Lending a Helping Hand As was demonstrated in our conversations so many of you have access to extensive networks of potential partners and other contacts for education network. Would you consider letting your fellow colleagues and associates know about the Charter for Compassion network? We can accomplish a great deal more by adding hands, hearts and minds to our end goal of bringing shared dialogue, and compassionate action to our network efforts. If you were on the call, and even if you weren't and are reading this, please consider inviting others to our compassion movement. It's easy to register.
Healthcare Compassion Section on the Charter's Website
Visit the Charter's Healthcare section on the website. Here you wll find links to our global healthcare partners: including Hearts in Healthcare in New Zealand, GlobalHELP, an organization that provides free and low-cost medical publications around the world; International Research Centre for Communication in Healthcare in Hong Kong; University of Tasmania's Healthcare Division, and Supplies Overseas, Louisville, Kentucky-based nonprofit organization that meets critical health care needs in medically impoverished communities around the world by collecting and distributing surplus medical supplies and equipment. We currently have 116 healthcare partners.
While you are at the the Healthcare section, take note of the Compassion Heathcare Reader. Each of our sector's has it's own Reader. You'll find that the Healthcare Reader is divided into eight chapters: Confronting and Improving Healthcare Practices, Defining and Understanding Compassion, Discovering Happiness, Discovering Kindness, Discovering Self-Compassion, Discovering Empathy, The Importance of Mindfulness, and Gaining Emotional Strength.
You'll also find a new section that has resulted because of the Conference Call we had this week. It is our new Healthcare: Annotated Bibliography. So many of you wrote and gave us the names of books, we thought we would organize these into a new page on the website that would continue to grow along with our work and conversations.
Finally, you'll find under Reports and Document in this section, newsletters and reports for the Healthcare sector.
Charter Staff on the Healthcare Call
This call was facilitated by Elizabeth Rider, a pediatrician and social worker associated with the Institute for Professionalism and Ethical Practice at Harvard. Dr. Rider is a member of Charter for Compassion’s Global Compassion Council (GCC).
The most powerful form of teaching is by example. ~Patrick Pietroni
The first of two speakers on this call, Dr. Patrick Pietroni, was introduced by Dr. Rider. Patrick is the author of several books including Greening of Medicine and Holistic Living. He also serves as a member of the Charter’s Global Compassion Council and is currently working to establish a Compassionate Ireland. His background is in general family practice and public health. He has done research concerning empathy between health care providers and their clients. He spent many years trying to help medical school students learn skills in empathy.
During the last 30-40 years, the United Kingdom national health service has changed and introduced the “market mechanism.” Groups of managers are given a budget and asked to purchase healthcare from providers as if it were a commodity. This has resulted in a purchaser/provider split. There have been many critiques of this model and some concerns about it causing competitiveness and a less compassionate system. The question is: If we can purchase care, can we also commission and purchase compassion and kindness in healthcare?
The word “kindness” comes from word “kin.” Who is your “kin?” Everyone is part of our “kin” –not just family and/or our community. All studies show that we are more likely to exhibit compassion to those close to us. Compassion: “com” means “with” and “passion” is “suffering.” Compassion means being able to be with someone who is suffering.
Do you always act compassionately when you have kind thoughts and kind feelings? Do we feel more compassion when we have behaved in a compassionate manner? All religions have certain traditions and practices that seem to encourage compassion.
- Provide sanctuary
- “Hospital” means providing hospitality
- Active listening – be with, share burdens
- Management of rituals to help people move from one life event to another
There are many ritual events in our lives that are often sacraments, e.g., marriage, birth, death. Ceremonials and rituals are ways that cultures help people go through events in our lives. There are no rituals for helping people get through some events—losing a job, having an abortion, going through a divorce—and these people show up in healthcare system.
Question to consider in Small Groups: You are a manager responsible for health practitioners, and you’ve been told to commission and purchase services that will enhance the level of compassion in your services. What actions would you take to do this? How would you evaluate your program?
