Authors

  1. Falter, Elizabeth (Betty) MS, RN, NEA-BC

Article Content

See Me As a Person ... Creating Therapeutic Relationships With Patients and Their Families, Mary Koloroutis and Michael Trout, 2012. Minneapolis, MN: Creative Healthcare Management. Softcover, 431 pages, $39.95.

 

There is a popular phrase in the movie, Gerry McGuire, with Tom Cruise (Gerry) and Renee Zelweger (Dorothy): "You had me at hello." This book had me at its title: See Me as A Person. Newly insured people (some with preexisting conditions) are coming into the health system now. An aging baby boomer population is entering Medicare with its own set of medical issues. With a potential shortage of providers to care for these populations, an increasing use of technology in our care, and a fundamentally redesigned health care system, we may be on the precipice of assembly line medicine. As a boomer, I do not want to be in that line. I want to be seen. This book is timely and offers an approach that we can integrate into the care of patients.

 

The first step in any care relationship is in fact to acknowledge the person and his or her story. Among the tribes of northern Natal in South Africa, the most common greeting, equivalent to "hello" in English, is the expression Sawa Bona, which means "I see you." The response is Sikhona, which means: "I am here." The order of exchange is important: until you see me, I do not exist (Peter Senge, The Fifth Discipline Fieldbook, Random House, 1994).

 

In 2012, the authors of See Me As a Person take us beyond acknowledging the patient and delve more deeply into what is a therapeutic relationship and how to have one both professionally and personally. Further they show us how both the clinician and the patient benefit. The book has 7 chapters laden with case studies, examples, applications, and profound quotations that help the reader put the concepts in perspective, in their practice. The chapters are supplemented with an epilogue, 6 appendices, and references. The book is written for clinicians in all professions. It is not limited to Nursing but fits well into the practice of Nursing as most of us were taught. Even the experienced practitioner benefits from the reflection this book encourages. In fact, chapter 7 is devoted to Reflective Practice, the Means by Which Learning Becomes Permanent. Even the best of us can get caught up in tasks and forget why we are here or what motivated us to practice-the care of patients as the center of our care. This book is not just limited to patients. It can help with the multiple relationships in our professional and personal lives.

 

Their approach to a therapeutic relationship has 3 therapeutic practices that every caregiver can learn no matter his or her discipline: wondering, following, and holding (p. 3). Sound simple? In a sense, it is not difficult to understand, but in practice, it takes time to learn and thus the book. A full chapter with case studies and examples is devoted to each of the practices. The chapters are essential to understand the application and language of the practices. They are as follows:

 

Wondering (inquiry/questioning) refers to clinicians having a mind open to wonder, one ready to learn about, and even be surprised by, the person before you. (Chapter 3, pp. 93-124)

 

Following (listening) calls for a tuned ear, mind, and heart. (Chapter 4, pp. 129-168)

 

Holding the patient and his family is to devote yourself to creating a safe haven for them. It means to watch over them to ensure that they don't have to contend with procedures for which they have not been adequately prepared or be subject to the use of unflattering labeling by your peers. (Chapter 5, pp. 175-227)

 

The authors reference relationship and people experts throughout the book. Early in the book, they reference The Schwartz Center for Compassionate Healthcare (2012). The center's research showed that effective patient-caregiver communication and relationships are associated with measureable outcomes of enhanced patient satisfaction, informed, shared decision making, increased adherence to recommended treatments, improved health outcomes, and reduced malpractice claims (p. 15). Another, like Stephen Covey (Seven Habits of Highly Effective People), is already familiar to us. How many of you recall Covey's Seek First to Understand, Then to be Understood? If we could only learn to listen, that would be a great first step.

 

Anticipating that many of the readers will exclaim, "But I don't have the time," and other obstacles to this kind of practice, the authors devote chapter 6 in its entirety to obstacles. For the time obstacle, the authors share Five Minutes at the Bedside-One Small Investment in Human Connection That Yields More Time Than It Takes. They teach the importance of taking approximately 5 minutes seated at the eye level with each patient, connecting with what is important to this specific person, and partnering with him or her on the best plan for the day or until you are with him next (p. 276). They take us through solutions to other obstacles such as chaotic care environments, patient and family anger, the judging mind, and compassion fatigue.

 

This book is not a short read. My desk copy is full of highlight and page markers. The content is evidence-based and thought-provoking while being written in a friendly style. It is a book that becomes its own workbook. It may not be the only book of its kind, but next time you realize you need that human connection with your patients, you will want one in a convenient place to grab at the end of the day, particularly the tough ones.

 

-Elizabeth (Betty) Falter, RN, MS, NEA-BC