Elsevier

Nurse Education Today

Volume 30, Issue 8, November 2010, Pages 752-755
Nurse Education Today

Empathy and nurse education

https://doi.org/10.1016/j.nedt.2010.01.018Get rights and content

Summary

It is widely accepted that the ability of nurses to empathise with their patients is a desirable quality. There is however little discussion of the implications of this for nurse educators. This article reviews the nursing and counselling literature related to empathy. We begin with an exploration of different perspectives of empathy; from its behavioural and measurable characteristics to its less tangible, intuitive qualities. By drawing upon both policy and research, it is clear that patients want empathic and emotionally competent nurses. Nurse educators therefore have a responsibility to provide an education that engenders empathic understanding. We explore the implications of these findings for nurse education, identifying key areas for consideration in the preparation of emotionally skilled, empathic student nurses.

Introduction

The capacity to empathise may be described as the ability to supportively communicate a sensitive awareness and affirmation of another person's feelings and the unique meanings attached to them (Mearns and Thorne, 2007). It is asserted that empathy facilitates development of mutual trust and shared understandings and in doing so is a fundamental quality in any helping relationship. In the nursing literature empathy has become widely seen as an essential condition of effective nursing care and at the heart of a therapeutic nurse/patient relationship (Alligood, 1992, Herdman, 2004, Kalisch, 1973, Kunyk and Olson, 2001, Maatta, 2006, Peplau, 1952). In the medical literature Larson and Yao (2005) corroborate this by recognising the centrality of empathy in the development of a therapeutic relationship between patient and physician. They develop this further to state that a therapeutic relationship is an integral part of healing.

However, despite the frequent appearance of empathy in the nursing literature, patient's perceptions suggest that it is often lacking in the relationships offered to them by nursing staff (Kunyk and Olson, 2001, Reynolds and Scott, 2000). Research into empathy is complicated by the various conceptualisations of it, and its meaning in the nursing context is not universally agreed (Kirk, 2007, Lemonidou et al., 2004). Empathy is a contested and complex concept to understand, experience, practice and teach.

If they choose to do so, nurse educators are able to model empathy to their students. In the therapeutic relationship, this is often referred to in the context of Rogers' core conditions (Rogers, 1967, Rogers, 1983). Students are studying to become nurses and they in turn will be required to foster helping relationships with their patients. Empathy therefore has relevance to educators in the influence they have as a role-model to foster positive attitudes and behaviours in student nurses that may ultimately impact upon patient care. The concept of empathy is firmly embedded in nursing discourse; for example “empathy” as a keyword typed into CINAHL produces 2719 results. The concept has not however been the focus of any article in Nurse Education Today since 1999 (Cutcliffe and Cassedy, 1999).

This inquiry reviews contemporary and classical literature from both nursing and counselling sources. The aim is to explore the concept and meaning of empathy in terms of both definition and significance to nurse education and practice.

Section snippets

Beginning with Carl Rogers

The meaning and significance of empathy has been frequently debated since the seminal work of Carl Rogers on core conditions to facilitate therapeutic relationships (Rogers, 1967). It seems appropriate therefore, to begin the literature review with some insights into his thinking. Rogers described empathy as an ability to communicate a sensing of the client's feelings as though they are the therapist's own, but without becoming bound up by them and losing a sense of self. A defining quality is

Implications for nurse education

An analysis of pre-registration programmes in England in 2000 (Randle et al., 2003) found widespread inconsistencies in the approach towards, and emphasis upon teaching communication skills. The requirement to address this is now formalised by the recent implementation of Essential Skills Clusters (Nursing Midwifery Council, 2007). These include specific expectations of proficiency in the provision of “empathy-based care” with educational institutions required to develop their own strategies to

Practical difficulties within nurse education

Herdman (2004) identifies the move of nursing from hospital-based training to Higher Education as leading to greater value placed upon intellectual focus and skill acquisition to the detriment of caring. At the same time the professionalisation of nursing in an attempt to gain status has reduced the value of caring (Fletcher 2000 p 1083 in Herdman, 2004). Correspondingly Larson and Yao (2005) identify the low emphasis on compassion and emotional aspects of care in medical education. Another

Conclusion

Although empathy is widely accepted and expected to be a central component of the nurse-patient relationship, patient's perceptions are that it is frequently lacking. Drawing upon nursing and counselling literature, this article has explored the concept and different meanings of empathy and as a result of this inquiry, we conclude that the meaning of empathy that is most relevant to nursing practice, relates to the significance of the quality of the presence that a nurse may bring to the

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