Recording of Healthcare Call: April 1, 2014: https://www.dropbox.com/s/frwhjtvs3euu8w3/Charter%20Healthcare%20140401%20edit.mp3
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2. Values and Behavior
5. Compassion for Others
6. Compassion for Self
7. Receiving compassion from others
8. Blocks to Compassion and taking Behavior Forward
Each session will provide an introduction to the concept and some psycho-educational framing. Applied research will establish impact of the dyads on compassion (self, others, fears of), stress, anxiety, depression, resilience, flourishing, burnout and compassion fatigue. The initial surveys will be available soon. Dr. Martin would be thrilled to partner with health care organizations to offer CDD in the initial research stage (they can be implemented at your convenience). Please contact Dr. Martin for further information and involvement.
Dr. Robin Youngson Author of Time to Care: How to Love Your Patients and Your Job. Involved in quality improvement and patient safety. Compassion and love do not set well in committee agendas. When health professionals do small acts of compassion on a daily basis--it helps. Opportunity to create international social movement--connecting people together who wish to be more kind, compassionate, and more mindful. Dr. Youngson operates a network, Hearts in Healthcare, of supportive communityies. Meeting this week in NZ to plan a national strategy to make NZ the most compassionate healthcare system in the world. He will be using workshop “reawakening purpose”- people will tell stories of when they had an extraordinary relationship with a patient. Transformative process in 1 and ½ hrs. Choose small acts of kindness and compassion--these become contagious. This is the only way to change healthcare. If each one of us chooses a way of being, we will change the entire system. If you join the community, you can access a kit that gives you all you need to hold a workshop. Visit Dr.
Youngson, Robin. Time to Care (CreateSpace, 2012).
In today’s beleaguered healthcare system, burdened with epidemic levels of stress, depression and burnout, TIME to CARE offers health professionals the opportunity of renewal. Here are the secrets to building a happy and fulfilling practice, wellbeing and resilience.
Youngson bravely relates his own transition, from a detached clinician to a champion for humane whole-patient care; at times poignant, sometimes funny but always brutally honest. TIME to CARE offers a deeply compassionate and insightful account of a health system that is failing both patients and practitioners all over the world. But there’s more….
Drawing on advances in neuroscience and positive psychology, and tapping the power of appreciative inquiry, Youngson conveys in clear and simple language how health workers can strengthen their hearts, learn the skills of compassionate caring, and rise above institutional limitations to transform patient care…. and rediscover their vocation. Tipped to become an international best-seller, TIME to CARE is recommended reading for today’s health professionals, students, health leaders, patients, and all those passionate about re-humanizing healthcare.
Group Composition for Breakout Session
Appreciative Inquiry Question: Think about your experiences in compassion and healthcare- what has worked? Where/what would you like to see in the future to infuse compassion into healthcare?
Kelly Swauger (Host)
Lesa Walker (Host)
Not identified on anyone’s group list
Group 6 (Kelly Swauger, Host)
Sande Hart: Chief Compassion Officer for Compassionate California working with Compassion Games. Current president of URI.org for North America. Spoke about the collective impact and cooperation. What is working is the concept of collective impact, bringing together the wisdom of the community, citizenry empowerment, solutions are connected. CA Charter for Compassion is changing the way people look at what it means to be “fit”, coopetition. Currently work is happening in LA and Orange County.
Usha Mehta: Midwest Palliative Care physician whose dream is to go to practice medicine in a small village in India Dr. Mehta was a palliative care volunteer for 30 years and an ED physician in Chicago. She spoke about the need that people have for compassion and love. Believes that the most practical approach to practicing compassion is “absolutely non-judgmental listening”. Spoke to teaching compassion vs. practicing compassion.
Kelly Swauger: Nursing Director at a large health care facility who is working to move compassion forward through appreciative inquiry. Spoke about moving compassion through authentic dialogue and conversations.
Linda Yann: Healing ministry practitioner from Connecticut for the Congregational Church. Navigator for the healthcare exchanges. Spoke about finding ways to keep doing the work of compassion.