Dr. Rider then introduced Judy Pigott, co-author of “Personal Safety Nets: Getting Ready for Life’s Inevitable Challenges and Changes” and experienced in care-share teams and hospice work. She has also taught English as second language. “Personal Safety Nets” is about the teamwork aspect of getting ready for life’s inevitable challenges and changes. This book, a workbook, and an audio recording can be downloaded from the Charter’s website. (See programs listed on home page of www.charterforcompassion.org).
“Personal Safety Nets” addresses the need for more compassion and connection in all relationships. The authors want to demonstrate that there is an essential connection between our humanity (need to see, hear, and matter to each other). If we neglect it, the quality of everything deteriorates. People who prefer to be isolated are the minority. People need connection.
If we look at healthcare as how to treat people and make them better, it is too narrow. We should look at trying to create health in all people--it goes beyond the medical profession. Healthcare- could be how to maximize the health and care for the health for the majority of the people from youth through old age. Healthcare requires individual responsibility as well as teamwork. What are the intellectual pieces that help us keep healthy minds? What relationships with families and others keep us healthy? What is it that fills our spirit (not necessarily religion) so that we have enough to give to others? Also, looks at financial pieces as well. Many broken places in our world—how do we heal the various parts of it?
One proposal: Start earlier with training physicians and all in the field to include a broader scope of people in the planning for what constitutes greater health.
Question and Answer Period
Kathy O’Keefe: in her country (U.S.), have an organization called “Child and Family Life” in children’s hospitals. They provide the enriched, compassionate care. These workers need to be extended into adult hospitals as well. These workers respond to all the psychosocial issues. Designed to combat hospitalism, which is trauma caused by the hospital event itself. They are trying to normalize the hospital experience. Often Child Life specialists are not in acute care pediatric areas of general hospitals.
Patrick Pietroni: In UK , we have health visitors for 0-5 year old children. We are currently doing a research project to study the impact of these visitors.
Individuals Registered for the Call
|Alem Makonnen||James Campbell||Nicole|
|Alison Adams||James R Doty, MD||Nikki|
|Alison Gray||Jane Ann Leeves||Olivia McIvor|
|Alistaire Moore||Janice Sheppard||Pam Jensen|
|Alun Rees||Jim Nonnemacher||Paola Alessandri-Gray|
|Andres Gleich||Jim Torbert||Patricia Keenan|
|Angus Skinner||Joan Halifax||Patricia Wiklund|
|Annette Karr||John Kim||Patrick Pietroni|
|Barb Colvin||John Knuerr||Pattie Williams|
|Barbara Kaufmann||John McCreedy||Paula Giffen|
|Barbara Kerr||Judy Pigott||Peter Mogk|
|Belinda Perriman||Julie Schaar||Phil Schervish|
|Carin Bernard||k||Raine Spencer|
|Carol Paris||Karen Herzog||Randal Synder|
|Carolyn||Kathleen Quinn||Rebecca Alexander|
|Carolyn Hidalgo||Kathy Ising||Rev. Dr. Alden E. Spoull|
|Carolyn (SMUMN)||Kelly Griffin||Rosalie Wilkinson|
|Carrie La Jeunesse||Kirsten Deleo||Rosario Ellie Rengil|
|Cathy O'Keefe||Kosh Patel||Roselie Gillam|
|Christine Santisteban RD, MD||Laurel||Sandra Gilifilan|
|Connie Adler||Laurie Ross||Sandy Byrne|
|Crystal Cullerton-Sen||Lee Good||Sarah|
|Danielle Fotheringham||Lesa Walker||Sarah Knorr|
|Dave Champion||Lisa Picciuti||Selina|
|Debra Hagen||Louisa Hext||Shelby Havens|
|Demelza Costa||Lucia Samaras||Sherri Henderson|
|Denise Edelson||Lynn Ahrens||Stacen Keating|
|Denise Nash||Marc Dunn||Stephanie Barnett|
|Dian Williams||Margo Lalich||Stuart Cable|
|Diana Kern||Marian Boyle||Susan Wesley|
|Diana L. Spring||Marie Eisele||Tan Yew Lay|
|Diane Frederick||Marilyn Eisenberg||Ted Roberts|
|Dianna Fortnum||Marlies Houtbraken||Terry|
|Dina Capitani||Martin Heltai||Tom E. Bowers|
|Elena Falcone||Mary Tehan||Victoria Thorne|
|Elizabeth Rider||Mary Catherine Burgess||William See|
|Emma Eaton||Michael||Wilma Ardine Kirchhofer|
|Garfield Linton||Michael Swanberg|
|Glen Farrimond||Monica Kilburn-Smith|
|Hilary Cummings||Nance Duffy|
|J A Mossbarger||Nicolas Husain|
Popcorn Session (Sharing the kernels of wisdom)
Marion Boyle: Self compassion and self care--we need to care for ourselves before we can care for others.
