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Nonviolent Communication and Healthcare: COVID-19 Front Line Responders

(For our general Covid-19 page please click here.)

Expressing our Gratitude for Healthcare Workers During the COVID-19 Outbreak

We want to start by stating how much gratitude and appreciation we at PuddleDancer Press feel for the work of all front line responders during the coronavirus outbreak. These include law enforcement, ambulance drivers, nurses, doctors, physician assistants, technicians, respiratory therapists, and cleaners (who face similar peril but get less credit and pay).

Recognizing the Emotional Effects of COVID-19 on Healthcare Workers Worldwide

We also want to acknowledge the toll and the devastating impact this crisis has had on our healthcare community. Many of our healthcare professionals, in order to serve others, are putting at risk their and their loved ones’ health, and potentially their lives.

We hear and acknowledge the stories of the work environments in which there are many sick, people are dying, workers do not have protective equipment, working long hours, and being inundated with more sick people.

We can only imagine the physical and emotional toll.

We know many of you are fatigued, emotionally drained, and frustrated with so much misinformation being spread.

We want those working to protect and save lives to know how much we appreciate you and the work you do.

We see you, and we have some resources for you at the bottom of the page.

Zooming out, even before this crisis, hospitals have been known as challenging places to work. Healthcare for a long time has been an area fraught with challenges.

This is why hospitals and health care settings that have availed themselves of NVC tools and skills report so many benefits.

In her book, Humanizing Healthcare, Melanie Sears shows us why Nonviolent Communication is such a powerful resource for creating a culture of compassion in healthcare settings.

Our COVID-19 front line responders need both the emotional support and the sense of cohesive teamwork NVC can provide us.

Providing Emotional Support for Healthcare Workers in Their Time of Need

Providing emotional support for healthcare workers in their time of need is not complicated, and it is something anyone can do, whether already within that person’s circle of trust, or in an everyday interaction.

In fact, the basis of emotional support is empathy — which in essence is listening with full presence. It is NOT fixing a situation, bypassing uncomfortable feelings, investigating how we got here, or offering advice.

Being present means that I put my agenda aside — and I am with another person. Presence can be in silence while someone cries. Presence can be simply listening with the intent to understand rather than to respond.

In empathy, the listener is in complete non-judgment, and fully trying to get the other person’s experience.

As a result of being heard, of having a safe place to vent, our COVID-19 frontline healthcare workers will be able to let their feelings flow and dissipate grief or angst which would otherwise remain as unprocessed grief. When we can process our grief we are less weighed down, and we allow new freshness to enter our being.

The Importance of Communication in Healthcare During the Coronavirus

It would be almost impossible to overstate the importance of communication in healthcare during the coronavirus.

In ordinary circumstances human relationships need communication. When working in teams, communication is even more important. When those teams interact with many other teams — in the midst of a crisis — excellent communication skills, in healthcare, during the coronavirus, are paramount!

The Importance of Effective Communication in a Hospital on the Front Lines

A hospital is a complex institution with many departments or divisions — and effective communication is essential in normal times.

The importance of effective communication in a hospital on the front lines can literally make the difference between life and death, because it can impact hundreds of variables, including treatment decisions and hospital healthcare workers having access to adequate personal protective equipment (PPE).

Poor communication and the breakdown of interpersonal relationships becomes a distraction and a burden.
Effective communication in a hospital on the front lines means that people have clarity regarding: their role, who is doing what when, who needs what support from whom, and the timing of both shifts and ever-important downtime. When teams have clear communication they are more able to work cohesively to get the job done, and there is at least one less layer of suffering added to an already challenging environment.

Maintain Healthy Intrapersonal Communication Skills to Cope With Stress at Work

How to maintain healthy intrapersonal communication skills to cope with stress at work?
(Intrapersonal communication is how you communicate to yourself within yourself.)

When we are harsh and judgmental with ourselves we only increase our stress.

When we can be kind and patient with ourselves we still learn and grow, but the emotional cost is less.

When our emotional resources are low, it’s easier to fall into old patterns, some of which may include being judgmental or harsh with ourselves.

Nonviolent Communication (NVC) gives us tools and skills for maintaining a positive interior space, so that we can be most effective at maintaining healthy intrapersonal communication skills to cope with stress at work.