Group 7 (Andrew Himes, Host)
Magdalena Whoolery: Gabarone, Botswana: Magdalena is a co-founder of Botho, the compassion movement in Botswana. Background is as a nurse, trained through the National Health Service in the UK. Botswana, second highest HIV rate in the world, 1 suicide a day, compassion fatigue is a real problem. “There were two of us friends, both originally from the UK, who decided to start Botho. My friend had a terrible burglary in her home, members of her family were beaten by four men who entered. When the family went to the hospital for treatment, the nurses would not even get off their chairs to help. So the challenge is to create compassion programs, find funding, create relationships with partners. Trained 250 people using materials from the Virtues Program. We now have over 40 Partners for the Charter for Compassion.
Anna Betz: London, community assessment service for the public health service. Anna is a specialist in Cognitive Impairment and Dementia. This is a big issue in the UK. Last year there were reports of patients who are neglected and abused. Anna is now part of a group focused on providing compassionate health care. Showing compassion for patients requires first that we are able to show compassion for ourselves. Mindfulness is the entry point to knowing ourselves. How perceptive we are to our mental processes? How we can respond to others from an inner space of compassion rather than reaction? We can become more conscious of our impact on others, and then can speak from a place of compassion, rather than talking at others.
Group 8 (Lesa Walker, Host)
John Englehart: senior chaplain Texas Health Resources, Arlington Texas. Hospitals all across North Texas. An organization with 24 hospitals; faith-based healthcare--United Methodist and Presbyterian. Looking at compassion. It is one of their values. Doing a # of initiatives- caring across continuum of care- before, during, and following illness- working with faith communities, schools, businesses. Integrating compassion in1st day of orientation. Doing some things similar to the Relays. Faith and spirituality integration cabinet. How to integrate mindfulness, faith. How to connect with local faith groups- relates to over 400 clergy.
John needed to leave early. Expressed it would be good to have face to face opportunity to discuss these issues. Employees in healthcare today are very stressed. Important to talk about things that make a difference. Hard to get to know patients and families in healthcare systems. Hospitalists are taking care of patients and nurses asked to do a lot. Trying to develop small groups and let people talk a lot about what makes a difference. Look at “compassion scores.” What are they hearing from patients that they need to address. “One” is thanks for listening to me.
Suzanne Robertson-Malt: professor of healthcare in Australia. Works in the organization focusing on evidenced implementation; looks at research and application to health. Teaching of inter-professional health teams (how teams of different disciplines come together and work). Much of her work is in public engagement.
Suzanne- Reminds her of an experience with patient a couple of weeks ago. Patient has severe rheumatoid arthritis- in and out of hosp a lot. Hospital ward knows her. One day she burst into tears when Suzanne was about to leave. Said she was moved by the style of care of Suzanne’s team compared to the earlier team. She is in “barrier care”- people have to gown/mask, etc. Other team had come in and exited- not much interaction. Suzanne’s team had connected with her. All it takes is for someone to touch you- hand or with eyes- to show level of compassion needed. Any sort of structures that can be put in place to ensure that care is patient-centered and focused is of the greatest importance. Unfortunately, systems are so stressed, that compassion is taken for granted and not actively given. Professor Jane Watson- has been doing work with Kaiser Permante- working with patient-healthcare teams to introduce compassion into care. No systematic review to pull all of compassion research together in healthcare. **Would like this group to do a systematic review of the research.
Dr. Youngson: excused himself. Looks forward to connecting.
Dr. Lesa Walker: Suzanne asked about the Compassion Relays. Lesa shared info. Suzanne is very interested and would like the website and info about the Relays shared in the notes for the call.
Group 9 (Barbara Kaufmann, Host)
Kay Janssen: Massage therapist, previously: X-ray medicine tech at VA hospital. “I heard Karen Armstrong on TED and knew I had to be a part of this.” Felt an emotional surge of overwhelming joy and sorrow. Currently doing Shamanic studies. Kay has come at this from both sides – personal family especially with patients. Has personal and professional experience (family and profession) that identifies what works and what doesn’t. What works: Healthcare worker living from their heart . What doesn’t work: Healthcare workers who are too “clinical.”
Current interest and study: Dying compassionately work (dying consciously). Felt “called” to be here and felt guided to be on the call and involved.
