Relieving emotional stress for health care providers
May 2, 2013
A patient in one of the many cancer support groups Dr. Jeff Kane has facilitated over the years observed that "buried feelings are always buried alive."
That's just one of the reasons Dr. Kane wanted to introduce Schwartz Center Rounds to doctors, nurses, and others who work with patients at Sierra Nevada Memorial Hospital, where he is director of psychosocial education at the Community Cancer Center.
He wanted to create a safe place where people working in the spiral of patient stress and suffering could allow their feelings to surface — and be at least acknowledged if not dealt with.
"Working with suffering causes you to suffer," Dr. Kane said of his colleagues in health care. "Holding that suffering inside is what accounts for why doctors have abysmally high rates of drug and alcohol abuse, divorce and suicide."
Ironically, physicians are trained to be dispassionate about their patients as a way to protect themselves from their constant exposure to pain, suffering and dying, Dr. Kane noted. But it does affect them.
"We're talking about people who went into medicine because they were compassionate altruists, who then were taught to become these dispassionate medical scientists," he said. "These people need to emote, and we're offering them a safe place to do that through the Schwartz Rounds program."
The Schwartz Center for Compassionate Healthcare is a national nonprofit organization whose mission is to strengthen and preserve the human connection that traditionally has been so important between caregivers and their patients. Some 300 hospitals across the country have adopted Schwartz Rounds, which provide a safe place where doctors, nurses and other health care professionals can talk about their own emotions and how they are affected by the suffering of others.
Anyone who has patient contact, including housekeepers, volunteers and maintenance staff, is invited to the Rounds, according to Dr. Kane. Staff from the Hospice of the Foothills has also been invited, he said.
Dr. Kane facilitates the Rounds along with Dr. Winni Loesch of Grass Valley. Both physicians have long been interested in what she called "the human component" of patient care.
"So much of medicine has become so technical, so dense, that the human component is not focused on enough," Dr. Loesch said. In her view, that human component is vital not only to the patient but to the professionals who provide their care.
"In the medical field, you're exposed to things that are not normal in life," she explained, pointing to the recent Boston bombings as an extreme example. "It can be emotionally challenging, and after dealing with patients and families in crisis, caregivers don't have much of a chance to download their own emotional distress."
Two Schwartz Rounds have been held so far at SNMH with four more planned during the year, Dr. Kane said.
At the Rounds, actual patient cases are discussed, although patient identities are never revealed. The caregivers talk about the emotional aspects of their treatment and how it affected them, after which audience members are invited to talk about their own experiences.
"You can't work around suffering all your life and not absorb it," Dr. Kane said. "But there is a taboo in the medical profession about expressing your emotions, and you hold it all inside at your own peril. We're trying to break that taboo. It's a gradual process, but if you can learn to let those feelings out in a safe environment, it's a gift that will keep on giving."
All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.