting where people are sick and scared and hurting!  Well........not exactly.

I am learning that there is little time, in my facility at least, to provide that empathetic touch.  Inpatient rehabilitation is a lot of work for the patient as well as the clinician.  There is physical therapy, occupational therapy, speech therapy, diagnostic tests, nurses, and doctors all vying for time inbetween meals, showers, and family visits.  There are barely enough hours in the day to provide the required services, attend meetings and trainings, and complete the required paperwork for all of the assigned patients.  I understand that a patient's time in the rehab facility is limited, so medical staff try to get the most out of the time they have to help a patient return as close as possible to their prior level of function. It is wonderful that the staff work so hard to help clients reach their rehabilitation goals, and I have seen some amazing results.  I have also seen patients confused about why they are being asked to complete certain tasks, rushed around without explanation of where they are going, and disregarded or brushed off when they expressed pain or fatigue.  Yesterday, I had a patient tell me he would rather be dead than be in his current condition.  Harsh.  I have had to walk out of rooms knowing a patient is confused, upset, or in pain because I have to move on to the next patient or because another clinician is waiting to take them to their next therapy.  I certainly don't believe that staff don't care about their patients, but rather they are busy doing their jobs and have been doing this long enough to become desensitized. 

The fact remains that the patients are human beings.  Most of the patients at my facility are older.  Many have lost the ability to walk, swallow safely, and/or communicate effectively as a result of stroke, surgery, TBI, or some other ailment.  Many of them have always been healthy and are having difficulty accepting their infirmities.  There is not only physical pain but confusion, helplessness, and depression.  Can you imagine being an active, healthy individual that suddenly finds yourself unable to walk, bathe yourself, or speak intelligibly enough to express your basic needs?  You have to ring for a nurse just to go to the bathroom or get a drink of water.  Perhaps, all of your food is pureed, and your liquids (coffee, juice, and even water) is thickened to a nectar or honey consistency.  I tried drinking thickened water for a day.  Major yuck!  You hurt, possibly more than you ever have, and every activity you must perform wears you out.  Ugh, depressing.  It is something most medical staff and clinicians have never experienced, and it is hard to place oneself in that situation.  Don't we owe it to our patients to at least try? I absolutely think we do.

I refuse to get to the point that I am desensitized to the feelings of another, especially when that other is suffering and scared.  I will find a way to balance fullfilling the needs of my job and fullfilling the needs of my patients.  I will listen and respond with patience and compassion.  I will take the time to explain why, and how, and what happens next.  I will always remember that this person with whom I am interacting is a living, breathing, feeling human being.  If I cannot do these things, I cannot be.  Simple as that.