Elizabeth Rider: Pediatrician and social worker; Harvard Children’s Hospital; Intl Charter for Human Values; and Global Compassion Council Executive for CfC. Lot of teaching locally, nationally and internationally. Relational competency/ what works: following your passion in compassion, appreciative inquiry, would like to see training in all levels of healthcare. Appreciative inquiry is a complex concept. Organizations in healthcare should spend more time identifying problems than creating solutions. The difference is that of identifying problems and identifying what’s working--how do we expand on what is working; tell stories; create dyads with 5 minutes each: Tell about most extraordinary story of compassion in your life
Recommended book by Elizabeth: Susan Hammond, The Thin Book of Appreciative Inquiry.
Hammond, Susan Annis. The Thin Book of Appreciative Inquiry (Thin Book Publishing, 3rd edition, 2013).
The Thin Book of® Appreciative Inquiry is the introduction to the exciting organizational change philosophy called Appreciative Inquiry. Appreciative Inquiry is a way of thinking, seeing and acting for powerful, purposeful change in organizations. It is particularly useful in systems being overwhelmed by a constant demand for change. Appreciative Inquiry approaches change by assuming that whatever you want more of already exists in all organizations.
Wendy Sergeant: Providence Hospice of Seattle; Grief Counselor. Interested in integrating the idea of compassion in her agency. Spoke of the Language of caring. Would like to increase that kind of language. Working with core group around ethics- training of clinicians who go into the field (teams- nurses, Occupational, social workers etc.). Training on ethics – “how do we change the way we are?”
Conscious and use care in the language we use with patients, families and team members. Create positive boundaries in the work. Forming: National Training: Language of Caring. Often there are problematic: Judgments, Living, Working, Dying, Poverty, Family units and how they work, Developmental Disabilities.
“Would love to see changes in the future about our agency changes.” Would like to see our agency as a leader- National Hospice and Palliative Care OrganizationAgency is a member and supervisor is Rex Allen- who is actively involved as a bereavement section leader.
Group 10 (Marilyn Turkovich, Host)
Stephanie Barnett: co-host, Compassionate Louisville Healthcare Constellation, group of people who are asking the question: What if compassion was the driving force in our healthcare community; we connect with others who can help with integration of compassion in all aspects of healthcare (training, insurance companies, etc.).
Comment: “I'm a lay person, my paying job is representing physicians in rural Kentucky. I realize that I didn't even use the word ‘compassion’ previously. I find that when I take a stance to evoke compassion it invites others to be a part of the compassion conversation and begins to break down silos. Spoke of the First health care insurance company in the country to recognize the importance of compassion: Passport Health Plan.
What would a thriving healthy community look like: begun a program with mothers who suffer from substance abuse--asking the mothers what do they need to take care of themselves; what does it mean for them to take the first steps with healthcare workers and insurance groups. How do we focus on the first 1000 days of healthcare, if not, then we might have lost the battle.
Kirsten DeLeo: international program working in 9 countries; bringing compassion into healthcare; secular approach, bringing mindfulness and compassion into the profession; inspired by Sogyal Rinpoche (see below the description and resources Kirsten sent in).
Question: how open healthcare providers are when you bring up the topic of compassion is amazing. Compassion is a skill and needs to be nurtured. Our work is about caring for others.
It is so important to listen to people first. If we really listen well the answers are there. We are the system. Many people might not feel that way, but we are. We need to provide the tools and processes to overcome the sense of isolation.
Steve Overman: rheumatologist in Seattle. Have experienced burnout and many of the situations that are being addressed. Question: outcomes of compassionate care are important. How did you bring the "c" word to the conversation. Recently attended a Whidbey Institute on Thriving Communities (see below information Steve sent in) weekend. Here it was clear that the internal focus of compassion is important; questions to explore: how do you develop compassionate communities,.
Highlights from the Group Debrief
- Is there something you want to share (reflections?)
- “The most practical approach to Practicing compassion is absolutely non-judgmental listening.”
