A study reported in the January issue of the Journal of Professional Nursing shows a decline in an important nursing skill that is more about understanding a patient’s perspective and fears than about technical ability: empathy.
Empathy improves patient outcomes and patient satisfaction scores, but empathy isn’t an easy skill to learn. For example, a new young nurse who comes from an urban background might find it difficult to empathize with a middle-aged rural Amish woman with several young children who is facing a medically necessary hysterectomy. Students may also experience empathy challenges when they need to deal with areas of nursing that does not interest them. In this case, a student interested in being a pediatrics nurse could have a difficult time mustering empathy for geriatric patients.
Empathy requires nursing students to focus less on the practical aspects of nursing (the science) and more on the nurse-patient relationship (the art).
The study focused on 214 undergraduate nursing students at the same institution from three degree types: an associate’s, a bachelor’s and a post-degree (for second degree students). Eighty-four percent of the students were female. Surprisingly, the more clinically experienced students showed the greatest decline in empathy. In other words, the more exposure to patients and to a professional environment, the less empathy a nursing student demonstrated. Similar declines were also noted in students with previous clinical work experience. Younger nurses and the less clinically experienced students showed greater empathy with their patients.
The decline in empathy is not only limited to nursing students. Medical students demonstrated less and less empathy as they worked through their degree programs. Unfortunately, researchers could not isolate a single cause as the reason for the decline. Researchers could only speculate that lack of time for meaningful patient and caregiver interactions, anxiety, pressures of academia, and an increased need for technical expertise – for which the students felt unprepared – as possible contributing factors of empathy decline. The researchers also considered the role of technology-driven education systems, such as distance learning, which limit exposure to faculty members who can serve as role models. These role models not only provide examples of professional behaviors, but provide counseling to students who find themselves challenged in their empathy skills.
The researchers suggested five initiatives to slow the decline and improve nursing students’ confidence in the use of empathy with their patients:
– Selecting preceptors who demonstrate empathy.
– Clinical experience where a great deal of empathy is needed.
– Role playing.
– Study and recording of therapeutic communication between patient and nursing students.
– Recognition and reward for demonstrating empathetic skills.
The science of nursing is easier taught than the art of nursing, but the question remains as to the root cause of the decline and whether or not clinical experiences could be taught or experienced in a manner that would enhance the students’ levels of empathy rather than contributing to the decline of this important attribute.