Creating Compassionate Connections

Compassion comes in many forms of verbal and non-verbal actions and behaviors. In healthcare, we teach scripting as a “best” way to respond, express care and concern, and share information with our patients. We create processes and best practices to manage the technical application of healthcare. Yet observation of compassionate feelings and emotions may also be a motivator to feel secure and supported, to take action, and maintain a sense of hope.

I was passively listening to a television interview with a recent Biggest Loser winner. When asked what kept her motivated and inspired to lose more than 125 pounds she said, “When I saw the love and compassion in the face of my trainer, I knew I could do this.” As Larry Dossey states in his article Bedside Manner: A Case for Compassion, “Compassion can be conveyed in moments; it is not proportional to time.”

As we teach our scripting and process flows, do we include the power of a compassionate expression? Do our patients see the love and compassion or do they just hear the care and concern? Or, do they just hear the script? Do our colleagues and subordinates see and hear empathy, compassion, care and concern? How is your internal compassion enlightening your message of care and concern?

For one moment once a day, share a compassionate expression with someone you know, someone you don’t, someone who is kind and helpful to you, and someone who is not. And yourself. Let us not discount the power of a moment of compassionate expression.

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I enjoy a little structure in my life. I have a love affair with lists – to do lists, project lists, grocery lists, errand lists, pre-and post workshop checklists. Lists of annual personal and professional goals. I receive a great sense of joy when I can mark something off my list and prioritize the remaining items if necessary.

I’m not the best about my internal memory lists – hence, we drove 35 miles on Sunday to go bike riding in the country and I left my helmet at home. I’m also not wild about relearning the alphabet at almost 51, so, quickly back to the house, I picked up the helmet, and we were off to a new destination – and a written list for this activity. As many times as I ride, I can’t believe I left the helmet but honestly, rather than wrack my brain trying to remember everything for a bike trip, a short list would suffice to prevent this error from occurring again.

In the Checklist Manifesto, Atul Gawande, shares his experience and insight into the application of checklists in the healthcare environment to improve patient safety and efficiency. In addition, there are additional potential outcomes in regards to cost-savings from duplication of efforts, tests, etc. An interesting by-product of the checklist is the significant increase in communication and perception of teamwork within the groups effectively using a checklist.

An historical discipline used in other industries including the airline and architectural industries for safety and project management, Gawande proposes the checklist is the key to taming a high-tech world – a world in which our information doubles every year. That’s a lot of data to digest and assimilate!

Gawande creates the distinction between errors in ignorance (lack of knowledge) and errors in ineptitude (poor utilization of knowledge.) For some, it may be humiliating to use a checklist – to potentially admit a human mind cannot store the vast number of processes and complex problem solving required on a required basis. But it happens in our personal life as much as it does in the HR, Risk Management, Finance Department, the OR, on a med-surg unit or ICU.

So what does this have to do with compassion?

Perhaps as we create and fine-tune our checklists for patient safety, quality and efficiency, we add one more little “to do.” Personally and empathetically communicate care, concern, comfort and encouragement to the patient. Check. Complete.

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The concept of compassionate thoughts is responding primarily to suffering. In Eastern thought, true happiness is based on two concepts – desiring no suffering or pain in our own lives and wishing no pain or suffering for others.

 Experiencing our own pain or suffering may be easy. Experiencing and responding to other’s pain may be challenging. Our “others” in the world are a combination of individuals who are close to us and who we love and cherish, those who love and cherish us back, strangers who we have not created a judgment call on so therefore are neutral, and those who we have hurt us or who are challenging to connect with in a genuine, loving manner.

In our daily lives and activities, we come across our “others” from the moment we arouse. We may awake with our significant other, get our children ready for school, Skype our in-laws to check on them, chase the garbage collectors on the street to come back and pick up one more bag, drive to work and avoid a near collision, meet the tired, out-going shift at work, receive directives from our manager and so on through the day of interacting at some level with the “others.” (more…)

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What would happen if compassion was your internal compass?

We are human and it’s natural to try to define and rationalize what we see, or think we see. A simple action step for resetting our compassion compass is suspending judgment – not jumping to conclusions, criticizing, labeling or analyzing without truth and facts. It’s possible to spend a great deal of energy hypothesizing about people that can take us down a negative trajectory opposing the path of empathy and understanding.

In last weekend’s USA Weekend, Katie Couric shared her own experience of realizing being critical and judgmental isn’t much fun. I truly admire Katie’s courage and compassionate humility in sharing the story. Katie found herself describing a certain woman as “materialistic.” Katie’s 16 year old daughter shared with her that the woman had a very kind daughter and the woman bought things to compensate for being in a loveless marriage. Katie’s interaction with her daughter helped Katie reset her compassion compass and think twice about judging others too harshly. (more…)

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Almost every Saturday morning, weather permitting, my husband and I grab our coffee and head out to local garage sales.  We love the hunt for treasures and the anticipation of never knowing exactly what we will find.  We are a symbiotic team of form and function. For myself, it’s all about the “pretty” and the “message”, and for my husband, the treasure has to serve a purpose. Last Saturday, I found both in an unsigned work of art for the amazing low price of $2.

The genderless form tossing his/her heart to the world spoke to me. I suppose one could interpret the action as throwing the heart away – perhaps in despair or grief.  In my opinion, though, the joyful, peaceful colors don’t’ quite match a negative or depressive emotion.  Perhaps the heart is soulfully following the ageless tosser? Or maybe the heart is gently following our tosser as a kite on a puff of wind. I’d like to think the form is tossing the heart to the world – wholeheartedly sharing of the self, a symbol of trusting the universe, and of being OK with the vulnerability of humanity.

