Compassion in Practice

by Anna

And once again did I find myself closely accompanied by death. Maybe it really is time to make friends with him, for the more compassionately I engage with others, the more they open up and tell me about their thoughts about dying.

For a long time have I hidden myself closely behind a wall, keeping a distance that I thought to be safe. Safe, as in not getting involved emotionally, to keep up my appearance, to not loose control and to not accept that one day I will indeed shake hands with death.

Compassion is something I have been reading into lately as part of a university project on the fundamentals of care. There is so much about it in the news at the moment, especially after many an inquest into neglect and failings of care standards, that I began to wonder why some people are naturally compassionate and others weren’t. And if the government proposes a more compassionate approach in care, how can anyone ensure that those working in care will suddenly release their zest for compassion and become better people? Surely that isn’t the case.

I wondered, can compassion be learnt? Looking into past research that had been done on the development on empathy, the foundation for compassion, I learned that it is the sense of connection to our mother as infants that aids the development of empathy (Goleman 2009). So, if that connection wasn’t there, research suggests that it might be the reason for psychopathy, the inability to feel for others (Lang, Klinteberg, Alm 2002).

However, some research also suggests that we are much more resilient and are able to pick up on and learn empathic behaviour through later life experiences (Clarke 1976). My conclusion is that it is likely not possible to learn compassion, however, with the right mind set and under the right conditions, compassion may be developed. But it needs personal awareness and the ability to reflect on yourself and your actions in order to change your behaviour.

Being compassionate on a busy NHS ward can be difficult. Compassion needs time, which isn’t always available. But once you take that time and fully engage with your patients, listen to them actively, acknowledge their whole being, not just the condition their in with, you will get a lot back in return.

But you also open up to the other side of life. After a life of pretty good health, with his mind still fully active, now with persistent bleeding in hospital, this 95 year old said to me: “Maybe it’s time to give in now.” He had a good life and lived it to the full and knew all too well that his body would likely not carry on in such good condition for all that long. Earlier he had told me that he has been writing into a diary every day for the past 30 years but had accepted that this was not possible now that he was here in hospital. So I went to get him some paper and a pen and suggested he carry on writing, it might put his thoughts into perspective.

A little bit later in the day, when checking on another patient of mine, he indicated that the doctors had just told him that there is nothing else they can do for him. “Them doctors were so blunt”, he said to me. I thought maybe that they were just very busy, but no, he insisted that blunt was the right word. He worried about his wife, who was of course terribly upset by the news. He then turned to me and said: “I want to go home to die.” I tried to make him comfortable, set up the radio for him which he appreciated and the last look I remember of his deep blue eyes was filled with exhaustion as much as sadness and gratitude. He passed away within two days. We couldn’t get him home in time.

Sometimes it is not the grandiose gifts and efforts that make up compassion. Quite often it is the small things, to enable someone to carry on writing, or to set up the radio for someone who needs to escape the world for a little while. I am glad I was there to do this and hope it helped. And I am saddened by the thought that some people don’t have the awareness to do something similar when the need arises.

Somehow I hope that just by me writing about it, someone might be able to develop compassion, to begin to feel for others, to develop the awareness to go that little extra step.

To sum up the essence of compassion, lets have a think how we can be more compassionate, especially when working in a care environment. Building on simple empathy, seeing the world from someone else’s view, treat others as you would want to be treated. Encourage independence. Caring with compassion doesn’t mean to take away someone’s independence by smothering them with your well-meaning care.

Listen actively to what the individual has to say, make eye contact, stop what you are doing for a moment. And when it all gets too much, time running away again, staffing low again, stop for a moment and take a deep breath, remembering that our brain needs oxygen to function properly and that to be able to emphasize we need a state of calm. And smile, even if you don’t feel like it. Chances are you might brighten someone else’s

Leading by example means you act compassionately and others are more likely to follow suit observing the difference you make rather than lecturing them about it. And last, but certainly not least, help build a strong and positive team. Together you can make the client’s stay much more endurable and feel supported yourself at the same time.

There is certainly much more to learn about it, this is just a brief glimpse of my insights that I wanted to share with you. I hope you gained something from it.