Angus Skinner: Mindfulness is a constant process. Making allowance and provision for staff to meditate for 20 minutes and provide a place. This could enhance teamwork and compassionate care.
Judy Pigott: Importance of teamwork—pulling a whole team together. Find out how patient wants to be treated and attend to that.
Elizabeth Rider: Agree. The patient’s experience of care is essential.
James Doty: All these steps are important. We do have enough data and information that allow us to translate research into practice. Key is to get leadership to understand and be supportive. How do we take what we are learning and make leadership understand the importance of this? Many people are looking at this.
Judy Pigott: Personal Safety Nets has been looking at aligning with a hospital system to start with the patient who wants to be healed and a provider who wants patient to be healed and implement intervention.
James Doty: Creation of Center for Compassion Healthcare will do some of this. The Center will create a think tank, a research center, and entity that translates research into practice, and become a convener of seminars, conferences, and workshops for discussion. Using Dignity Health, Stanford Medical School, etc. for research. Important dates: Nov 10-16: StanfordCCARE is sponsoring science and compassion research conference as well as compassion healthcare conference. Living compassion retreat. This will be an entire Compassion week for San Francisco. Marilyn Turkovich will include information in upcoming newsletters as the Charter for Compassion is a partner of the conference.
Kathy O’Keefe: Mayo Clinic has experienced training of staff using a workbook, “Attention and Interpretation Therapy” by Amit Sood, to enhance present moment awareness, etc.
Angus: Frontline staff and often leaders get it. The difficulty is often in the middle--to get middle management to understand importance of compassionate and future-oriented approach.
Elizabeth Rider- how do you measure compassion as a competency? How do we train our faculty?
THOUGHTS FROM PARTICIPANTS
From Marian Boyle
Acknowledge that it is important to consider self compassion and self care in one's professional life.
Promote working in teams by:
- Educating the team.
- Recognizing that communication is vital.
- Promoting discussions within team about what is compassion.
- Giving the team tools; installing courage, tools to enable a person to "show up" for the person they are with.
- Engaging in 'laugh sessions' to release hormones and bring people to a positive space within.
- Involving everyone including clerks, housekeeping staff, etc
- Ensuring everyone feels deserving, deservability
Importance of mindful presence, vulnerability, empathy.
Look to the work of those dealing with 'end of life' issues and needs.
From Nance Duffy
This link is for a program that works with alzheimer's and dementia through music musicandmemory.org
MUSIC & MEMORY℠ is a non-profit organization that brings personalized music into the lives of the elderly or infirm through digital music technology, vastly improving quality of life.
We train nursing home staff and other elder care professionals, as well as family caregivers, how to create and provide personalized playlists using iPods and related digital audio systems that enable those struggling with Alzheimer’s, dementia and other cognitive and physical challenges to reconnect with the world through music-triggered memories.
By providing access and education, and by creating a network of MUSIC & MEMORY℠ Certified elder care facilities, we aim to make this form of personalized therapeutic music a standard of care throughout the health care industry.
