Since early 2020, the nursing profession has served on the front lines of the fight against COVID-19, including treating the fear, despair, sickness, death, socioeconomic distress, and so much more that none of us expected, but that we as nurses always knew we could handle for patients of all ages, genders, colors, religions, and ethnicities. We know stress like this leads to discontent, but what about kindness?
What role does kindness play in our post-2020 nursing profession? Is kindness a value or an individual trait? Or is kindness a responsibility that all patients deserve, including those patients who may not necessarily appreciate us?
In this nurse's opinion, kindness plays a role throughout the nurse-patient relationship. Unlike the complex clinical skill set needed to perform a large range of duties such as injections, suture removals, dressing changes, COVID-19 testing, and so on, I've found that kindness consists of four essential but simple components, or really, ingredients: 1) compassion, 2) advocacy, 3) confidence, and 4) empathy (CACE). Much like a cake that doesn't rise or tastes bad if it's missing any ingredients, successful patient care requires all the CACE ingredients.
Yes, we already possess the skills to treat our patients' health conditions. However, our patients often present in vulnerable, scary, and anxiety-ridden situations that call for all four ingredients of CACE. Think of the scared parents of a child who enters the ED, the patient arriving for their first cancer treatment, or the family member seeking an update about their loved one. In each of those situations, our patients benefit most when we utilize our CACE ingredients as follows: show Compassion for their physical and mental health needs; Advocate for their care; instill Confidence that we have our patients' backs (figuratively, and sometimes, literally); and relate with Empathy to what each of our patients present to us.
For example, I met with a patient for a consultation to teach how to self-inject hormonal therapy. I acted with compassion when I observed scarring to the injection sites caused by not rotating those sites on a weekly basis. Recognizing that the patient was needle phobic, I advocated for him to trust that I could teach him how to properly self-inject and remained confident that, with my guidance, he would learn to better perform self-injection, including rotating the injection sites. The teaching process required empathy because of the patient's ongoing fear to self-inject. As an outcome, the patient successfully learned a proper way to self-inject.
Since the pandemic, dispensing kindness to our patients has become more essential than ever as they look to us for support. Our kindness can reassure them that we'll care for their health and also provide them with the four ingredients of kindness.
And what about us? Who's kind to us nurses who have continued on the front lines of a pandemic for over 2 years, often with minimal breaks and too few "thank yous"?
Here, I recall Florence Nightingale, one of our profession's most famous nurses, who selflessly cared for hundreds of British soldiers in 1854 together with a team of nurses she assembled during the Crimean War. Nicknamed "the lady with the lamp" and "the Angel of Crimea," Nightingale's efforts reduced the death rate by two-thirds in the British hospital in Constantinople where she and her team worked.1
Our efforts, too, have saved countless lives during the COVID-19 era, and many among us have also performed our duties as angels for our patients and their families.
So, even when patients don't treat us fairly or properly thank us, I encourage the members of our profession to follow in the footsteps of Florence Nightingale and remind ourselves that our patients come to us often vulnerable, scared, and deserving of those four CACE ingredients for kindness.
As Mother Teresa teaches us, "Kind words can be short and easy to speak, but their echoes are truly endless."2
Personally, I'll never forget the following comment from one of my patients: "Thank you for letting me be me. Thank you for not judging me and allowing me to be myself." That experience made me realize that patients present themselves to us in physically and mentally difficult conditions, and they deserve to be treated with kindness and dignity.
In making this case for kindness, please consider the following: We all have the ability to be kind from the day we're born. As we grow, we develop kindness by experience. If we can feel and know the gift of kindness in our own lives, then we can continue providing our patients with the ingredients of compassion, advocacy, confidence, and empathy during these challenging times and beyond.
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