When assisting the provider in delivering stressful news it is important to consider which of the following?

Índice Show

What is clinical empathy?
Empathy in physician communication
Expressing empathy
Lacking empathy
7 tips for showing clinical empathy to patients
Start the appointment by making eye contact
Let your patient know you're listening
Be aware of your body language
Be curious about your patient
Record details that humanize your patient
Show support to your patient
Look deeper for ways to empathize with your patient

Stress is part of being human, and it can help motivate you to get things done. Even high stress from serious illness, job loss, a death in the family, or a painful life event can be a natural part of life. You may feel down or anxious, and that’s normal too for a while.

Talk to your doctor if you feel down or anxious for more than several weeks or if it starts to interfere with your home or work life. Therapy, medication, and other strategies can help.

In the meantime, there are things you can learn to help you manage stress before it gets to be too much. These tips may help you keep stress at bay:

Keep a positive attitude.
Accept that there are events that you cannot control.
Be assertive instead of aggressive. Assert your feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.
Learn to manage your time more effectively.
Set limits appropriately and say no to requests that would create excessive stress in your life.
Make time for hobbies and interests.
Don't rely on alcohol, drugs, or compulsive behaviors to reduce stress. Drugs and alcohol can stress your body even more.
Seek out social support. Spend enough time with those you love.
Seek treatment with a psychologist or other mental health professional trained in stress management or biofeedback techniques to learn more healthy ways of dealing with the stress in your life.

There’s a lot more you can do to help manage stress. Consider these lifestyle changes:

To start with, physical activity can help improve your sleep. And better sleep means better stress management. Doctors don’t yet know exactly why, but people who exercise more tend to get better deep “slow wave” sleep that helps renew the brain and body. Just take care not to exercise too close to bedtime, which disrupts sleep for some people.

Exercise also seems to help mood. Part of the reason may be that it stimulates your body to release a number of hormones like endorphins and endocannabinoids that help block pain, improve sleep, and sedate you. Some of them (endocannabinoids) may be responsible for the euphoric feeling, or “runner’s high,” that some people report after long runs.

People who exercise also tend to feel less anxious and more positive about themselves. When your body feels good, your mind often follows. Get a dose of stress relief with these exercises:

Running
Swimming
Dancing
Cycling
Aerobics

If you don't have the time for a formal exercise program, you can still find ways to move throughout your day. Try these tips:

Bike instead of driving to the store.
Use the stairs instead of the elevator.
Park as far as you can from the door.
Hand-wash your car.
Clean your house.
Walk on your lunch break.

The benefits of eating health foods extend beyond your waistline to your mental health. A healthy diet can lessen the effects of stress, build up your immune system, level your mood, and lower your blood pressure. Lots of added sugar and fat can have the opposite effect. And junk food can seem even more appealing when you’re under a lot of stress.

To stay healthy and on an even keel, look for complex carbohydrates, lean proteins, and fatty acids found in fish, meat, eggs, and nuts.

Antioxidants help too. They protect your cells against damage that chronic stress can cause. You can find them in a huge variety of foods like beans, fruits, berries, vegetables, and spices such as ginger.

Stick to a healthy diet with a few simple tips. Make a shopping list. Carry healthy snacks with you when you leave the house. Stay away from processed foods, and try not to eat mindlessly.

Scientists have pinpointed some nutrients that seem to help lessen the effects of stress on the body and mind. Be sure to get enough these as part of a balanced diet:

Vitamin C
Magnesium
Omega-3 fatty acids

A common side effect of stress is that you may struggle to fall asleep. If this happens three times a week for at least 3 months, you may have insomnia, an inability to fall and stay asleep. Lack of sleep can also add to your stress level and cause a cycle of stress and sleeplessness.

Better sleep habits can help. This includes both your daily routine and the way you set up your bedroom. Habits that may help include:

Exercise regularly.
Get out in the sunlight.
Drink less alcohol and caffeine close to bedtime.
Set a sleep schedule.
Don’t look at your electronics 30-60 minutes before bed.
Try meditation or other forms of relaxation at bedtime.

