Oct 01, 2011
By Pat Sealy, RN, PhD

The power of empathy

We often see patients at the height of their pain and distress, but how ready are we to respond if they unexpectedly share their innermost fears and vulnerabilities? In my nursing career, I have always tried to respond to these moments with empathy, and I have tried to empower nursing students to be prepared to do so as well, in the hope it might make a difference in the lives of patients. It was not until I feared for my life and received true empathy from a nurse that I really understood the power of such moments.

I have survived many major and minor crises in my life, but none has been as big a challenge as my journey to survive locally advanced breast cancer. My cancer was not caught early. For eight months during 2008, doctors thought I had chronic mastitis because the mammogram and ultrasound tests were negative. The shock of the diagnosis was overwhelming. The treatment was aggressive: six months of chemotherapy, a double mastectomy and 30 radiation treatments.

With each dose of chemotherapy I became progressively weaker, while my fears and anxieties grew, fuelled by unresolved grief over the premature death of my mother when I was five years old. I was terrified that history was going to repeat itself, that I would die and would abandon my spouse, Kevin, and my daughters, Eliza, 13, and Leonie, 9. I felt powerless and as though my life was being sucked away. It was a physical, emotional and spiritual crisis.

This is the story of how one empathetic nurse helped me find my way back. It began one week after my outpatient double mastectomy, when sepsis forced me to go to the emergency department. As a former intensive care nurse, I knew I was seriously ill as a result of being immunocompromised from the chemotherapy and weakened from a post-surgical bleed. I was terrified the sepsis would kill me. My husband went home that night to our frightened children, and I was left alone. Although I told the nurses how fearful I was, they offered me no comfort. I felt ignored and that my fears were being minimized. From my stretcher across from the nurses’ station, I listened to them flirt with the doctors, exchange recipes and vent their frustrations and pet peeves while I lay awake all night, anxious and afraid.

I met the nurse who made such a difference in my life the next morning, in an inpatient ward. As I painfully struggled into bed, I started to sob. Even though it was shift change, the nurse pulled up a chair when she saw that I was distraught and asked me how I was. Her relaxed posture and compassionate facial expression told me she was open to listening. I responded by pouring out the fear, anxiety and frustration that had built up during my treatment but also in the 50 years I’d grieved the loss of my mother. I told her how afraid I was of dying and of leaving my daughters abandoned, as I had been, and about my inability to care for myself and my family. She listened attentively to my outpouring of emotion, without interrupting or peppering me with questions. I am sure that she had other tasks she needed to do, but she made me feel like I was the only person she was taking care of that morning. I forget her exact words, but she conveyed the sense of deep caring for my welfare. She was with me for probably only 10 minutes, but, in that short period of time, I felt an affirmation of my suffering and was able to find the strength to want to live. She had rescued me from an abyss, and I fell into a deep healing sleep.

I am telling my story because I think nurses can sometimes get caught up in functional tasks and social diversions and completely miss the emotional suffering of patients, as was my experience in the emergency department. A perfectly changed wound dressing does not give the patient the will to live or the energy to cope with day-to-day living.

Empathy cannot be demanded of us, and I am not even sure it can be requested. The power of a nurse’s empathetic presence is its ability to open a door that encourages patients to share the burden of their fears and anxieties. Affirmations of suffering can lead patients to a sense of empowerment with greater strength and determination to face an uncertain future. I am certain that my nurse knew she helped me in the moment, but she would not know the impact that her empathy had on me as a nurse, researcher, sociologist, wife, mother, friend and spiritual person. I believe those 10 minutes of her time truly changed the course of my life.

Pat Sealy, RN, PhD, is the Clinical Learning Specialist in the Faculty of Nursing at the University of Windsor, Windsor, Ont. She is also the author of A Family's Resurrection from Breast Cancer.
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