|Providing Emotional Support Should Be Part of Hospital’s Mission|
By Barry J. Jacobs, PsyD
Crozer-Keystone Family Medicine Residency Program
Patients, family members, and health care professionals can benefit from efforts to help them deal with emotional challenges related to health care delivery in hospital settings. Targeted interventions are especially important after unexpected negative events. As a clinical psychologist who specializes in working with patients and families coping with serious and chronic medical illnesses, and who educates family medicine residents about providing compassionate care, I know that there are major unmet needs in this area. By establishing programs to help people recover emotionally after such events, hospitals can achieve gains in patient satisfaction and in staff retention.
The experience of being hospitalized, or having a family member in the hospital with a life-threatening condition, often triggers anxiety, grief, dread, and other intense emotional responses. Although hospital social workers, pastoral counselors, nurses, and physicians have always tried to support emotionally overwhelmed patients and family members, the program at St. Joseph Mercy Hospital emergency department is a more comprehensive effort than any I’ve previously seen. In general, medical centers do not have a hospital-wide approach that specifically trains staff to respond more effectively to emotional stress and trauma.
Providing such support should be seen as part of a hospital’s mission to cure disease and reduce suffering. Everyone involved in providing care has some responsibility to help address the emotional concerns of patients and family members. That’s why I’m impressed by the team-based support program at St. Joseph Mercy Hospital, which offers a model for better meeting the emotional needs of hospitalized patients and their families. At the Crozer-Keystone Health System where I work in Delaware County, PA, we recently set up a committee to find ways of better supporting patients’ family members who have been traumatized by negative medical events involving their loved ones. I hope to bring the innovations of St. Joseph Mercy Hospital to our committee.
The key innovation at St. Joseph Mercy Hospital is that formal avenues have been created for patients and family members to directly communicate their emotional concerns—sometimes weeks or months after a negative medical event—to hospital clinicians and administrators. The program also sanctions the idea that health care professionals should listen to patients and family members in distress. A hospital that accepts responsibility for bad outcomes, and offers monetary compensation when warranted, can reduce liability costs in the long run, because family members feel empowered to rectify the tragic situation without having to resort to taking legal action.
Most medical centers do an inadequate job helping their staff members better cope with their own emotional responses to patient care, especially during high-stakes, life-or-death situations such as resuscitation codes. When there are no formal programs for providing emotional support, staff members often conclude that they are expected to suppress their work-related feelings. This is demoralizing for many hospital clinicians, and it leaves staff members feeling more emotionally stressed. As a result, staff members are more likely to numb themselves and become emotionally withdrawn from the patients they’re treating.
In contrast, the University of Missouri Health Care program focuses explicitly on clinicians’ emotional responses to stressful or negative medical events. The program has similar aims, but different means, as staff support programs at other medical centers, including Schwartz Center Rounds (which provide a large group forum for staff to discuss emotional reactions to patient care) and Balint groups (where primary care physicians discuss their feelings about difficult interactions with patients and family members).
The Missouri program explicitly acknowledges that clinicians may experience vicarious traumatization that can undermine job satisfaction and performance, possibly leading to burnout. The program’s three-tiered approach makes a lot of sense by providing a system that enables hospital staff to help anyone who has had a difficult experience. Staff members are likely to benefit from knowing that their colleagues are concerned. Just making an effort to respond with empathy can make a big difference.
Both of these innovative programs have great potential, but unfortunately I don’t see many health care systems adopting such approaches. Wider adoption of such innovations will hinge on having enlightened administrators who recognize that investing in such programs will serve the long-term financial interests of their health care systems by decreasing liability lawsuits and increasing staff retention.
About the Author:
Barry J. Jacobs, PsyD, a clinical psychologist and family therapist specializing in helping families cope with serious and chronic medical illnesses, is Director of Behavioral Sciences for the Crozer-Keystone Family Medicine Residency Program, Springfield, PA. He is the author of The Emotional Survival Guide for Caregivers—Looking After Yourself and Your Family While Helping an Aging Parent (Guilford, 2006).
Disclosure Statement: Dr. Jacobs reported having no financial interests or business/professional affiliations relevant to the work described in this commentary.
Original publication: June 20, 2012.
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Last updated: October 09, 2013.
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Date verified by innovator: May 23, 2013.
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