The role of your bedroom in good sleep hygiene also is important. In general, your room should be dark, quiet, and cool. Your bed also plays an important role. Your mattress should provide support, space and most of all, comfort.

Yoga. This is a form of exercise, but it can also be a meditation. There are many types of yoga. The ones that focus on slow movement, stretching, and deep breathing are best for lowering your anxiety and stress.

Meditation. It has been around for over 5,000 years for a reason. Meditation works well for many people and has many benefits. It can lower stress, anxiety, and chronic pain as well as improve sleep, energy levels, and mood. To meditate, you will need to:

Find a quiet place.
Get comfortable (sitting or lying down).
Focus your attention on a word, phrase, object, or even your breath.
Let your thoughts come and go and do not judge them.

Deep breathing. When you practice deep breathing, you turn on your body’s natural ability to relax. This creates a state of deep rest that can change how your body responds to stress. It sends more oxygen to your brain and calms the part of your nervous system that handles your ability to relax.

Try belly breathing. Get comfortable, close your eyes, and place one hand on your stomach and the other on your chest. Take a deep breath in through your nose. You should feel your belly rise more than your chest. Now, exhale through your nose and pay close attention to how your body relaxes. Repeat.

Biofeedback. Learn how to manage your heart rate, muscle tension, and blood pressure when stress hits. Biofeedback gives you information about how your body reacts when you try to relax. Sensors are placed on your body that call out changes in everything from your brain-wave pattern to your muscle tone. Working with a biofeedback therapist, you can start to take control of the signals by changing how your body reacts to the sensor.

Connect with people. Spend time with a friend or family member who will listen to you. It is a natural way to calm you and lower your stress. When you connect with people in person, your body releases a hormone that stops your fight-or-flight response. You relax.

Behavior. How you respond to people directly impacts your stress levels. Manage your response with these tips:

Try not to overcommit yourself
Share the responsibility
Count to 10 before you respond
Walk away from a heated situation
Distract yourself with music or podcasts

Inner voice. Nothing affects your stress levels like the voice inside your head. The good news is you are in control. You can exchange negative thoughts for positive ones. There are more benefits to positive self-talk than reducing stress. These include a longer life, lower levels of depression, greater resistance to the common cold and cardiovascular disease, and better coping skills for when hard times hit.

Laugh therapy. When you laugh, you take in more oxygen. Your heart, lungs, and muscles get a boost and your body releases those feel-good hormones. Laughter also improves your immune system, lessens pain, and improves your mood for long periods time.

Talk therapy. Long-term talk therapy helps some people deal with stress. One approach, cognitive behavioral therapy, helps you change negative thought patterns. Your therapist can guide you toward other approaches that might be helpful.

It's been a long, busy day, and charts are piling up. The patient you see next says they're feeling lousy and want an antibiotic. This is the fourth person today to whom you will need to explain that antibiotics aren't effective in viral illness. The previous three all left unhappy about their visit.

You're feeling rushed and frustrated. You know taking the time to listen to this patient is important, but you aren't sure how to show empathy to patients when you're feeling so stressed yourself.

We've all been there. Here's a look at what empathy looks like in a clinical setting and how to express it, even on your off days.

What is clinical empathy?

An Academic Medicine article defines empathy as "the distilling or connecting of feelings and meanings that are associated with a patient's experience while simultaneously identifying, isolating, and withholding one's own reactions."

Put more simply, empathy is the ability to understand and share the feelings of another person emotionally. It is a necessary part of any doctor-patient relationship, and its expression creates an alliance between you and the patient, assuring them that you care about them.

Sometimes this communication comes easily, but other times it can be quite challenging. However, it's a skill worth mastering. Research shows that there are numerous benefits of expressing empathy. It can result in improved doctor-patient relationships and patient satisfaction, according to study results published in PLoS One, as well as increased adherence to medications, according to a study published in the Journal of Research in Medical Sciences. It can also lead to decreased malpractice claims, according to an article in Emergency Medicine Journal.