From Joan Halifax
Compassionate Silence in the Patient–Clinician Encounter: A Contemplative Approach
In trying to improve clinician communication skills, we have often heard clinicians at every level admonished to ‘‘use silence,’’ as if refraining from talking will improve dialogue. Yet we have also noticed that this ‘‘just do it,’’ behavior-focused ‘‘use’’ of silence creates a new, different problem: the clinician looks uncomfortable using silence, and worse, generates a palpable atmosphere of unease that feels burdensome to both the patient and clinician. We think that clinicians are largely responsible for the effect of silence in a clinical encounter, and in this article we discuss what makes silence enriching—enabling a kind of communication between clinician and patient that fosters healing. We describe a typology of silences, and describe a type of compassionate silence, derived from contemplative practice, along with the mental qualities that make this type of silence possible. Read more.
A heuristic model of enactive compassion
Purpose of review This article is an investigation of the possibility that compassion is not a discrete feature but an emergent and contingent process that is at its base enactive. Compassion must be primed through the cultivation of various factors. This article endeavors to identify interdependent components of compassion. This is particularly relevant for those in the end-of-life care professions, wherein compassion is an essential factor in the care of those suffering from a catastrophic illness or injury. The Halifax Model of Compassion is presented here as a new vision of compassion with particular relevance for the training of compassion in clinicians.
Recent findings Compassion is generally valued as a prosocial mental quality. The factors that foster compassion are not well understood, and the essential components of compassion have not been sufficiently delineated. Neuroscience research on compassion has only recently begun, and there is little clinical research on the role of compassion in end-of-life care.
Summary Compassion is in general seen as having two main components: the affective feeling of caring for one who is suffering and the motivation to relieve suffering. This definition of compassion might impose limitations and will, therefore, have consequences on how one trains compassion in clinicians and others. It is the author’s premise that compassion is dispositionally enactive (the interactions between living organisms and their environments, i.e., the propensity toward perception-action in relation to one’s surrounds), and it is a process that is contingent and emergent. Read the full article.
Impact of a contemplative end-of-life training program: Being with dying
Objective: Health care professionals report a lack of skills in the psychosocial and spiritual aspects of caring for dying people and high levels of moral distress, grief, and burnout. To address these concerns, the “Being with Dying: Professional Training Program in Contemplative End-of-Life Care” (BWD) was created. The premise of BWD, which is based on the development of mindfulness and receptive attention through contemplative practice, is that cultivating stability of mind and emotions enables clinicians to respond to others and themselves with compassion. This article describes the impact of BWD on the participants.
Methods: Ninety-five BWD participants completed an anonymous online survey; 40 completed a confidential open-ended telephone interview.
Results: Four main themes—the power of presence, cultivating balanced compassion, recognizing grief, and the importance of self-care—emerged in the interviews and were supported in the survey data. The interviewees considered BWD’s contemplative and reflective practices meaningful, useful, and valuable and reported that BWD provided skills, attitudes, behaviors, and tools to change how they worked with the dying and bereaved.
Significance of results: The quality of presence has the potential to transform the care of dying people and the caregivers themselves. Cultivating this quality within themselves and others allows clinicians to explore alternatives to exclusively intellectual, procedural, and task- oriented approaches when caring for dying people. BWD provides a rare opportunity to engage in practices and methods that cultivate the stability of mind and emotions that may facilitate compassionate care of dying patients, families, and caregivers. Read the full article.
From Diana Kern
Let me preface this sharing that I first came to this issue of compassion in healthcare with many experiences as a patient and client of mental health services.
Because I was fortunate enough to receive more positive care toward recovery than many people I knew, I wanted to advocate for those who could not speak for themselves. Helping others compassionately has always been natural and intuitive for me.
Working under state and local leadership--Texas--as a non-clinician and "former patient" has proven to be more daunting than my own personal recovery was (and is). Whereas it seemed so easy for me to show compassion toward both patients and staff, it became clear that most staff worked under the constraints of limits and boundaries that hindered their ability to model compassion and even show compassion.
