Angeliki Kerasidou, Ruth Horn, The Ethox Centre, Nuffield Department of Population Health, University of Oxford
Recently, a number of media reports and personal testimonies have drawn attention to the intense physical and emotional stress to which doctors and nurses working in the NHS are exposed on a daily basis. Medical professionals are increasingly reporting feelings of exhaustion, depression, and even suicidal thoughts. Long working hours, decreasing numbers of staff, budget cuts and the lack of time to address patients’ needs are mentioned as some of the contributing factors (Campbell, 2015; The Guardian, 2016). Such factors have been linked with loss of empathy towards patients and, in some cases, with gross failures in their care (Francis, 2013).
We recently argued for the importance of professionals’ emotional wellbeing in the development and exercising of empathy (Kerasidou, Horn, 2016). Empathy is the ability to comprehend another person’s experience, and the capacity to understand the world from their perspective. Feeling empathy towards someone is also what motivates positive action and the desire to help. The beneficial effects of empathy on patient care are well researched. It has been shown to improve adherence to therapy, increase patient satisfaction, decrease medical errors, and lead to fewer malpractice claims (Hickson et al. 2002). However, very little attention has been given to the moral and emotional labour empathy requires from physicians. In order for medical professionals to be able to develop and exercise empathy, they themselves need access to support and the right work conditions to be in place (Eichbaum, 2014). Sharing experiences and gaining self-awareness of one’s own emotions is an essential element in the development of empathy. Professionals need to first engage with, and understand their own feelings and emotions (Halpern, 2001).
It is true that many hospitals offer discussion and support groups for medical professionals nowadays. Yet, these resources remain underused (Fridner et al. 2012). Due to heavy workloads and limited resources, physicians and nurses can rarely find the space for participation in such activities. Changes in the current system are needed to allow healthcare professionals to make use of the existing support systems and integrate it into their professional routine.
Instigated changes to improve the work conditions in the NHS, would require empathy from the State towards healthcare professionals. Because of the nature of their profession, doctors and nurses are expected to address others’ needs; but their own needs are often neglected. Gaining awareness of and acknowledging the physical and emotional pressures to which medical professionals are exposed in daily practice, could play an important role in addressing them. Such an insight could be the first step towards developing empathy for the difficult conditions under which healthcare professionals work. It is this empathetic engagement with their situation, and ability to comprehend their experience that can spur changes at the political level; changes that would create working conditions in which professionals can develop empathy. Expectations for ‘compassionate care in the NHS’ (Department of Health, 2015) cannot be achieved by overworked and burnout healthcare professionals in an understaffed and underfunded environment. The media can play an important role in drawing public attention to these problems. But what is needed, is for the responsible authorities to look empathetically towards healthcare professionals, and sincerely engage with these issues. It is only by fostering a climate of mutual support that the goals for empathetic and compassionate care, set by the Department of Health over the last five years, could be achieved (Department of Health, 2015).
- Campbell D. NHS workplace stress could push 80% of senior doctors to early retirement. The Guardian, 10 September 2015.
- Department of Health, Policy paper. 2010 to 2015 government policy: compassionate care in the NHS, Gov.UK, 8 May 2015.
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- Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office, 2013. http://webarchive.nationalarchives.gov.uk/20150407084003/http:/www.midstaffspublicinquiry.com/
- Fridner A, Belkić K, Marini M, Gustafsson Sendén M, Schenck-Gustafsson K. Why don’t academic physicians seek needed professional help for psychological distress. Swiss Med Wkly. 2012;142:w13626.
- Halpern J. From detached concern to empathy: humanizing medical practice. USA: Oxford University Press, 2001.
- Hickson GB, Federspiel CF, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P. Patient complaints and malpractice risk. JAMA. 2002;287(22):2951–7.
- Kerasidou A, Horn R. Making space for empathy: supporting doctors in the emotional labour of clinical care. BMC Medical Ethics, 2016; 17(1):1-5. http://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-016-0091-7
- The Guardian. By the end of my first year as a doctor, I was ready to kill myself, 5 January 2016.