Health care regulatory agencies demand that patients receive efficient, competent, compassionate care; however, because of caregivers' own unhealed issues along with other factors, care often falls short of those goals. Melanie Sears, RN, MBA, PhD, leverages more than thirty years of nursing experience to look at what really prevents patients from getting the care they need and health care workers from getting the support needed to thrive in the stressful environment of health care. From domination-style management, fear and judgment-based practitioner relationships, and a poignant separation between physical, mental, and emotional care, the costs of these factors are enormous. Sears argues that the most effective way to evolve this problematic culture is to shift the language used by those providing care.
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Melanie Sears, RN, MBA, PhD, has been a CNVC certified trainer since 1991. She works with businesses, hospitals, nursing homes, hospices, individuals, couples, and parents in transforming communication and interactions to ones that are more compassionate, conscious, and effective. Melanie presents Nonviolent Communication at conventions, at universities, and at churches. She has been interviewed on the radio and on television, and is the author of several titles, including the workbook Choose Your Words: Harnessing the Power of Compassionate Communication to Heal and Connect available at www.dnadialogues.com. Her presentations have been described as exciting, inspiring, educational, and transformative. Melanie says, “Everything is about communications. Any problem can be resolved within minutes when negative energy is transformed into caring connections.” Melanie has worked in most areas of health care as a Registered Nurse (RN), administrator, and supervisor for more than twenty-five years. She has observed common communication themes in each area she experienced. These themes adversely affected both patient and staff satisfaction, which resulted in increased operating costs, increased staff turnover, increased sick leave, and, in general, poor teamwork and lack of harmony. Melanie discovered that by shifting the communication patterns used, everything else shifted to create more positive outcomes for staff, patients, and administration. Melanie lives in a cohousing community in Seattle, Washington, close to her granddaughter. She retired from nursing in 2016 and now enjoys her days doing whatever she wants.
Preface,
Acknowledgements,
Chapter 1. A Crisis in Health Care,
Chapter 2. Understanding Nonviolent Communication,
Chapter 3. From Domination to Partnership: The Evolution of Health Care Systems,
Chapter 4. The Languages of Diagnosis, Judgment, Analysis, and Labeling,
Chapter 5. From "Power Over" to "Power With": The Case of Psychiatric Medicine,
Chapter 6. Compassion, Empathy, and Honesty: A Road Map for Creating Life-serving Systems of Care,
Index,
The Four-Part Nonviolent Communication Process,
Some Basic Feelings and Needs We All Have,
About PuddleDancer Press,
Trade Books from PuddleDancer Press,
About the Authors,
A Crisis in Health Care
By many indications, all is not well in the emotional lives of health care workers. Studies show that the suicide rate for male doctors is about 1.4 times the general population, and female doctors commit suicide more than twice as often as women in the general population. Health care practitioners and technicians have a depression rate of 9.6 percent per year. This is 2.6 percent higher than the average for full-time workers. Why are doctors and health care workers so unhappy?
A 1996 Lancet study indicated that doctors and other health care workers commonly struggle with emotional exhaustion, depersonalization (treating people in an impersonal, unfeeling way), low estimation of personal accomplishment, work overload, and poor management and resources. Dealing with the suffering of patients and their distressed, angry, or blaming relatives on a daily basis is extremely taxing.
The doctors in the Lancet study reported their primary sources of job satisfaction were good relationships with patients, relatives, and staff, and having professional status and esteem. They said being understood by management contributed to their happiness, as did enjoying a high degree of autonomy, and performing a variety of tasks.
Significantly, only 45 percent of the doctors in the study thought they had received adequate training in communication skills, while all believed they had received adequate training in the treatment of disease and management of symptoms. As the report reaffirms, "The mental health of (doctors) may nevertheless be protected by maintaining or enhancing their job satisfaction ... through giving them autonomy and variety in their work, as well as providing effective training in communication and management skills."
It seems that at least some of the missing pieces in the wellness of health care professionals relate to the personal, human dimensions of their work rather than the technical dimensions: less than half feel adequately prepared to communicate effectively with others, which means less than half feel skilled at connecting in meaningful and effective ways with the people around them. Doctors are also terrified of giving empathy to a patient for fear that it will take too much time. That absence of meaningful connection is surely a contributor to the kind of alienation and depression that underlies the grim suicide statistics.
Health care institutions also feel the costs of these missing pieces. Low job satisfaction and high turnover are extraordinarily costly for hospitals, which shoulder an average cost of $60,000 for every employee turnover. No wonder many hospitals are looking for ways to increase retent
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