Compassion and Palliative Care

Compassionate practice

  • Compassion has been described as 'sensitivity to the distress of . . . others with a commitment to try to do something about it'.

  • Includes creating psychological safety so people can speak up (students, patients, colleagues) regarding concerns

  • Listening well, to the voices of all, in an inclusive way

  • Connecting humanly with others

The social movement for compassionate leadership is strengthening within the NHS, supported for example by the evidence-based national framework on leadership development: Developing People Improving Care sponsored by all the national NHS bodies (Care Quality Commission, Department of Health, Health Education England, Local Government Association, NHS Clinical Commissioners, NHS Confederation, NHS England, NHS Improvement, NHS Leadership Academy, NHS Providers, NICE, Public Health England and Skills for Care).

Compassionate practice - a call to reflection on yourselves

Todays working environment holds an increasing demand for employees who can facilitate and work well within teams. Educationally it is important both to work in teams, as well as on a metacognitive level consider what makes a team work well, how can you better facilitate a team or become a better team member? This too in the face of increasing virtual working collaborative arrangements as per this GP3 placement where weekly tutorials will be virtually facilitated across home and practice based students.

Below are some links and ideas to get you started in the field of compassionate practice and compassionate care.

What is compassion?

Compassion, hard to define, impossible to mandate

‘I cannot emphasise enough how meaningful it was to me when caregivers revealed something about themselves that made a personal connection to my plight,’ he wrote. ‘The rule books, I’m sure, frown on such intimate engagement between caregiver and patient. But maybe it’s time to rewrite them.’


Assessing and promoting compassion in the group

Drawing on this article please consider the following questions alone and together:

  • 'What do I contribute to the learning experience of my fellow students that they most value in me?

  • 'What do my fellow students contribute to my learning that I most value in them?'

Exploring compassion in the interpersonal setting:

  • Share accounts of negative group or consultation experiences

  • How might you notice, or anticipate disadvantage to others?

  • How might you prevent or reduce disadvantage to others?

    • Initiate and sustain inclusive eye contact (disrupt alpha pairs, interrupt monopolisers, encourage spread of participation)

    • Initiate and sustain inclusive vocalisation (invite quieter members to speak, standardise language/avoidance of colloquialisms & slang, curiosity and questions to speaker, speak concisely so others can contribute too)

https://www.herts.ac.uk/link/volume-2,-issue-1/assess-compassion-in-higher-education-how-and-why-would-we-do-that


Equal talk time, sensitivity to the group

What Google learned from its quest to build the perfect team - new research reveals surprising truths about why some work groups thrive and others falter:

https://www.nytimes.com/2016/02/28/magazine/what-google-learned-from-its-quest-to-build-the-perfect-team.html

First equal talk time across the group, second social sensitivity across the group on how others were feeling...not how brilliant individuals are or style of leadership etc... the quality of relationships is key.


Psychological safety

To measure a team’s level of psychological safety, Edmondson asked team members how strongly they agreed or disagreed with these statements :

  1. If you make a mistake on this team, it is often held against you.

  2. Members of this team are able to bring up problems and tough issues.

  3. People on this team sometimes reject others for being different.

  4. It is safe to take a risk on this team.

  5. It is difficult to ask other members of this team for help.

  6. No one on this team would deliberately act in a way that undermines my efforts.

  7. Working with members of this team, my unique skills and talents are valued and utilized.

https://rework.withgoogle.com/guides/understanding-team-effectiveness/steps/foster-psychological-safety/


Humanising the machinery of care

As we see it, the top five universal psychological and spiritual needs of the human condition can be simplified as follows:

To be loved

To be heard

To belong

To make a difference

To have meaning and purpose

These universal needs apply equally to all of us whether we are giving care or receiving it, and should be held in mind in the development and delivery of health care.

https://www.resurgence.org/magazine/article5273-humanising-the-machinery-of-care.html


Compassionate practice - patient voices

A workbook with some questions for reflections and links to patient/staff brief narratives:

https://www.patientvoices.org.uk/pdf/workbooks/DNAoC%20Compassionate%20leadership%20r1.pdf