https://www.infirmiere-canadienne.com/blogs/ic-contenu/2024/11/04/introspection-fournir-soins-empathiques
A deep and genuine understanding of ourselves can be a foundation for effective nursing practice
By Olivia Noone
November 4, 2024
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The ability to engage in introspection contributes to what is generally viewed as one of the ideal qualities of nurses — the unique harmony between professionalism and humanitarianism.
In nursing, it is essential to remember that we are still subject to the same continuum of human emotion, vulnerability and suffering as our patients. For this reason, our awareness of and connection to our sense of self and humanity are imperative in this multifaceted and immensely rewarding field of work. Without these skills, we grow morally weak in our ability to embody the principles of therapeutic care to interact with our patients effectively.
Courtesy of Olivia Noone
“When I learned to approach scenarios from a preventive and public health perspective, it was liberating. By combining this approach with introspection, I was better able to understand myself and adopt a more empathetic view,” Olivia Noone says.
This article delves into relational practice and empathy with the goal of highlighting their importance in health care. I hope to demonstrate the importance of self-improvement and the necessity of having a deep and genuine understanding of ourselves as a foundation for effective nursing practice. I focus on introspection because it strengthens patient-provider boundaries and contributes to better clinical outcomes, safer workplaces, and enhanced social justice via an equitable distribution of power.
What is introspection?
Introspection is described as a skill of “self-observation and and a reporting of conscious inner thoughts, desires, and sensations. It is a conscious and purposeful process that relies on thinking, reasoning and an examination of one’s own thoughts and feelings” (Andersen & Dybbroe, 2017, p. 22). In other words, this intuitive activity provides practitioners with an avenue of reflective practice that promotes self-awareness.
The ability to engage in introspection contributes to what is generally viewed as one of the ideal qualities of nurses — the unique harmony between professionalism and humanitarianism. This quality underpins the foundation and integrity of a health-care system that is accessible to all, reinforcing the need for advocacy to better serve patients.
Putting introspection to work
Despite the many benefits of introspection, it has often uncomfortably placed health-care workers in tumultuous waters where they struggle to navigate how to best advocate for the patient’s health and well-being, especially when it is seemingly disharmonious with their life choices. In these moments, we must self-reflect and maintain alignment with our own beliefs and desires while also realistically meeting the patient where they are in their health journey.
For example, I once had a patient who was hospitalized after spinal surgery, having already been bedridden for nine months by other comorbidities. When I asked her what her goals for the day were, she longingly whispered to go home. Unfortunately, she was in no state for this, and although I could not single-handedly change her physique, I instantly connected to her desire to be in a comfortable, familiar space at a time of perceived instability and distress. With this discernment, I was able to honour how she felt and affirm that our goal for the day could be to work toward greater independence as a step to meet her eventual goal of being able to leave the hospital. This brought a smile to her face, and I could feel that she immensely appreciated a solution that held space for her own values. She felt trust in my initiation of therapeutic care.
This example illustrates how introspection can enhance one’s empathy, which in turn improves therapeutic communication and motivational interviewing. This approach ensured that I was able to connect with my own experiences and feelings to provide an answer that satisfied her underlying needs. In contrast, the next day, I witnessed an interaction between the physician and the same patient. He was truthfully explaining, in a blunt manner, that there was no possibility of going home, and her demeanour instantly changed to one of withdrawal. This is a prime example of how the manner in which we interact with patients can change clinical outcomes and can either leave a patient motivated and active in their care or not on board at all.
How communication can advance social justice
The practical applications of therapeutic communication techniques are endless, extending even beyond the realm of nursing and into the domain of social justice. Most of these relational techniques can be found in employer-provided professional development resources to better enhance our fluency and confidence in implementing them into our practice areas. For instance, through a regional health authority, I found a course on how to navigate difficult conversations with intrinsic sensitivity and precision (Island Health, n.d.). The concise nature of the course helped streamline theory into practical clinical usage and offered a perspective for writing this article.
Within my own sense of self, both personally and clinically, I firmly subscribe to and embody the belief of an upstream approach to obtaining health through multidimensional education. I urge readers to consider fully adopting such an approach, as it will challenge you as a health-care practitioner to delve into career development and ongoing education with the purpose of understanding how pathological trends and variations fit into a picture of wider-world issues and conflict, which is no easy feat. Envisioning health as attributable to the compounding dimensions of social identity and environmental influences upholds a principled understanding of intersectionality.
The role of preventive measures
Understanding the root of ill health and making amends early in the process promote community health on a much broader level, thereby challenging cause and effect to maximize societal advantage.
This is imperative, but in my belief, commonly overlooked.
This oversight illustrates how society is quick to find solutions counterintuitively that, although often well intentioned, prove to be futile in the grand scheme when viewed more critically. To demonstrate, a nurse can lecture on the importance of glycemic control for diabetes, but without access to the necessary medical equipment, the patient has no way of making this happen.
When I learned to approach scenarios from a preventive and public health perspective, it was liberating. By combining this approach with introspection, I was better able to understand myself and adopt a more empathetic view. This epiphany of a professional worldview validated a long-held individual thought process that felt otherwise incomprehensible to explain after being perceived as merely a complexity by others for far too long. We are all, in essence, the result of compounding dynamics within our systems, environments and opportunities. With this knowledge, we can spark social change that encourages the inclusion of all voices, integrating how social justice promotes equity in population health (Fawcett, 2019). Thus, nurses do have an ethical obligation to embrace this approach as part of our routine practice as patient advocates.
At the same time, however, we must never forget to check in with ourselves and create boundaries that distinguish our struggles as separate from the lives of our patients and be mindful of when a situation is beyond our ability and starts to cause triggers within ourselves. This is a sign that we urgently need to seek external team support to ensure that the patient’s needs are going to be met while still establishing self-compassion (Maté & Maté, 2022).
Conclusion
This reflection demonstrated the necessity of introspection among competent nurses in all settings as a measure of maintaining patient-provider boundaries for better clinical outcomes and safe workplace practices. Introspection embodies the principles of social justice by placing our humanity on equal standing with that of our patients and subsequently equalizing the distribution of power. This starts by empathetic caregivers initiating and preserving a therapeutic relationship that conveys support for and understanding of differences.
References
Andersen, L. L., & Dybbroe, B. (2017). Introspection as intra-professionalism in social and health care. Journal of Social Work Practice, 31(1), 21–35. https://doi.org/10.1080/02650533.2016.1142952
Fawcett, J. (2019). Thoughts about social justice. Nursing Science Quarterly, 32(3), 250–253. doi:10.1177/0894318419845385
Island Health. (n.d.). Essential conversations: Sensitive questions and messages in health care. [Online learning module]. Retrieved from https://learninghub.phsa.ca/Courses/29201
Maté, G., & Maté, D. (2022). The myth of normal: Trauma, illness & healing in a toxic culture. Avery.
Olivia Noone is a nursing student from Victoria, B.C., who is passionate about global health promotion and enhancing patient-provider dynamics. Her advocacy stems from both diverse clinical experiences and personal diagnostic health challenges.
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