EMPATHIC PROFESSIONAL CARE FOR DYING PATIENTS

The biggest challenge for the health professionals is to support their patients and to guide them through the stages of dying. When working with dying patients, we become more sensitive to our own mortality and to our own vulnerability. Attitudes to death and the resulting primordial fear affects behavior patterns in people “working with death and loss”. However, if we focus far too close and far too long on the illness of our patients, our relationship with them may be endangered and may cause to feelings of rejection and guilt. Finding ways to establish relationships that go beyond illness and death thus becomes crucial in our efforts to maintain and promote the dignity, intimacy, and quality of life that our patients deserve. The shortage of well-trained staff is a problem of the modern world in the field of care for dying patients. Adequate education and training for such professionals is a necessary first step toward a more compassionate, humanistic, and dignified care for dying people. The data from own researches carried out among 162 healthcare professionals and 23 patients from 8 hospitals and 3 hospices of Sofia, outlines their basic difficulties and personal experiences in the provision of health care and care for seriously ill and dying patients. Used methods include: documentary method, inquiry method - direct inquiry, observation. Approximately 2/3 of respondents have difficulty in communicating with a dying patient and his relatives. To increase the understanding and to improve the care of people who are near death, there needs to be a change in the attitudes and the stereotypes that physicians, psychologists, social workers, nurses and caregivers. Lack of education in developing communication skills that help connect medical professionals to their patients and families; and also, ways to take control on dealing with suffering, death and loss, are the main source to keep professional distress. Good communication between medical staff and patients is based on both psychological established rules for interaction between people and the specific behavioral health practice models. The development of emotional competence should be present as an essential element in the process of professional training of healthcare professionals. In this connection Faculty of Public Health at the Medical University - Sofia provides education on Communication skills in student learning and postgraduate training of medical professionals. Here innovative approaches to improve emotional intelligence of the healthcare staff are applying. The failure to recognize and to acknowledge the own feelings while working with the dying patient is the biggest obstacle in front of empathic care. Patient-centered approach holds a significant place in the training of healthcare professionals. Interventions are focused on issues like consultation style, developing empathy, identifying and handling emotional problems. In the learning process, the most activating effect in this direction is the reflexive practice with real patients, aimed at mastering the appropriate style of counseling, developing empathy and dealing with emotional problems. In order to overcome on the educational deficit and need from enhancing health professionals’ competences in the field of person- centered care started the implementation of "learning at the working place" in medical and social institutions. We carry out discussion using educational presentation and interactive activities. The external training and discussions on current issues in health care for dying patients associated with the specifics of the workplace has many advantages, such as discussing concrete issues and case studies related to care places, reflection and sharing experience, saving the time of healthcare professionals. Substantial reserves are offered with informal processes and episodic learning in the workplace and their combination with formal education. Such training for students and working healthcare professionals can improve communication with patients and facilitate empathic professional support and care for sufferers.