Essential Narratives of Care
Essential narratives of care is an international research project to investigate how health professionals in England, Canada and Ireland are influenced to develop empathy, care and compassion.
The arts enable us to access emotional responses that we suppress for fear of looking unprofessional, thereby risking the loss of ability to connect and empathize with others (Gaut 2007) and can help enable this explication of moral professional practice (Newham et al 2014).
The aims of the project are:
- To develop a clearer narrative of caring and compassion, as expressed in books, articles, poems, plays or films.
- To develop a list of resources and strategies to help educators develop caring and compassion in health and social care workers.
The first phase asked 38 academic health professionals to identify a narrative, defined as a film, book, poem, novel or work of art, that had influenced them.
Interpretation of the chosen narratives showed that non-abandonment of the suffering person was present in 23 narratives and the strongest theme present was the need to be able to see the other person as who they really are; someone suffering. What's more, being moved by the suffering of another to respond in a practical way (regardless of whether the person has had a good life or not), was evident in 21 narratives.
The theme of generosity (giving of the self more than the professional role) was evident in 14 narratives, whilst shouldering the burden of others' suffering carried an emotional toll in 8 narratives. Furthermore, taking a balanced approach in the care of the individual patient was present in 7 narratives, and 'robust' or 'muscular' versions of compassion were evident in 15 narratives.
Educating for Care and Compassion — 6 areas to explore
Many of the nominated narratives provided examples of an absence of compassion, though not necessarily care.
"The bath I am given bears more resemblance to drawing and quartering than to hydrotherapy"
— The Diving Bell and the Butterfly
When he is sleeping and dreaming a nurse woke him up after her flashlight to tell him that she had bought his sleeping pill:
"Do you want it now or shall I come back in an hour?"
John Clare's (1793 — 1864) poem "I am" reveals anger as he feels a total absence of caring or compassion in his life as a 19th century 'mental patient' abandoned by family and friends (probably due to the social constructs of time):
"I am, yet what I am no one knows or cares... And e'en the dearest — that I loved the best are strange, nay, rather stranger than the rest."
"To him, no one is invisible."
— Invictus (Film)
"I saw a grest deal of my GP. I didn't need to make appointments — his receptionist would lead me to a side room and he'd come to see me between his other patients"
— Reading by Moonlight
"She had learned to know how comforting a smile, even from a stranger, may be"
— The Little Princess
"Hold on, you're going to be just fine"
— MASH
Victims should help themselves or try to rise above their suffering.
"...don't you go pitying me"
— Anne of Green Gables
How the educators used their narratives
- Reflection — "to consider in a whole new light the emotional and psychological feelings, that patients might be or were experiencing."
- To develop curiosity
- Discussion — "to think really deeply about what we do, how we behave..."
- Role modelling
- Reflective writing activity — "This is me" — Encouraging people to write their own poem or narrative about how they would want others to see them if they were unable to communicate.
Points to consider
- Which are better - negative examples or positive examples?
- 'Muscular' or 'robust' compassion?
- Educators need to question their own understanding of 'care', 'caring' and 'compassion'.
- The arts are invaluable in humanising healthcare education and we should encourage students to engage with wider narratives than simply health and social care.
References
Gaut ,B (2007) Art,emotion and ethics.Oxford: Oxford University Press
Newham,R., Carr,G., Curzio,J,.Terry,L.M.(2014) Contempory nursing wisdom in the UK and ethical knowing:difficulties in conceptualising the ethics of nursing. Nursing Philosophy 15 (1), pp.50-6