My mission was to build bridges between the givers and receivers of health services through sharing my experiences, strengths and hopes NOT as a patient but as a human being. Little did I know just how complicated it would be to shift their perception of me and all the "receivers of their care" as a person first. Within the context of a hospital, it's typical for patients to seen as their illness and not holistically. This presents a fundamental barrier toward communication and understanding and consequently compassion.
I did feel like I made a small difference in the move toward compassion while I worked there as evidenced by changes they made in staff trainings. I also added a module on self-compassion. If you want I can email more info on this.
I did my best to be courageous and stand on my principal of "the golden rule", but I wasn't strong enough to do it alone and I had to quit working. Even though the hospital's mantra was changing the "culture of care" at the time, I realized the system itself was in an early stage of this change. Only a few of us were ready to put theory into practice. So I've had to turn my compassion energy toward myself AND quit feeling so guilty for not helping others enough.
I do feel like I have to gather up courage to be a part of this group. It's been painful to transition from mental patient to human being.
Discover how to cultivate your inner capacity to lead a more authentic, meaningful and engaged life. We’ll help you find the clarity and courage to bring your true self to your life’s work.
Courage & Renewal programs offer a profound experience of our time-tested Circle of Trust® approach — as described in Parker J. Palmer’s book, A Hidden Wholeness: Journey Toward an Undivided Life. Founder and senior partner of the Center for Courage & Renewal, Palmer was named in 2011 an Utne Reader Visionary, one of “25 people who are changing your world.”
This website provides information about self-compassion, and is intended for students, researchers, and the general public.
Dr. Kristin Neff is an Associate Professor in Human Development and Culture, Educational Psychology Department, University of Texas at Austin.Biographical Information
I wanted to summarize my contribution to the group this morning in response to the question about what actions and services we could bring to health care that would created a more compassionate and kinder set of experiences for those we serve and for those doing the serving.
Here's a piece of the timeline for the development of Child Life services to hospitalized children and their families.
|1955||Emma Plank was asked by Dr. Fred Robbins (Nobel Laureate) to create a program to address the social, emotional and educational needs of hospitalized children at Cleveland City Hospital. Emma Plank served as director for the Child Life and Education Division until 1972.|
|1962||Emma Plank authored the book, Working with Children in Hospitals.|
|1965||Organizing committee met to discuss creating an organization, established in 1966, called the Association for the Well-Being of Hospitalized Children and Their Families (renamed the Association for the Care of Children in Hospitals, or ACCH in 1967).|
|1970s and 1980s||Child life movement experienced rapid growth. Many new programs were started.|
The point of this service is to add services to the traditional medical model that would enhance the psychological and social well-being of children and families often negatively impacted by the trauma of hospitalization and illness.
My point in today's call was to note that the principles of enhancing overall well-being are at the root of this movement, and it certainly could be easily adapted to adult hospitals and clinical services as well. These specialists are charged with assessing the peripheral issues in all domains and responding with personal and programmatic actions that show kindness and compassion:
One on one processing of emotions related to illness with supportive active listening, affirmation, feedback, and reframing/interpretation. Noting resilience and celebrating courage through a variety of activities designed to recognize positive coping and expression of emotions.
Opportunities for Legacy building and story telling to provide the child opportunities to claim his/her own strengths and gifts and frame them so others can see them.
Also, in his 1982 book, The Nature of Suffering and the Goals of Medicine, Eric Cassal, writes brilliantly about the need for intimacy in the patient/physician relationship and what that should look like in clinical settings. Actions of compassion, actions of kindness beyond what is normally expected of clinicians offer a more intense level of response required to match the level of intensity of the illness. And I've admired Dr. Bernie Siegel for his books and speaking tours in which he articulated the a higher commitment to his patients and willingness to redefine the boundaries of the patient/clinician relationship so that kindness and compassion could be included. Dr. Siegel was roundly criticized by his peers initially. Over time, other brave physicians echoed his "passion for compassion," and added their voices to his. Dr. Siegel was an artist before becoming a surgeon, and he stated that this was a huge influence on his perspective. Dr. Patch Adams, another outcast of the medical community, has long been a prophet for a kinder, more compassionate relationship between patient and clinicians. An invitation should be extended to some of these great visionaries to join the Charter for Compassion community.
