Daniel E Epner

Empathy: Real Stories to Inspire and Enlighten Busy Clinicians

• Broschiertes Buch

Produktbeschreibung

The complete guide to handling emotionally charged patient conversations with the empathy vulnerable people deserve The Clinician's Guide to Empathy helps you approach tough conversations with patients in a new, more effective way-by understanding and recognizing their emotion and perspective, and then communicating that recognition clearly and without fear. The authors define empathy on an operational level-rather than a theoretical, scientific, or conceptual level-and provide the actionable advice you need to make empathy the central focus when faced with denial, questions about prognosis, existential concerns, difficult family dynamics, anger, and nonmedical opiate use. Each chapter, authored by an experienced expert in their field, is anchored by a story that clearly illustrated how empathy can unfold in the clinical setting. Vignettes throughout provide sample dialogue and specific examples of actual words to use in specific situations. Trained to solve problems, clinicians often have difficulty expressing empathy to their patients. This guide provides a new way of approaching that problem-not as a technician but as a fellow human being. Much more than a guide to breaking bad news or a brief overview of all communication skills, The Clinician's Guide to Empathy is a must-read for almost anyone connected to the healthcare industry.

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Produktdetails

• Verlag: McGraw Hill LLC
• Seitenzahl: 304
• Erscheinungstermin: 8. April 2022
• Englisch
• Abmessung: 221mm x 150mm x 15mm
• Gewicht: 363g
• ISBN-13: 9781260473414
• ISBN-10: 1260473414
• Artikelnr.: 62314734

Autorenporträt

Daniel E. Epner, MD, is a professor in the Department of Palliative, Rehabilitation and Integrative Medicine at the University of Texas MD Anderson Cancer Center.

