Closeness and distance: a way of handling difficult situations in daily care

Abstract

If the experienced difficult situation is not handled in a way that is beneficial to the care team member, patient and relatives, it is assumed that this can result in stress, burnout and, above all, non-optimal care.

Negotiating the Normal Birth : Norms and Emotions in Midwifery Education

“…Some studies of midwives' emotional labor in delivery wards (Rayment 2011) or of nurses within end-of-life care (Blomberg & Sahlberg-Blom 2005) show that these medical professionals try to harden themselves and keep an emotional distance to their patients, in order to carry out their work. They learn to "'mask' their feelings", meaning to hide their feelings or reactions and express what is expected of them in the work role.…”

“…Death is not the expected outcome of a birthing trajectory; thus they have to learn a new approach to the situation as compared to what they did before. While death to a patient with, for example, an advanced cancer may seem by the nurses involved to be a relief from pain and suffering (Blomberg & Sahlberg-Blom 2005), death within midwifery may appear as an unexplainable and tragic outcome.…”

Negotiating Uncertain Terrain: A Qualitative Analysis of Clinicians' Experiences of Refractory Suffering

“…26 While the language of ''being with'' is now found almost exclusively in the palliative care literature on spiritual and/or pastoral care, the nursing profession has also recognized that the ability to be present to the person with refractory suffering is an essential clinical skill. 27 The ability to work with uncertainty and to remain present with people in distress requires courage, commitment, and an ability to let go of the need for control, 1,25,[28][29][30] all capacities identified by the participants in this study. In addition, Arman 31 specifically highlighted the need for courage as a prerequisite for being able to witness suffering and to ''take the necessary step into the life world of the other'' (p. 91).…”

The CARE heuristic for addressing burnout in nurses

“…[45] Nurses at risk of burnout should be informed about the syndrome, know how to recognize the signs and symptoms, have sufficient self-awareness to recognize if they are showing signs of these symptoms, and also to be aware of the resources and techniques at their disposal for addressing burnout.…”

“…[46] Self-awareness is particularly important in the context of addressing burnout, because one of the strategies that nurses sometimes use to protect themselves against distressing stimuli is to use "distancing" as a coping strategy. [45] Distancing means removing oneself from the painful stimuli, and can occur on either an inter-personal level (staying away from people or relationships that are difficult) or intra-personal (avoiding thoughts and emotions that are troubling and difficult). This can contribute to the depersonalization associated with burnout.…”