The Role of Compassionate Communication Between Doctors, Nurses and Staff

During the coronavirus pandemic, effective teamwork between doctors, nurses, and staff will be a critical factor in both the level of healthcare worker burnout as well as healthcare outcomes for patients.

So the role of Compassionate Communication between doctors, nurses, and staff is fundamental at establishing the rapport and mutual goodwill that makes for the most effective teams.

(Compassionate Communication is another name for NVC.)

The Role of Empathy in Communication Between Healthcare Providers and Patients

Empathy plays a strong role in the communication between healthcare providers and patients.

We want to acknowledge that healthcare workers are expected to have a confident bedside manner — and that this is very challenging when they themselves are afraid.

And while healthcare providers are under a tremendous burden of stress, patients — and their families — are also stressed and often lonely.

And one often-underutilized resource pertains to the role of empathy in communication between healthcare providers and patients.

When a patient is in a hospital setting and feeling ill, that in itself can be disorienting and emotionally taxing.

Having someone provide even a small amount of emotional comfort — in the sense of presence, “I’m here,” “I understand this is hard” — can help someone relax a bit and trust that there is someone there who cares.

Of course, sometimes things are hectic and the focus becomes the work on hand. But even in the small spaces, in between the hectic moments, there can be time to share our humanity with each other, even if it’s simple eye contact communicating compassionate understanding.

Use NVC to Comfort a Patient in Isolation Dying from Coronavirus

Some of the more heartbreaking ways this pandemic is showing up is people unable to visit with a loved one near death, and people dying in isolation.

How to use NVC to comfort a patient in isolation dying from coronavirus?

NVC is much more than the words we use, because what we exchange in communication is the meaning behind the words.

Someone wanting to use NVC to comfort a patient in isolation dying from coronavirus may not have access to verbally communicate or connect with the person dying in isolation. So we revert to any way we can — often, nonverbally.

NVC has three areas of practice: our connection with ourselves, how we listen to or receive others (empathy), and how we express ourselves truthfully (honesty).

When we try to use NVC to comfort a patient in isolation dying from coronavirus, we may find our attention moving among and between these three areas.

It might look like being empathically present, then if something is triggered for us we can turn our attention inside for self-empathy, then coming back to being present with the other person, then perhaps something else emerges as something to express, perhaps some kind words. NVC gives us all these options, which can also be exercised nonverbally.

Use NVC to Make a Meaningful Connection and Comfort Someone Who’s Grievings

You can use NVC to make a meaningful connection, and to comfort someone who is grieving.

The main skill is holding space for them; this means you are fully present. With your presence and your attention, you can create a space within which someone feels safe to fully feel their feelings.

Most of us are uncomfortable when we are with someone who is suffering. In our angst, we want to make it better for them — often by wanting to fix it, focus their attention on something positive, helping them shift to happier feelings.

But this does a tremendous disservice to the person grieving!

More than something we do, grief is a capacity. We avoid it because it is uncomfortable — and yet, it is universally human. When we don’t allow ourselves to grieve, we store this unprocessed grief in our tissues. When we do allow ourselves to grieve, we create more space within ourselves for more joy to come in later.

Part of the trick is to simply allow the feelings to flow. In NVC we recognize that there is sadness and mourning, precisely because there was something beautiful or wonderful. Therefore, life-connected mourning is when we can stay present with the feelings while staying connected to that which was precious and wonderful (in NVC we typically use a language of universal human needs).

So when you use NVC to comfort someone who is grieving — the primary thing you need to do is let them feel their feelings and simply hold space for them with your presence. For some people physical touch will take them out of their process; for others, it is comforting and exactly what they need. So it’s very valuable to ask if physical touch — holding a hand, receiving a hug — is desired by the person in grief.

Also, resist the story or the belief that “it’ll never end” — because it does… and usually on the other side are both relief and healing.

The Effects of Stress on Family Relationships for Medical Workers during COVID-19

Though each individual and family situation is unique, there are patterns to the effects of stress on family relationships for medical workers during COVID-19.

We’ve heard stories of many front line workers sleeping in separate areas of their house, practicing social distancing with their immediate family, and some even sleeping in hotels or in their cars.