Inhaltsangabe

Contents
Introduction: A Case for Empathy
The introduction begins with a story of a young mother whose cancer has
become resistant to treatment. The story leads to her impossible question
to her physicians, "I can't die, who will take care of my children?" This
narrative stimulates the reader to reflecton the benefits of responding
with empathy and the hazards of instead offering a factual response in an
attempt to fix the unfixable.
Section 1: Weaving Empathy into the Fabric of Every Clinic Encounter
Section 1 outlines the philosophy of the text: empathy is not just
something you do when things go wrong, but rather something we do every day
no matter the circumstances.
Chapter1: A history of empathy in patient care.
Chapter 1 considers the changes that have occurred in medicine after the
Flexner Report was published in 1910. Prior to the Flexner Report, empathy
was the most powerful tool available to the clinician. Similarly, in the
modern world when we reach a point when focusing on a specific disease,
like end-stage cancer or cystic fibrosis, is no longer helpful, empathy is
the most powerful medicine. Unfortunately, under such circumstances we all
too often continue to focus on disease to the detriment of the patient.
Chapter 2: Learning any skill takes practice, like playing tennis
It's easy to grasp what empathy is on a conceptual level: standing in the
other person's shoes or imagining how another person is feeling or
thinking. However, practicing empathy in the clinic takes much more than
conceptual understanding. Just as winning the Wimbledon tennis tournament
takes much more than viewing an instructional video about forehands,
backhands, and overhead serves, empathy requires coaching and practice.
Mirroring the coaches' modelling of an effective forehand, all the way from
backswing to follow-through, the extensive dialogue in the Clinician's
Guide to Empathy provides a model of empathy that every student can embrace
and refine.
Chapter 3: Speaking to people like people rather than as patients: How
empathy looks and sounds.
Chapter 3 illustrates that empathy is not only a concept meant to be
understood on the conceptual, physiological, or neuroanatomic level, but
should also be embraced on the practical and operational level. Empathy is
something that great clinicians weave into every conversation, not just
classically difficult ones. We present an assortment of case vignettes
written by expert clinicians depicting "typical" patient encounters that
would not ordinarily be considered challenging, and demonstrate how to
weave empathy into such conversations by speaking to patients like people
rather than as patients. People enjoy knitting, bull riding, painting, and
riding pontoon boats with friends and family. Brief discussions about human
topics like these builds strong bonds between clinicians and their
patients.
Chapter 4: Empathy as Collaboration
Daniel Epner, M.D., Laura Meyer, and others TBD
Chapter 4 addresses the Parallel process of empathy: treating coworkers
with empathy involves the same skills as empathy during clinical
encounters. The chapter illustrates how team members can utilize empathy to
collaborate to the betterment of their patients and themselves.
Chapter 5: Difficult Conversations in Cancer Care
Previous chapters offered areal-life, operational definition of clinical
empathy. Beginning with section 2, The Guide discusses how to apply the
same empathic skills to emotionally charged and challenging conversations
that commonly arise in clinical practice.
Section2: Common Challenging Conversations: What to say and not to say when
the patient or family throws a curve ball.
In section 2, each chapter will begin with a narrative that epitomizes the
role of empathy in responding to a particular conversational challenge in
medical practice. The text will then offer specific responses and
strategies that facilitate connection between providers and patients under
such circumstances. These same responses are summarized in the pocket
empathy-reference booklet.
Chapter 6: "Denial:" what we see on the surface that covers strong negative
emotions, such as fear, sadness, and grief. Under such circumstances,
patients and family members often cling desperately to unrealistic
expectations.
Daniel Epner, M.D., and co-author TBD.
* "We want mother to be alert and talk to us like she did just the
other day."
* "You're just going to let me die?"
* "I know he is brain dead and there's nothing more you can do for him.
Stop telling me that."
* "I have faith God has a plan for me. I am sure I will be completely
healed."
Chapter 7: Prognosis
Daniel Epner M.D., andco-author TBD.
* "How long do I have?"
* "Why can't you cure him?"
* "Will I ever be normal again?"
* "I can't believe that I have cancer. I take good care of myself."
Chapter 8: Existential Concerns: "What comes later, and can you help me get
there sooner?"
Marcia Brennan, PhD, Medical Humanities Professor at Rice University, and
Daniel Epner M.D.
* "Where am I going after this?"
* "I'm not sure what there is to look forward to. What's the point of
trying anymore?"
* "Doc, I'm ready for this to be over. Help me end this now. I want you
to help me die."
* "Why are you taking away my hope?"
Chapter 9: Family Impact: "But my family needs me..."
Authors TBD
* "What if I'm not there for my daughter's sixth birthday?"
* "I don't want to talk to my kids about this. I need to be strong for
them"
* "Who will raise my family if I die?"
* "Will my children remember me?"
Chapter 10: Empathy and Pediatric Care
Kevin Madden, M.D., pediatric palliative specialist and Professor at M.D.
Anderson.
This chapter addresses the lopsided triangle of pediatric care: supporting
ill children and their parents with great finesse.
* "I can't stop life support. This is my daughter. I can't give up on
her."
Chapter11: Difficult Family Dynamics
Authors TBD
* "Please don't tell my mother she has cancer or any other bad news."
* "Oh, it doesn't matter what he thinks. He may be the sick one, but we
make his decisions for him."
* "I know my daughter is suffering greatly, but she said, 'Never give
up on me.' I have to honor her wishes, so I can't make her DNR."
Chapter 12: Dealing with Anger and Blame
Laura Meyer and co-author TBD
* "Of course, I'm depressed! Wouldn't you be if you were told you are
going to die?"
* "This place has failed me miserably."
* "You can't possibly understand how I feel. I'm dying, and I'm only
36! You are perfectly healthy. Don't try to convince me to feel
better with your psychological mumbo jumbo."
Chapter 13: The question of opiates and uncontrolled pain.
Joseph Arthur M.D., Assistant Professor at M.D. Anderson and Daniel Epner,
M.D.
* "Doc, I know where you're going with this. I hate to be asked all
these questions all the time. You're talking to me like I'm a
criminal and you think I'm taking these meds and trying to sell
them."
* "I've been giving my son some of my pain medication."
* "I've been coming to this clinic for 2 years, and every doctor has
given me the meds I need. You are the first doctor who has denied
me."
* "You don't know how I feel. I may not look like I'm hurting, but I
have a high pain tolerance. I need meds."
Chapter 14: Empathy and Culture
Laura Meyer and Daniel Epner, M.D.
Using a case to exemplify person-centered care, the authors demonstrate how
to engage with and respect patients of all cultures and backgrounds. This
chapter outlines universal truths about empathic practice with patients and
coworkers from all over the world: we all want the same things, and we are
all deserving of empathy.
Chapter 15: Empathy and Spirituality
Marvin Delgado, M.D., Associate Professor at M.D. Anderson and
Alejandro Chaoul PhD, Assistant Professor at M.D. Anderson
In chapter 15, the authors demonstrate how a clinician can hold respectful
space for the patient's spiritual needs or practices. The authors reflect
on how empathy can be expressed effectively in encounters where
spirituality (or a lack there of)emerges.
* "Do you believe in miracles?"
* "I can't believe God would abandon me like this."
Chapter 16: Empathy and Technology
Ali Haider, M.D., Assistant Professor at M.D. Anderson and
Kimberson Tanco, M.D., Assistant Professor at M.D. Anderson
Chapter 16 illustrates how empathy is adapted to overcome the modern
realities where there are computers in every exam room and the electronic
medical record sometimes pulls the clinician's attention away from the
patient.
Chapter 17: Focus on process rather than rainbows
Author TBD & Laura Meyer
Describes unresolved predicaments, such as those involving patients with
personality disorders, who sometimes do not respond to empathy, or those
who have no spiritual foundation in their lives and therefore are never
able to process the various stages of grief. Sometimes it is impossible to
connect with patients or families despite our best efforts. This chapter
reinforces the premise that learners should continue to shape and refine
their own "art of medicine" through all encounters, positive or negative.
Section 3: Compact Empathic Responding Summary
An abbreviated version of Chapters 6-17.