Compassion, in its purest form, is sharing your heart with the world through the expression of care for an individual, a cause, or in the case of earthquakes and tsunamis, a country. Do you feel safe sharing your heart with the world? Does your heart follow you on gentle puffs of empathy and acts of kindness?

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It’s 22 in Houston, TX and we are having purposeful, rolling electrical outages to manage the demand for heating. I may not have the data accurate, but for the past six hours, 45 minutes on, 15-30 minutes off, the lights go out, the heat turns off and I try not to get irritated. I realize we are helping someone else have heat too.

My husband is from Nebraska and grew up in the cold weather. He is quite amused at my intolerance for the cold. But for today, I have to think about how I can get my work done around the rolling blackouts. It’s a little disconcerting but I begin to think about how I can make the best of the day and realize there are things to consider when it’s 22, windy and cold for us! When there is no heat, no running hot water, needing gloves to wash dishes, realizing food just likes to clump when 25 degree water hits it, and remembering to avoid putting garbage down the disposal. So I begin to make a mental list of things to consider if the temperature drops again or if I have the chance to live in a colder climate. It could happen. (more…)

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My mother truly loved to go to her outpatient cancer center for her radiation and chemotherapy treatments. She would rave about the “girls at the front desk” and how wonderful the nurses and staff were in the treatment area. Although my mother had Stage IV pancreatic cancer, she never gave up hope a miracle would occur, or at least live as many days as possible to experience every precious moment she had during her last six months to savor a peach, listen to updates from her friends on who’s getting married, having children, graduating from college and, most importantly, visit and play with her grandchildren.

The staff at the treatment center represented hope for her and the other patients and caregivers. Above all the safety, quality, efficiency, equity and timeliness actions and initiatives that I know the center continually implemented to provide  care, the patient-centeredness characteristic and feeling of hope was the key driver and motivator to keep her, and us, fighting the inevitable.  

• When we think about our medical office, unit or clinic, what is the key characteristic we want to demonstrate?
• If you could write one word that describes what you represent, what would that be?
• What would you want it to be for each of your patients?
• What emotion do you want to evoke?
• What actions should they remember you for that connects you in their heart(s)?

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Managing the End …

to Bridge the Beginning

Practical tips and encouragement for caregivers of terminally ill loved ones.

No matter what your knowledge base, caring for a parent with a terminal condition is a solemn, courageous, loving yet chaotic journey. Caring for two parents who are on separate paths to eternity can be doubly painful. Managing the End…Bridging the Beginning is a caregiver’s guide based on the author’s own family experience with caring for her mother during the last year of her life and her father’s rapid decline after a 10 year battle with his own chronic condition.

Weaving a soulful and heartfelt story and offering over 90 practical tips and words of encouragement, Lisa draws not only from her experience caring for both parents but also her professional experience to support the caregiver in experiencing life’s natural journey of the dying process, grieving and rejoining life as what she joyfully calls “a leave-behind.”

Subjects addressed in the book include:

Practicing “TCOY”

Managing difficult conversations with the loved one

Proactively managing work responsibilities

Practical tips for managing estate matters

Tips for family and friends of caregivers who are supporting the experience.

Through sharing her story, Lisa hopes to bring encouragement to caregivers, guidance for a peaceful end, comfort during grief, and strength for a new beginning.

In paperbook and e-book!

  Click here to purchase!

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In Sunday’s Houston Chronicle, Brene´Brown discussed the adult addiction to reality tv and its potential tie to bullying behavior in children. In essence, uncivil behaviors such as humiliation, gossiping, name-calling, derisiveness, screaming and exclusion are glamorized in television and thus may be considered generally, acceptable behaviors. She continues her concern regarding the impact of these shows on daily adult interactions and role-modeling of children.

Our culture values perfection and anything imperfect may be seen as weak and vulnerable. Brown states that is this vulnerability and imperfection that drives our longing to be of worth and which eventually leads to bullying. To pursue civility and fight bullying and disruptive behavior, we must reclaim the courage and compassion in our family, schools, organizations and communities and accept and embrace our imperfections as that which connects us to each other. She concludes with a most thoughtful question: Do we have the courage to be the adults that our children need us to be? (more…)

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Providing caring service and meeting others’ needs can be extremely rewarding. On the other hand, it can also be stressful and cause physical and emotional fatigue. Balancing giving of oneself but leaving enough for everyone, including yourself, can be challenging and may create a sense of chaos, and potential misery if not managed.

Each of us has varying capacities of empathy and compassion and depending on our personality types and other factors including our motivation to be compassionate. What drives us to demonstrate compassion? Is it our unique, internal values?  The right thing to do? Guilt? Sympathy? The gentle pleasure of assisting others – that warm, internal, compassion feedback response that encourages us to reach out and help others? Our need for compassion satisfaction?

As a compassionate caregiver or service provider/associate, when is the last time you practiced self-compassion? Giving yourself that much needed mental break to empower yourself, fill your own cup back to at least half-full so you can continue to help others and complete your feedback loop? Think about it. We live in a world that requires us to meet specific expectations, quietly prefers that we exceed expectations , values perfection and zero defects.  We are imperfect humans. Ever thought about being a fly on the wall of the universe and consider how difficult it must be for imperfect humans to try to exist in a world that requires perfection?

So for today, let’s have a word with ourselves.  Accept our own humanity and accept others humanity. Realize that all that is seen in our window to the world may not be true. Practice kindness to ourselves and accept the kindness we impart to our very soul.

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