- Suggestion for systematic review of compendium of strategies (Suzanne)
- importance of self care requires that we first show compassion for ourselves beginning with mindfulness; fostering a place of inner compassion- speaking form a place of inner compassion rather than talking at each otherOne story moved me: the importance of simple things. Example: simple way of looking at a patient, honoring and touching. Time to sit down and talk with patients is less than before. Ways to connect with patients is important
- How do we integrate compassion into the system of care? Listen to the recipients of care- that makes it clearer.
- How to be of service in healthcare (which is a service industry). It doesn’t take any longer to connect if you’re working from a place of heart
Additional Resources Sent in from Participants
The Spiritual Care Program (SCP) (submitted by Kirsten DeLeo)
SCP offers contemplative-based training and education with the aim of improving care for patients and clients, and self care for caregivers. The Program is inspired by the acclaimed classic The Tibetan Book of Living and Dying by Sogyal Rinpoche and is under the patronage of His Holiness the Dalai Lama.
SCP has professional and public programs in 9 countries and collaborates with universities, hospitals and other institutions, and offers a variety of residential and online courses; and offer a 15-week course in "Contemplative End-of-Life Care" in partnership with Naropa University which attracts an international professional audience every year. To support people in need SCP has established a Care Centre in Ireland and are currently developing one in Germany.
Books Recommended by The Spiritual Care Program
Rinpoche, Sogyal. The Tibetan Book of Living and Dying (HarperSanFrancisco, 2nd Edition, , 2002).
A newly revised and updated edition of the internationally bestselling spiritual classic, The Tibetan Book of Living and Dying, written by Sogyal Rinpoche, is the ultimate introduction to Tibetan Buddhist wisdom. An enlightening, inspiring, and comforting manual for life and death that the New York Times calls, “The Tibetan equivalent of [Dante’s] The Divine Comedy,” this is the essential work that moved Huston Smith, author of The World’s Religions, to proclaim, “I have encountered no book on the interplay of life and death that is more comprehensive, practical, and wise.”
Longaker, Christine. Facing Death and Finding Hope (Random House, 2007.
Christine Longaker's experience with death and care of the dying began in 1976 when her husband was diagnosed with acute leukemia at the age of twenty-four. Since his death, she has devoted her life to ease the suffering of those facing death. In Facing Death and Finding Hope, she clearly and compassionately identifies the typical fears and struggles experienced by the dying and their families. The core of this book is presented in "Four Tasks of Living and Dying," using the Tibetan Buddhist perspective on death to provide a new framework of meaning. A book of great depth and grace, it is destined to become a classic in the literature on death and dying.
Giles, Cheryl and Willa B. Miller (editor) The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Care (Wisdom Publications, 2012).
Powerful and life-affirming, this watershed volume brings together the voices of pioneers in the field of contemplative care--from hospice and hospitals to colleges, prisons, and the military. Illustrating the day-to-day words and actions of pastoral workers, each first-person essay in this collection offers a distillation of the wisdom gained over years of compassionate experience. The stories told here are sure to inspire--whether you are a professional caregiver or simply feel inclined toward guiding, healing, and comforting roles. If you are inspired to read this book, or even one touching story in it, you just might find yourself inspired to change a life.
Introduced to Group 10 by Steve Overman
The Whidbey Institute is a place of renewal and inspiration, and home to the bold seekers of positive change. We nurture and connect people who are doing uncommon work for the common good. Woven throughout our work is the spirit of the 100 acres of northwest woodland and historic farmstead, which hold and energize everything that happens here.We host and convene organizations engaged in three primary areas of endeavor:
- Leadership Transformation
- Thriving Communities
- Ecosystem Vitality
We believe our best work cannot be done alone. We come together in community to share our individual wisdom and to push far beyond what are able to do on our own. We invite those who seek this to come here to be nourished by nature, food and community, and to challenge all those who might be interested to journey boldly with us. Our community is global, made up of those working for social and environmental change – individually, in organizations, in communities and through movements. We are united by a commitment to hope and optimism that we can rejuvenate our world, living harmoniously with nature and with each other. We nurture people at all ages and stages: this is an invitation to explore, think deeply, and grow with us.
Upcoming conference on Empathy and Compassion in Society, in San Francisco, November 13-14. Learn more about the Empathy conference and the Charter’s post conference to be held on November 15.