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It takes a Village: The Importance of the Compassionate Stranger

Tuesday, February 14, 2017
Mary Beth Modic, DNP, RN, CNS, CDE, is a clinical nurse specialist in diabetes at Cleveland Clinic main campus. She also holds a position in the Center of Excellence in Healthcare Communication in the Office of Patient Experience as the Director of Advanced Clinical Practice.  It has been suggested that patients can encounter more than 50 caregivers in a three-day hospital admission. That may seem like an exorbitant number, but not when you stop and reflect on all the individuals who interact with a patient starting with the hospital admission… the receptionist, patient transporter, phlebotomist, food service hostess, environmental service worker… the nursing assistant, physician and registered nurse… it can add up to a myriad of people entering a patient’s world. These individuals are caregivers who do their best very best to display empathy and concern, hence the term “Compassionate Stranger”.

When you enter the words “Compassionate Stranger” into your friendly search engine, the name of Asenath Nicholson appears. Nicholson was a social activist, who walked throughout the counties of Ireland reporting and working to alleviate the suffering of the Irish people on the Eve of the Great Irish Famine. Nicholson’s work would have gone largely unnoticed if it weren’t for the writings of an Irish scholar, Maureen O’Rourke Murphy.

The likelihood that any academician will be writing about our life’s work when entering the lives of people who are suffering, fearful or despondent is highly unlikely. Yet day after day, year after year, each of us encounters an unfamiliar person and decides in that moment to envelop him or her in compassion, generosity and understanding without regard for notoriety or fanfare. The “compassionate stranger” protects and comforts the suffering, often, upon encountering the person for the very first time.

 What is it about us who have dedicated our lives to healing and attenuating suffering that compels us to be compassionate? How are we able to bear witness to the inconsolable and offer presence? What are the care philosophies and beliefs that compassionate strangers demonstrate so effortlessly but intentionally? In my four decades of nursing, I have witnessed the care of “compassionate strangers” provided to patients and their families and I have been the recipient of this generous and tender care.  I would like to offer a few guiding principles that I believe formed their moral compass for person-centered care and to which I subscribe :

·       A patient is a person not a disease, surgical case or label
·       Patients are the experts on their own lives
·       Every interaction can contribute to healing
·       Caring can happen in a moment
·       Curiosity is central to establishing a therapeutic relationship
·       Connection is possible through the gift of presence
·       Fixing, advising, and reassuring can be obstacles to listening
·       Care is predicated on identifying patient strengths rather than concentrating on deficits
·       Caregivers are the visitors in the patient /family relationship
·       Patients and their loved ones are our very best teachers
  
 Author Brene’ Brown has said that stories are “data with soul”. I would like to share one of my most coveted “compassionate stranger” stories with you.  A colleague was assuming the care of a woman in her final days of living.  She had been diagnosed with head and neck cancer three years earlier and had undergone surgery and additional therapies. She was receiving nutrition via tube feeding. The patient was surrounded by her loving and adoring family.  Amy, the nurse, entered the room to respond to the alarm sounding from the patient’s Intravenous (IV) Pump.
 
While making the necessary adjustment to the IV pump, the pastoral minister came in to offer communion to the patient. The patient responded softly, that as much as she wanted to receive communion, she could not as she was unable to swallow.  Amy, looked at the patient and responded “I am Catholic and it would be an honor to receive communion on your behalf. Let me hold your hand as if we are one.”  An extraordinary act of compassion by a person who entered a patient’s room as a stranger and left as a healer.

Tags: communication, patient engagement, service, best practices, empathy, leadership, nursing, perspective, teamwork
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