GENERAL RECOMMENATIONS FROM PARTICIPANTS AND STAFF
The Health Ministries Association (HMA) http://hmassoc.org/#
Health ministries include the many ministries of a faith community that promote wholistic health. Health is viewed as a gift from God and a way of relational living in community. These caring ministries are an essential part of congregational life. They incorporate the values, beliefs, and practices of a faith community as components in motivating persons toward health and wholeness. Health promotion and religious beliefs are integrated into the normal cycles of life – birth, wellness, development, maturation, illness, and death – to celebrate life; to enhance coping, wholeness, and a sense of peace; and improve community well-being. Intentional contextual practices of caring honor a faith community’s sense of mutual dependence and foster persons’ ability to both give and receive care.
The mission of the Health Ministries Association (HMA) is to encourage, support and empower leaders in the integration of faith and health in local communities. HMA includes faith community nurses, health ministers, program leaders, and spiritual leaders who have developed health ministries in diverse faith communities. They are available to assist you in your development of meaningful approaches to health, healing, and wholeness.
Compassion & Healthcare Conference - November 12, 2014, San Francisco, CA
The Compassion and Healthcare Conference is an innovative conference presented by the Center for Compassion and Altruism Research and Education (CCARE) in collaboration with Dignity Health, the 5th largest healthcare provider in the US that is dedicated to compassionate healthcare. This inaugural one-day conference will include talks by academic experts and healthcare industry leaders. The conference aims to address issues in healthcare such as compassion burnout, physician suicide, and more.
Empathy and Compassion in Society Youth Gather - November 12, 2014, San Francisco, CA
The Empathy and Compassion in Society Youth Gathering gathers students aged 14 to 18 from ten schools each year. Learn more.
Empathy and Compassion in Society Conference - November 13-14, San Francisco, CA
- The latest research on how compassion enhances our professional life
- Universal tools for cultivating empathy and compassion
- Case studies where these methods have been shown to be effective
Empathy and Compassion in Society aims to present universal and well researched methods for cultivating empathy and compassion, show how these methods can enhance one's personal and professional life, and share concrete examples of organisations and public institutions where these methods have been shown to be effective. Learn more.
Charter for Compassion International - November 15, 2014, San Francisco, CA
An all-day conference dedicated to the work of the Charter. Highlights will include new approaches to organizing and sustaining city initiatives, the unveiling of a new community building toolbox for city and partners, and keynote speakers focusing on compassion related to the Charters' sectors (business, education, environment, healthcare, peace, religion/spirituality/interfaith, science and research and the arts). Register for the day.
Compassion Games and Compassion Relays
The Charter for Compassion International and the Compassion Games International invite you to join the Compassion Relays!
The Relays are year-round and are a great way to engage everyone in compassion. They help mobilize compassion in individuals and throughout communities: in schools and youth groups, businesses, organizations, community groups, governmental entities, etc. The Relays generate energy and momentum leading up to the Compassion Games in September. When we take up the Compassion Torch, we agree to discover or do an act of compassion each day for a least a week, report on the Compassion Map, and pass the Torch on to someone else. After passing the Torch, we keep the flame of compassion in our own lives as a lifelong habit.
Anyone, any age, anywhere can participate in the Relays, now and year-round. The Relays activate each of us to seek, discover, and practice compassion in our daily lives. We share acts of compassion and pass on compassion person-to-person and group-to-group around the world.
**Use the Compassion Relays Torch logo to highlight and pass on news about the Relays to friends, family, and colleagues via social media and hand-to-hand.
Remember these 2 key links for the Compassion Relays!
Report your acts of compassion and your Relays experience via the Compassion Map: https://compassiongames.crowdmap.com/reports/submit.
Compassion Today! - A New, Free Mobile App
Lesa Walker, MD, MPH, a Charter Partner and Charter
Education Program Associate, has created the new, free "Compassion Today!" mobile app for iOS and Android devices: