Cultivating heart quality in professional practices


Carolyn Thomas, a heart attack survivor and women’s health advocate, writes about the importance of kindness in health care practice in her popular Heart Sisters blog, starting with a story about her visit to the emergency room and subsequent placement in the cardiac care unit:

What I do vividly remember, however, is a small but profound act of kindness later that day when I was brought to my bed in the CCU (the cardiac intensive care unit). The nurse who came to greet me as my gurney was pushed off the elevator placed one gentle hand on my shoulder (and more importantly kept it right there as she walked alongside down the long corridor). As we moved, she bent lower over my head to speak slowly and softly into one ear, introducing herself and assuring me that I was “in the right place” – and that her whole team would do their best to take very good care of me while I was with them.

She goes on to reference, among other things, studies showing that medical students’ levels of empathy begin to decline during the course of their training:

Much of this interaction, however, depends largely on health care professionals’ ability to empathize – to imagine what it’s like to walk in the hospital booties of their patients.

So it’s shocking for many people to learn that, even among naturally kind and empathetic medical students, studies suggest that empathy for others begins to wane by the third year of med school as students progress. This is particularly true, apparently, for future doctors entering technology-oriented specialties – like cardiology.

Thomas’s article raises important questions about the training and education of those entering the helping and human service professions, especially fields such as health care, law, and social services.

For example, a healthy dose of training in client counseling should be an important part of a law school program, including the cultivation of greater sensitivity to a client’s emotional state during often stressful legal proceedings. Therapeutic jurisprudence, the school of legal thought that examines the therapeutic and anti-therapeutic properties of the law, legal practice, and legal education, takes these matters seriously.

To illustrate, in a 2010 law review article, “Employment Law as if People Mattered: Bringing Therapeutic Jurisprudence into the Workplace,” I devote a lot of attention to client counseling in the context of employment disputes, including the recognition that clients may be experiencing considerable anxiety and stress in view of the stakes involved.

These considerations should be examined against the broader canvass of emotional and social intelligence. As I wrote four years ago in a post on leadership:

For those who have the personal qualities to be effective leaders but lack the background and experience, leadership and management training programs emphasizing the so-called “soft skills” would help sensitize them to the human aspects of their jobs.

In fact, it’s arguable that basic management training should be part of all professional degree programs, such as medicine, education, law, and business. This initial exposure can be augmented by continuing education offerings for those elevated to leadership positions.

Maybe this seems like a lot in order to get back to the point of Carolyn Thomas’s blog post: How a nurse’s simple words of comfort and reassurance helped her to deal with a life-threatening health crisis. Nevertheless, in professions that, by their nature, must place great emphasis on analysis and problem solving, the human element needs reinforcing as well.


Hat tip to Peggy Berry for the Thomas article.

13 responses

  1. Hello David and thank you for including excerpts from my Heart Sisters blog post (and also for your kind comment you wrote there). As some of my other reader comments to that original post suggest (I do seem to have the smartest readers anywhere!), it can be discouraging to think we even have to discuss whether qualities like kindness, courtesy and respect are important for, as you say, “the cultivation of greater sensitivity to a client’s emotional state” during stressful experiences.

    Particularly in health care, this seems like a no-brainer to me and to most other people who have found themselves suddenly thrust into the role of patient.

    • Carolyn, thank you for finding your way over here to say hello! Your comment prompted me to leave yet another on yours about how young med students and nursing students are socialized into their professions.

  2. Great posts, David and Carolyn! These beautiful moments are also very important to healthcare professionals and highlight the relationship piece about providing care. Patients feel cared about and we fell like our work matters. And they are relevant to patient safety, patient experience, workplace violence, and burnout. They require a skill set that isn’t often found in educational programs such as nursing and medical schools. I highly recommend ‘Medical Improv’ as a new way to enhance communication and interpersonal skills. Once you learn the principles, there are many activities that can be framed in ways that build empathy, trust, assertiveness , listening, critical thinking and much more. What’s more is that it is fun and decreases stress. And don’t we need that? Happy to share more info about the process

      • What great post, David. I’m fascinated to hear of Med Improv, thank you for this and thinking of the HDHS workshop! I hope to keep helping people discover improvisation – its such an amazing tool for any profession and simply being human. Can’t wait to learn more about the way it’s used in medicine.

  3. Great stuff, David. Have you ever run across Marshall Rosenberg’s various works on “nonviolent communication?” One of his students, Melanie Sears (RN, MBA), has a promising looking book that I have been trying to find time to read: Humanizing Health Care with Nonviolent Communication: A guide to revitalizing the Health Care Industry in America.

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