Unit 4: Empathy, Blending, + Engagement

What is the process of engagement?

Rapport

Allowing for our patients ot trust us to express their feelings/ experiences with respect and a sense of safety.

What is blending? Can you give an example?

The effectiveness of the interview/ orientation phase in result of the patients behavioural + emotional clues.

(e.g. patient being dismissive or hostile)

What are the 3 complementary perspectives of blending?

1. Subjective feelings of the nurse

2. Patient's behaviour (e.g. objective evidence: eye contact or smiling)

3. Patient self-report

Explain the degrees of blending.

1. Nurse's skill

2. Patient's psychopathology (e.g. paranoia)

= hostility or comfort in your patient's body language

What is empathy? How can we effectively communicate with empathy?

The emotional perspective of another person while maintaining your own perspective.

Communication: non-verbally + verbally (e.g. active listening and no bias language)

Describe a few steps on how to communicate empathetically?

1. Get rid of biases before entering the room

2. Focus on your patient

3. Provide non-verbal and verbal behaviour

4. Empathetic response (e.g. I hear what you are saying "paraphrase")

5. See if your response worked (e.g. smiling)

What are the 5 stages of empathy?

1. Indirect or direct feelings of the patient

2. Clinician recognizes the feeling

3. Clinician conveys/paraphrases the feeling of the patient

4. Patient receives the clinician's response

5. Patient provides feedback

What is the “Third Phase of the Empathy Cycle?”

Validating/ understanding your patient's feelings w/ empathy which depends on the clinician's skill, comfort, + response of the patient

Describe the feelings present and the empathetic response from a psychiatric nurse to a psychiatric nurse.

“I can’t believe how I got into researching the Caring theorists. I really enjoyed discovering the point of view of established nurse-theorists. One day I’m going to develop my own theory”

Feelings Present: Amused, capable + encouraged, enthusiastic, (e.g. "vigourous/strong/confident "surface feelings")

Empathetic Response: "It looks to you that you are enthusiastic of searching a caring theorist. I believe that you can do it!"

"It's sound like

Describe the feelings present and the empathetic response from a psychiatric nurse to a psychiatric nurse.

“I feel so... I don’t know... trying to juggle my family and do my homework seems impossible. Sometimes I wonder if I’ll be able to manage this program.”

Feelings Present: Anxious, concerned, discouraged

Empathetic Response: You appear to be concerned or anxious about managing and balancing your time with your family and your studies.

It sounds like you're feeling overwhelmed with all your commitments and maintaining your workload in the program.

Describe the feelings present and the empathetic response from a client/resident to a psychiatric nurse.

“So you’re going to be here for 6 weeks. Are you going to be asking us to tell you our whole life stories? Who are you going to tell?”

Feelings Present: Doubtful, confused, cautious, + apprehensive

Empathetic Response: "From where I stand it looks to me as though you are" or "You appear to be feeling... I wonder if"

Describe the feelings present and the empathetic response from a client/resident to a psychiatric nurse.

“I’m sure glad that you are here now. It’s so nice to have someone to talk to.”

Feelings Present: Calm, contented, delighted

Empathetic Response: What I hear you saying is that you are delighted to be able to talk to someone and I am hear for you.

What are some phrases we can use when the nurse accurately perceives what the client communicated?

1. What's happening to you is

2. What I hear you saying...

3. It looks to you.... You feel... It seems to you

4. It sounds like you

What are some phrases that are useful when you are having a difficult time perceiving clearly or what the client might not be responsive to the clinician’s response?

1. Your POV on it seems to be

2. This is just a hunch but ....... I guess when that happened, you felt

What are phrases that can be used to ask for clarification from a client?

1.Do I understand that, as you see it . .

2. I’m not certain I understand. Do you mean . . .. .. . . Is that what you’re saying?

Empathy response from a nurse to a patient:

“I used to enjoy biking but now I am in so much pain I can’t do anything anymore” (patient looks down)

What's happening to you is that you're feeling cautiou s and apprehensive about the physical pain you have. I can hear how difficult it can be to miss hobbies that you were capable of doing. .......

Empathy response from a patient to a nurse:

“I know I should be grateful to have this new job, but what if I totally blow it and embarrass myself?”

It sounds like you are anxious about starting your first day at work. .........

Your client is a 23 yr. old patient who was just referred to outpatient counseling because he/she needed to talk to someone. The client has recently suffered a break-up and is having trouble sleeping and concentrating at work. She has lost 5lbs in the past 2 weeks and is finding that she would rather be alone than go out with her friends. She has found herself tearful at work and feels her low mood is starting to impact her work performance.

How would you respond?

What brings you to the clinic today?

What I hear you saying is that you are disappointed + pained about your breakup w/ your significant other. Am I missing anything?

I can see that it was a sudden

As I see it, I get the sense that you are distracted and struggling at work.

Have you noticed anything about your sleeping or eating patterns

I'm curious has this happened to you in the past? What skills worked for you then? What's the difference between this breakup then and now?

I want to make sure I get this correct, I hear abandonment or betrayal that your friends are working.

When that happened, what did

It was sudden and you're feeling alone.

Who have you discussed this with?

Can you share with me your mood?

How is work going and the friendships you have?

What is the difference between sympathy + empathy

Sympathy: pity, blame + shame, minimize the person (e.g. "You should be happy")

Empathy: core emotion + feeling