In nearly every intensive care unit (ICU) at every pediatric hospital across the country, physicians hold numerous care conferences with patients' family members daily. Due to the challenging nature of many these conversations covering anything from unexpected changes to care plans for critically ill children to whether it's time to consider withdrawing life support these talks tend to be highly emotional. The study was published in JAMA Network.
Several studies have shown that when families believe that physicians hear, understand or share patients' or their family's emotions, patients can achieve better outcomes, Dr. October explains. When families feel like their physicians are truly empathetic, she adds, they're more likely to share information that's crucial to providing the best care.
For the most part, our families do not make one-time visits. They return multiple times because their children are chronically ill. Families who feel we're listening and care about what they have to say are more likely to feel comfortable as they put their child's life in our hands a second, third or fourth time.
They are also less likely to regret decisions made in the hospital, which makes them less likely to experience long-term psychosocial outcomes like depression and anxiety. During these conferences, the most common decision discussed was tracheostomy placement a surgical procedure that makes an opening in the neck to support breathing followed by the family's goals, other surgical procedures or medical treatment.
Twenty-two percent of patients whose care during these conferences died during their hospitalization, highlighting the gravity of many of these talks. They analyzed each conversation, counting how often the physicians noticed opportunities for empathy and how they made empathetic statements.
1. Followed immediately by medical jargon
2. Followed by a statement beginning with the word "but" that included more factual information
3. Followed by a second physician interrupting with more medical data.
That compares with "unburied" empathy, which was followed only by a pause that provided the family an opportunity to respond. The research team examined what happened after each type of empathetic comment.
The researchers found that physicians recognized families' emotional cues 74% of the time and made 364 empathetic statements. About 39% of these statements were buried. In most of these instances.
After the nearly 62% of empathetic statements that were unburied, families tended to answer in ways that revealed their hopes and dreams for the patient, expressed gratitude, agreed with care advice or expressed mourning information that deepened the conversation and often offered critical information for making shared decisions about a patient's care.
To express empathy more effectively, Dr. October recommends:
1. Slow down and be in the moment. Pay close attention to what patients are saying, so you don't miss their emotional cues and opportunities for empathy.
2. Remember the "NURSE" mnemonic.
3. Don't be afraid to invite strong emotions. Although it seems counterintuitive, Dr. October says helping patients express strong feelings can help process emotions that are important for decision-making.