Patient-Healthcare worker relations: Gaining empathy from patients.
By: Danielle M Holmes
Tags: Healthcare Worker, Patient Engagement, Cna, Workplace, Nurse

Photo by Kristine Wook on Unsplash

The year was 2017. I had quit being a Caregiver and had finally become a Certified Nursing Assistant. I didn’t know if I wanted to become a full-blown nurse, but I knew I wanted to help people. Fast forward to my first shift at a local Nursing Facility. I was to be working on the Friends Hall. That was the way of coding and covering the terms of Alzheimer’s Dementia and behavioral issues. I was to shadow a fellow Certified Nursing Assistant for the first three shifts. The first night, I saw her get bit by a resident. I knew what I signed up for while working in that hall. When it comes to brain disorders, such as Alzheimer’s Dementia, the person is not who they truly are — the disease takes over. After 6 weeks of taking the verbal and physical attributes of the job, I requested a transfer to a different hall, as I was burnt out. I knew if I was burnt out, I could not possibly give the best care possible. While in the new and different hall, I got a sense of a few residents who were kind, friendly, and appreciative. I then helped many more that told me “where I can go” and made it clear I was nothing short of a slave. I told myself every shift that if I were to be in their shoes I might lash out too and feel the same way. I’ve never gone through what they’re going through. I questioned but tried not to assume how much pain could interfere with an individual’s behavior. While I never took it personally, it was still very much a struggle. I had days I didn’t want to go to work anymore.

In early 2020 I married a nurse and had been out of the healthcare field for some time. I am currently at University working on my Business Degree. Life took me down a different path but I still have ties to the community. My husband is an Emergency Department nurse and I worry about what he might have to deal with. This worry escalated when COVID-19 hit and panic hit the community. With fear comes frustration and with frustration comes anger. According to the World Health Organization, “Between 8% and 38% of health workers suffer physical violence at some point in their careers. Many more are threatened or exposed to verbal aggression. Most violence is perpetrated by patients and visitors.” What could I, a student, do to help lessen this? That is where my current school assignment comes into play. I chose the topic of patient-healthcare worker relations because I am passionate about it and knew that if I could get readers to see what I have written, then maybe one person may be positively impacted and have a better experience if/when they become a patient.

For this specific class assignment, not only did I have to do research, I had to conduct two interviews, create a survey, and obtain results from that survey. This blog is the solution design. While I initially aimed to create an awareness campaign about what healthcare workers deal with in terms of their work impacting their mental health, the interviews and written responses from the survey led me to create this blog about patient-healthcare worker relations and aim to gain empathy from patients in future interactions.

SURVEY RESULTS

The goal of the survey was to get deep answers from questions that did not push the survey taker too far. The question that led me to where I am now is, “What would you like society to understand about your job? Write as much or as little as you would like.” Survey takers opened up surprisingly more than I assumed they would. One survey taker stated, “We’re more than just busy. We have to constantly deal with a wide variety of tasks and situations that we are not able to discuss with patients. I could walk out of a room after doing strenuous life-saving interventions and have the patient die and then walk into the next room and get yelled at because I forgot to get a water. There’s little understanding or consideration at times.” Another survey taker responded by stating, “We know we do services, but please respect us like normal civil people too”. Interactions sometimes don’t emotionally or mentally leave the healthcare worker at the hospital door. When asked if their work affects their personal life, one survey taker stated, “I have found that my weekday nights aren’t relaxing, it’s like I can’t turn off work.” Another stated, “I think about work when I'm at home and I stress out about waking up the next day.” These statements correlate with the percentage of people who were asked if they feel unable to keep up with all aspects of their job. Out of 15 responses, five people struggle 25% of the time during an average workweek. Five people stated 10% of the time, two people stated 50%, and two people stated more than 50% of the time. Only one person stated they never have an issue keeping up with their work. If interactions with patients were more positive, would keeping up with work tasks be easier?

INFORMATIVE INTERVIEWS

*Names have been changed for privacy.

Two Emergency Room nurses were so kind as to take a bit of time and allow me to interview them. *Amber is from Nebraska and *Kyle is from Nevada. Both live in two very different areas and gave passionate answers. *Amber spoke of how much heavier the workload has been [due to COVID-19] and had to up her anti-depressant medication to help make work more tolerable. When asked if there is anything that she would like society to know about her job, she stated, “Have patience and give us grace. Because we are dealing with a lot of things that are ultimately life or death. Like I can go and tell a family that their family member just died and now I have to go talk to somebody who smoked too much weed and has been puking for a day. We don’t always have the time to switch gears and take care of the next thing. So sometimes just giving us a little bit of grace goes a long way because we’re human too but we’re dealing with a lot.” When asked the same question, *Kyle stated, “Nothing, actually. There’s no way they could ever understand in the same way I could never understand what they are going through.”

RESEARCH

On April 8th, 2019, Marlene Harris-Taylor published an article through NPR titled, “Facing Escalating Workplace Violence, Hospital Employees Have Had Enough”. “There is a very fundamental problem in U.S. health care that very few people speak about,” he says, “and that’s the violence against health care workers. Daily — literally, daily — we are exposed to violent outbursts, in particular in emergency rooms”, Cleveland Clinic CEO Tom Mihaljevic stated. With metal detectors and security guards at entrances, the Cleveland Clinic has also created other safety tactics such as officers in civilian attire, more cameras, and ID Badges equipped with wireless panic buttons. I found that dealing with verbal and physical abuse gets blown off as simply being “a part of the job” and that many of those employees never stepped forward due to the stigma of not being able to handle the job. The reality is, “verbal abuse is a form of violence, too, that can contribute to burnout and low morale of physicians and staff — a problem that has come to the forefront at academic medical centers who have introduced training in anger management and other strategies to manage aggressive patients”, according to Kim Krisberg, AAMCNews (Association of American Medical Colleges). In 2012, a Joint Commission report stated, “victimized nurses experienced decreased self-confidence and competence, potentially influencing the quality of nursing care provided and subsequently patient care outcomes.” Thus, proving that the worse the environment and interaction is, the level of quality will be negatively impacted. A change in attitude, a bit of kindness, and some patience could change that.

Possible Solutions?

While teaching healthcare students of the realities of dealing with violence in the workplace once they have graduated will help better prepare them for the realities of their job, I am still so passionate about we as a people doing better. The way I see it is, a conversation needs to be had amongst us all about how we treat others, especially when we rely on those others to take care of us or save us. There are times where we need to look within ourselves and ask ourselves if that is how we want to treat, talk to, or act towards that other person. It is not hard to be empathetic; it merely takes the initiative and effort to do so. There are also times where it is easy to look around and know that you are not the only person who needs help and is being taken care of. The only solution I believe exists is for each individual to do their best. Before I became a Certified Nursing Assistant, I did not think very much about the interactions with those in the healthcare field. Personal experience and conversation with those currently in the medical field allowed me to gain perspective. This is why I believe that this blog will help start the much-needed conversation to gain perspective and empathy from patients. I hope that after reading all of the information written, you will have a new awareness going forward.

Survey Link:

https://forms.gle/zkmSsykPRPRxDWnY6

Reference websites: