Open hearts: Is compassion something you can teach?

Allie Tran, who works in UVA Medical Center’s Intensive Care Unit, followed in her mother’s footsteps when she became a nurse. Photo: John Robinson Allie Tran, who works in UVA Medical Center’s Intensive Care Unit, followed in her mother’s footsteps when she became a nurse. Photo: John Robinson

When Dorrie Fontaine became dean of UVA’s School of Nursing in 2008, a subtle shift in how nurses were taught to tackle tough situations—the death of a young patient, a family pushing back on end-of-life decisions—was already under way.

Toward the end of her tenure, former Dean Jeannette Lancaster partnered with philanthropist Tussi Kluge to create a resiliency elective course for nurses, designed to help them deal with the most emotionally taxing aspects of health care with mindfulness techniques like meditation and yoga.

Dorrie Fontaine, dean of the UVA School of Nursing, says taking care of the mental well-being of those who treat patients is a necessary part of health care. Photo: Courtesy UVA

Since her arrival, Fontaine has built on that idea with the Compassionate Care and Empathetic Leadership Initiative. It’s a long title for a simple concept: Give nurses the tools to take on the challenge of facing illness and death on a daily basis, and they’ll be better prepared to help patients and families do the same. Better health care relationships, better health care.

At the heart of the initiative is the idea that compassion can be taught. Nursing students keep journals reflecting on their experiences, practice tough conversations with simulated patient encounters, and attend workshops and retreats where they learn techniques to clear their minds.

The initiative has spread beyond the nursing school, said Fontaine. Medical Center staff have found ways to bring moments of peace into the hectic hospital environment, like the nurse who instituted a practice of taking a 45-second silent pause in the wake of every E.R. death to honor the patient who passed away.

So far, the implementation has been piecemeal, but Fontaine said she’s working with the Curry School of Education to build the practice of teaching compassion into the curriculum. We sat down with Fontaine and later with Rebecca Kneedler, the Curry School’s associate dean for academic partnerships and international initiatives, to talk about the process of making mindfulness part of medical care.

C-VILLE: Did you have pushback from people who thought this approach was too…New-Age-y?
I had a couple faculty members who felt like I was pushing religion—which is O.K. Now they’re on board. I’m very patient.

The way you deal with it is you fight science with science. Susan Bauer-Wu, the new Kluge Endowed Professor in Contemplative End of Life Care, got big money from the National Institutes of Health to show that mindful meditation programs for people who are having bone marrow transplants help in their quality of life, and it helps their families. She’s a trained scientist who’s doing this work. Mindful practices are getting mainstreamed now.

RK: We struggle with that. It is so easy to dismiss and demean this approach. I think that that’s why it’s really important that we bring the science to it. If you’re going to bring it into the university setting, then you have to approach it with the same language and rules about rigor and empirical evidence. But it’s there.

C-VILLE: Showing patients and nurses meditation techniques is one thing. Can you really teach someone to be more compassionate?
We can teach it, and we’re wrong not to teach it. We’re reclaiming the soul of health care. It’s why people come into the field. There are so many physicians and nurses who are just sad right now, because they’re not able to give the care they want.

But when we teach compassion, people are going, ‘Yes.’ It’s very hard to be angry or upset at somebody if you put yourself in their shoes. That’s a big first step to amplify compassion.

C-VILLE: So how do you teach it?
: We want to help our students to just be present. Try to forget the garbage from the past and the anxiety from the future. The power of bringing that to a struggling learner, a patient, your spouse, your mother-in-law, anybody—it’s overwhelming. We’re always told, ‘Pay attention, pay attention, pay attention.’ But we’re never given any tools to do that.

DF: You have to role model compassion. You have to be aware of what’s going on around you, and that’s what we’re teaching our students—to stop, observe, and think. Understand when somebody gets upset, and ask what’s behind it. Listen and be thoughtful, even when you don’t feel like it.

C-VILLE: What do you want to see as you implement this program?
I would really like to see it improve the lives of our students and faculty and the University as a whole. With so much focus on mindful practices in Charlottesville and with the Contemplative Sciences Center here, we’re like ground zero for this kind of approach. There’s probably not one university like ours—with a law school, with an education school, a nursing school—where it’s all coming together.

And now we’re asking, if it’s a national model, how do we scale it up? How do we help others implement this? If it really works, we need to demonstrate that and replicate it. Sometimes you just have to keep talking about things.

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