Empathy in physician communication

How should a physician respond to the above patient who wants antibiotics? Here's an example of how to show empathy to patients — or not.

Expressing empathy

It sounds like you feel terrible! There are some awful viruses going around, and it looks like you caught one of them. Unfortunately, antibiotics aren't going to work here. I would give you an antibiotic if I thought it would do anything other than give you a stomachache and diarrhea. Being ill is so frustrating, I know, but I have some ideas that could be helpful and may reduce your symptoms while we wait for the virus to clear.

Lacking empathy

You have a virus, and antibiotics don't cure viruses. We can't give out antibiotics unless we know it's a bacterial infection because unneeded antibiotics contribute to resistance and other physical problems. You can take a decongestant and anti-inflammatory, and you should get some extra rest while you wait it out.

Neither of these responses is clinically wrong. However, they will produce different outcomes. The first acknowledges and validates the patient's discomfort, while the second robotically expresses facts. Expressing empathy will do more to build trust with the patient, even if they're frustrated. If you were sick, which response would you prefer to hear?

What's more, without empathy, the patient may leave angry, still convinced that they need an antibiotic because they don't think you listened when they were saying how bad they felt.

7 tips for showing clinical empathy to patients

Some have suggested that empathy shortfalls may result from physicians not understanding — or growing hardened to — what it's like to be in their patients' shoes. That's why one Florida doctor had his emergency medicine residents "become patients," entering the system and interacting with staff, as Emergency Medicine News reported.

Other medical professionals have looked to their own experience as patients, or even in patient-like situations, to regain access to the patient point of view. For example, one physician assistant wrote in the Journal of the American Academy of PAs about how the parallels between being a patient and getting a tattoo — from setting up the appointment to experiencing vulnerability — prompted her to reflect on "the many chances [she] had missed to communicate the empathy [she] felt for someone and allow them to be vulnerable, to ease their burden."

Indeed, sometimes it's the realities of a practice and the pressures of our personal lives — more than an overarching failure of empathy — that get in the way of making that essential human connection with a patient. If you are physically and mentally depleted, sleep-deprived and stressed, it becomes challenging to meet the needs of others.

But even if you are rushed with a patient, a few simple communication strategies and cues can help your patients feel heard.

Try to integrate these pointers into even the busiest of your clinical days.

Start the appointment by making eye contact

Eye contact is essential for establishing a connection, yet the use of electronic medical records have made this increasingly difficult. Look up when you ask questions. When you look down at the computer, continue commenting to show that you're not distracted — or better yet, explain to first-time patients why you're using the computer during their visit.

Let your patient know you're listening

Give a nod or paraphrase what you hear them saying to demonstrate that you hear and understand them.

Be aware of your body language

Are you asking questions with your hand on the doorknob or your arms folded across your body? Are you standing? Sitting down doesn't take extra time, and it shows you aren't rushed.

Be curious about your patient

Ask questions so you understand more than just your patient's presenting issue. Ask how their symptoms are affecting their lives. This makes them feel heard and cared for while allowing you to see the whole picture.

Record details that humanize your patient

This means going beyond checking off boxes on the electronic medical record. What's impacting their life right now? A sick mother? An impending move? Not only will your patient feel connected when you remember to ask them about this next time, but the more you know about their life, the easier it is to feel empathy.

Show support to your patient

Recognize how a patient feels and acknowledge their fears and anger. Support them by responding to both their emotional and medical needs.

Look deeper for ways to empathize with your patient

This is especially important if you find yourself being judgmental. Find out a patient's story and identify common ground.

Medical training focuses on the technical skills that make us great diagnosticians, but it can often fall short on teaching us how to connect with patients. Human connection is an essential component of health care delivery, and the improved outcomes that accompany it benefit us all.