The cancer experience has become so pervasive—“If not you, then someone you love”—yet we can lose that caring thread in what is a very busy, high-stress context. Cancer treatment is complex and frustrating, not only for the patient but for those providing care. Possibly, the only constants are uncertainty and fear.
One interesting part of Norris’s letter is how to respond to patients’ requests like, “What would you do if it were you?” There has been a longstanding norm in clinical practice that we should avoid such questions or deflect the answer away from our personal experience. And yet Norris reveals that there is more to this question than advice: Patients seek our intimate connection to their experience as fellow human beings, rather than diagnoses or clinical solutions. At the most basic level, they want human understanding and someone to be with them on this journey.
It’s tempting to see ourselves as the “experts.” But because we don’t always have THE answer, doesn’t mean we can’t offer patience, information, and understanding to patients needing it rather than wave away the worry with an empty reassurance. As Norris realizes, if you don’t know, say you don’t know, and then offer as much as you do know. This admission of frailty can be humbling and unnerving. But in the end, whose comfort matters most?
The American Nursing Association Code of Ethics begins by pointing to our obligation to respect patients and to care for them with compassion, but what does this really mean? Norris’s insights suggest that we need to let patients guide us in what they need. For instance, are we so focused on treatment protocols and outcomes that we lose the human connection and leave patients feeling like a set of numbers on a whole row of clipboards? Or, are we focused on the patient experience and the human aspects of caring for individuals in crisis? There’s no question that the latter takes more time. But listening and truly connecting can ultimately save time and avoid misunderstanding.
Being respectful requires us to challenge assumptions we might make about what patients need or how much information they want about their illness and prognosis. We should ask them at the very beginning of our care relationship and proceed from there.
What we really need to learn is how to make compassion a foundation for every encounter. It starts with remembering the central purpose for doing this work and being able to stand in the shoes of those we serve—or at least try them on—with humility, openness, and kindness. As clinicians and educators, we strive to teach and model such compassion every day. Isn’t education itself intended to be a shortcut for what experience might teach us?
As for the “I’m sorry” letter, what matters here will be the rest of the story. How will Norris put her newfound understanding to work once (we believe and hope) she is well enough to resume nursing? In a recent blog post, she indicated that she has been doing well and missed few days of work.2 She will have been given the gift of empathy with the plight of her patients. The shoes fit. The steps she takes in them can be an inspiration and a guide to nurses everywhere.