We can only imagine — on top of the stress of exposing yourself to a potential dangerous virus — the terror of exposing your loved ones to it! And the stress for parents and children who are distanced from each other because of the parent’s critical role in helping others.

From an NVC standpoint, it would make sense that the impact of the current situation would be mitigated, or not, by the pre-existing levels of care, trust, and goodwill already in the relationship.

Some relationships — under normal circumstances — are already severely strained. Sometimes the trust is so low, that anything someone says is construed by the other person to be a judgment, criticism, or demand. When you put an already damaged relationship under stress it can fall apart.

In a stressful situation we can still maintain our emotional bonds, even at a distance. It’s more challenging. It’s very sad sometimes when we wish so badly to be together in person. But it is possible, and flexibility and imagination are wonderful human traits to put to use in situations like this.

Stress does not become a problem if we can stay connected. Crises do pass. And as long as trust and goodwill can be preserved, close relationships can prove to be incredibly resilient.

Maintaining Healthy Relationships with Family in the face of Severe Workplace Stress

So how does one maintain a healthy relationship with family in the face of severe workplace stress?

First, we want you to be gentle with yourself. Acknowledge all the stress you’re under and how difficult it’s been.
There’s also a mindset piece: every crisis is also an opportunity, and we want you to consider the possibility of using these hard times to let them shape you into a stronger person and a better human being.

Next we would want you to take some perspective, know that the crisis will pass, and think strategically so that you come out the other side in the best shape possible.

Part of strategic thinking in this kind of situation is where can I get emotional support! Because when we need emotional support, there are people at home who can give it to us, people who can’t, and people for whom it could be traumatic if we demand it of them (for example, children).

So while emotional support is a necessity, you want to be very discerning about where you get support because not doing so could damage the relationships with your loved ones.

Then there are the people you could reach out to among your extended family and friends.

If you are low in emotional support resources, there is also this support line, linking medical staff with an empathic listener: https://worldwideempathyformeds.org/.

Healthy relationships involve an exchange of both being real, i.e., speaking authentically, as well as getting (deeply understanding) one another, i.e., empathy.

We have a dangerous myth in our culture called “I need to go it alone.” And we extend this thinking to our close relationships.

But relationships also exist in the context of community, and we do ourselves and our loved ones a service when we avail ourselves of these resources.

Here is an opportunity to connect deeply, on a real level, during a situation that is assured to make our relationship bonds stronger and deeper — if we use it that way.

Dr. Marshall Rosenberg on Communicating with Compassion on the Front Lines

Dr. Marshall B. Rosenberg, PhD. lived and died before the coronavirus pandemic.

Nevertheless, he would have encouraged us to live with the utmost courage and compassion in these times.

Dr. Rosenberg left us with an exceptional methodology for creating a high quality of connection with ourselves and each other, in both the best and worst of times.

When we forge strong personal and professional relationships we are at our best for addressing issues such as the coronavirus epidemic. When we connect with our own humanity and the humanity in others, with compassion and tenderness, we are at our highest potential for contributing to the world in a way that increases connection and love.

Global issues such as pandemics, climate change, and species extinction require the highest level of coordination and cooperation among humans. NVC gives us powerful tools for interpersonal effectiveness in relationships, families, teams, and organizations.

More COVID-19 and NVC Resources for Healthcare Workers

Online Resources:

Books:

Online Courses:

Audio/Video:

  • National Public Radio News Story
    Seattle-Area Funeral Director Weighs In On Funeral Planning During Pandemic
    https://www.npr.org/2020/04/13/833623283/seattle-area-funeral-director-weighs-in-on-funeral-planning-during-pandemic
    From the interview:
    CHANG: “Forgive me. I imagine it’s also harder to personally comfort grieving families now. You can’t be face-to-face with them; you can’t hug them. You can’t touch them and offer comfort and support.”
    BARRETT: “Absolutely. It’s amazing what we convey through our eyes, through hand gestures. I am doing a lot of arrangements via Zoom and holding my hands across my chest and my heart as we say goodbye as sort of a symbol of hug to them.”
  • A Path With Heart interview with Wes Taylor
    My Lessons Trying to Transform a 4000 Person Organization
    From his work at Mercy Medical Center in Baltimore, Maryland, USA
    https://www.youtube.com/watch?v=A0UgEN7ukkY