Loving Kindness in Healthcare

"When we practice loving kindness and compassion we are the first ones to profit." ~Rumi

In Pali language, the concept of loving kindness suggests unconditional compassion or "metta." The expression of loving kindness requires an emotional inclusiveness that is not contingent on the worthiness of those to whom it is extended.

We are publicly reported on our achievement of ALWAYS treating patients with courtesy and respect; ALWAYS listening and explaining carefully to every patient, every time. Yet in spite of the elusive nature of an ALWAYS response, USUALLY or SOMETIMES is too low a bar. I don't think the issue is one of word choice; I think the words reflect a more fundamental moral dilemma we must constantly weigh - that of the delicate balance between getting it perfect and getting it done.

"Perfection consists not in doing extraordinary things, but in doing ordinary things extraordinarily well."

~Angelique Arnaud

Take nice and kind, for example. Remember the days when we measured patient satisfaction rather than patient experience? In the mindset of satisfying our customers, the goal was to create a favorable impression to build loyalty. We did lots of nice things. Service excellence was the message of the day and organizations looked to hospitality and even entertainment (If Disney Ran Your Hospital and The Nordstrom Way - I have both on my bookcase) for insights into what makes customers come back.

"Never worry about numbers. Help one person at a time and always start with the person nearest you." ~Mother Teresa 

But thankfully we've moved forward to embrace a broader spectrum of the patient and family experience. Our perspective has shifted to the demonstration of empathetic benevolence that includes everyone along the continuum of care - particularly the caregivers. We are finally acknowledging and reacting to the causative relationship between patient experience and workforce engagement.

It is unsettling to contemplate the stressors reigning down on healthcare professionals these days. We study the impact of compassion fatigue and burnout, oftentimes surrendering to a conclusion that a human's capacity to experience compassion is depleted over time, particularly in such intense circumstances. The proposition that such a debilitating malady might exist casts a dark shadow on ALWAYS kindness. But I'd ask you to hover over the premise of compassion fatigue for just a moment and allow the insinuation to marinade in your mind.

"The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it." ~Michelangelo

In actuality, it feels good to be kind. According to some research out of Cedars-Sinai, a simple act of kindness releases chemicals that activate positivity. It's benefit impacts heart health, anxiety relief and the management of pain. There is, however a hitch to activating kindness. Like exercise, acts of kindness must be repeated at regular intervals to optimize its benefit because the oxytocin boost from a single act only lasts 3-4 minutes. That phenomenon makes acts of "random" kindness about as effective as acts of random exercise. To be effective - to benefit us - kindness must become a practice that is hardwired into our interactions with everyone ALWAYS. Like a good habit, kindness must be intentional.

Don't get me wrong. One can be randomly nice in the Starbucks drive-through and its so very nice to keep the break room stocked with snacks or spring for the occasion pizza party. But loving kindness is what you demonstrate with the coworker despairing in the break room because she can't afford a babysitter, but needs the extra hours so she can pay her electric bill. Loving kindness happens in those moments when we put on the shoes of others and walk a path other than our own - if only for a short time. We must ALWAYS work toward creating an environment that is conducive to expressions of loving kindness. We must ALWAYS be mindful of how our words and actions play on the sensitivities and vulnerabilities of those around us.

I have three things I try to do ALWAYS. I'm sure you can think of other ways to convey loving kindness. But just as an exercise, try rating yourself on the following:

I model loving kindness. ALWAYS, USUALLY, SOMETIMES, NEVER

• Indicators:  Stepping away from barriers that inhibit connection with others. Reaching out with curiosity and warm appreciation for the work of others. Offering assistance with little things and stepping into unfamiliar trenches from time to time. Exerting kindness inward, taking good care of yourself. Reflecting on all that is good around you. Practicing mindfulness.

I promote autonomy. ALWAYS, USUALLY, SOMETIMES, NEVER

• Indicators: Evaluating work processes and policies for ways to foster and encourage both shared and independent decision-making. Holding up the mirror to your leadership style and giving permission to fresh perspectives. Encouraging quiet voices. Listening, listening, and then listening some more.

I share stories of kindness. ALWAYS, USUALLY, SOMETIMES, NEVER

I remind people all the time that each of us are part of the patient's story - that we are woven into the fabric of their lives by threads of loving kindness. Storytelling is one of the most powerful instruments we have to perpetuate kindness. Think of the parables. Encourage coworkers to share their stories of loving kindness with one another and pass them on to your peers. Start meetings with a story that reflects the loving kindness you wish to perpetuate throughout your organization. Stories, like love, were not put in your heart to stay.

In parting, I'd like to share a story that has no doubt touched millions of hearts...

On a recent Jeopardy episode, in lieu of a Final Jeopardy response, a contestant wrote a note of loving kindness to host Alex Trebek, who is dealing with stage four pancreatic cancer. The contestant's note read simply "We heart you, Alex!" Tribek responded, his voice cracking with emotion, "That's very kind of you, thank you. It cost you $1,995. You're left with five bucks."

"There is no greater agony than bearing an untold story inside you." ~ Maya Angelou