Embracing Our Vulnerability

This entry is part 2 of 2 in the series Elephant in the Room: The Role of Shame in HIT Resistance

In the same way healthcare systems demonstrate increasingly rapid evolution, we’ve seen similar impressive changes in HIT. Twenty years ago, few had even heard of an EHR. Today you would be hard pressed to find a healthcare worker who has never heard the term. Yet technology change of any magnitude is tremendously disruptive – to society, organizations and individuals. We have many theories and models to predict and address the range of human reaction to change like an EHR implementation, including applying Kubler-Ross’ model of death and dying (denial, anger, grief, bargaining, acceptance). 1 We suggest considering adding Brown’s model of vulnerability and shame to our thinking.

But how, exactly?  Brown suggested that vulnerability is courage, and the birthplace of innovation, creativity and change – all critical in our current environment of rapid change and an uncertain future. Brown further identifies an antidote for this vulnerability and shame barrier that we can apply to healthcare as well, and that is empathy.

Empathy and sympathy are commonly confused. Sympathy is the feeling of pity and sorrow for someone else’s misfortune. Empathy is appreciating and sharing another’s feelings (having shared the same, or a similar, experience). The distinction is critical. Sympathy requires minimal emotional investment. Empathy requires making visible your own vulnerability. Brown notes, “Empathy is about being present and wholly engaged without your protective armor” and “Empathy fuels connection.”

Theresa Wiseman, a nursing scholar, proposed four qualities required to demonstrate empathy: perspective taking, staying out of judgment, recognizing emotion in other people, and communicating it. 2 In short, feeling with people not feeling for people.

What do we know about empathy in healthcare organizations? Again most of the research focuses on clinicians, and specifically on empathy’s value in the provider-patient relationship. A 2010 study reported in the International Journal of Medical Education found that “empirical evidence…confirmed significant links [between physician empathy] and patients’ satisfaction with their physicians, interpersonal trust, and compliance with physicians’ recommendations.” 3

So empathy between physicians and patients is present and beneficial – but what about empathy for fellow caregivers and all other people who work in healthcare organizations? Is it possible that one reason HIT projects fail is the absence of empathy for each other? We believe that the industry attracts empathic physicians and nurses who often receive additional empathy training.  We maintain that healthcare organizations must expand empathy training to its entire workforce. Embracing the courage of vulnerability by fostering empathy for and between caregivers may reduce resistance to HIT.  If we expect to realize the changes embodied in HIT, we must require that the healthcare workforce overcome shame and embrace courage.

If we consider shame a deep and widespread barrier in our healthcare organizations, experienced by nearly everyone, not openly acknowledged or addressed, and we consider vulnerability as strength and therefore key to innovation, creativity and change, then and only then will we see our industry transform. Therefore, it is imperative that we find ways to enable and encourage our people to embrace vulnerability.

Empathy training must be more than just another burden on a severely strained industry. It must integrate into ongoing quality improvement, making it a byproduct of healthcare. Overcoming shame, embracing courage, and including empathy in quality improvement shifts our focus to what matters most: our patients and the HIT projects that benefit them while keeping our healthcare organizations from heading back to Abilene.

  1.  Kübler-Ross model. (2014, August 24). In Wikipedia, The Free Encyclopedia. Retrieved 16:20, September 3, 2014, from http://en.wikipedia.org/w/index.php?title=K%C3%BCbler-Ross_model&oldid=622593087
  2.  Wiseman, T. (1996), A concept analysis of empathy. Journal of Advanced Nursing, 23: 1162–1167. doi: 10.1046/j.1365-2648.1996.12213.x
  3. Hojat, M., Louis, D., Maxwell, K., Markham, F.,  Wender, R., Gonnella, J. (2010). Patient perceptions of physician empathy, satisifaction with physician, interpersonal trust, and compliance. International Journal of Medical Education, 2010, Vol. 1, pp. 83-87. Retrieved from URL: www.ijme.net/archive/1/patient-perceptions-of-physical-empathy.pdf
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Posted on October 7th, 2014 in Innovating Health Care IT
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