While accurate diagnosis and effective treatment are paramount, simple acts of kindness can be a potent antidote to negative emotions and may improve outcomes for those experiencing the frightening journey called cancer.
I have long studied how to improve service in health care. My current work focuses on cancer care and includes field research at 10 innovative U.S. cancer centers and interviews with approximately 400 cancer patients, family members, oncology clinicians and staff.
Cancer care is about more than the science, which has led to important advances in treatment. High-touch needs to complement high-tech. In a recent paper, co-authors and I explored how six types of kindness can improve cancer care.
Do we really need to remind caregivers about the importance of kindness in serving seriously ill patients? Unfortunately, yes, as the stressors of modern medicine often interfere with good intentions. Let’s take a quick look at the six types.
Listening intently to patients and families, with minimal interruption, conveys respect for their self-knowledge. It also builds trust.
It enables the physician to act as a trusted guide who provides relevant medical expertise and translates it into a care plan consistent with patients’ values and priorities.
The stakes are too high for the clinical team to be uninformed about a patient’s fears, practical concerns, home support system and personal priorities.
As a hospice nurse stated during my field research, “We cannot be afraid of the deep conversations with patients to find out what’s important to them, which you are not going to get by asking, ‘How are you feeling today?’
Simple, open-ended questions can invite patients and families to share pertinent information. Intensive-care-unit nurses at Brigham and Women’s Hospital in Boston begin their shifts by asking patients, “What’s the most important thing we can do for you today?”
Nursing scholar Theresa Wiseman identifies four essential attributes of empathy: seeing the world from another’s perspective, avoiding judgment when assessing a situation, recognizing the emotion present, and responding to that emotion in a genuinely caring way.
Because he was anxious about this procedure, the team allowed him to sit on me during anesthesia. When he woke up, he got upset about lacking a shirt.
Now the team puts his shirt back on before he wakes . . . . To me, these small acts were the ultimate kindness, reducing his anxiety and distress and, therefore, my own.”
Empathy represents an anticipatory kindness based on a caring assessment of the patient’s situation and likely stressors. At Henry Ford Hospital in Detroit, oncology fellows are trained in empathetic communication by improvisational actors who role play as patients and family members.
Kindness often manifests as generous acts. In my study, I asked patients, “Can you think of the best, most meaningful service experience you had as a cancer patient?” Many responses reflected the kindness embedded in generous acts.
A bladder cancer patient who had undergone surgery praised a nurse who taught him the best way to get out of bed at home.
Support for family caregivers
Cancer patients commonly depend on family members for assistance with medical care, daily needs and emotional support.
Family caregivers themselves require training, timely assistance and emotional care to perform their role and to maintain their own health.
Research shows the benefits of preparing, empowering and assisting a patient’s family to effectively care for a loved one.
The personal stories of patients, families and clinicians illustrate the effect of kindness in cancer care. Six overlapping manifestations of genuine kindness offer a powerful, practical way for clinicians to temper the emotional turmoil involved with a cancer diagnosis.
A patient is a person first. Caring for human needs as well as medical needs through kind acts is good medicine.