Background Clinical communication plays a key role in conveying compassion between individuals. Positive non-verbal communication (NVC) has been shown to encourage connectedness and improve patient outcomes – i.e. reducing pain and anxiety – in a range of conditions, including major trauma. Whilst little is understood about how staff utilise NVC in the resuscitation room, quality of interpersonal interactions has been shown to be the largest overall predictor of patient satisfaction within the Emergency Department (ED). Existing studies within the ED highlight patient experiences of feeling ‘isolated’, with their distress being ‘insensitively disregarded’ by staff, hence further research is required to improve patient experience.
Methods This study utilised the video auditing system within the ED of Edinburgh’s Royal Infirmary to observe how emergency staff employed NVC with conscious patients across (n=15) resuscitation cases. Results were fed back to clinical staff, with suggestions for developing compassion awareness. Mixed method qualitative and quantitative analyses were employed to assess positive and negative staff NVC behaviours and evaluate how these appeared to influence patient experience. Several existing matrices for measuring staff non-technical performance informed design of a novel system for scoring five key aspects of clinical NVC: touch, eye contact, body language, proximity and patient exposure.
Results This study highlights significant variation in how emergency staff convey compassion to patients during resuscitation. Staff members exhibited a range of positive and negative NVC behaviours, which were occasionally at odds with verbal cues given. Patterns of communication appeared related to members’ roles within the emergency team, with medical and nursing staff exhibiting different strengths.
Conclusions Our findings are consistent with the idea that acts of compassion are ‘emotional labour’, underlining the need for staff education surrounding positive NVC, as well as increased workplace support. We suggest environmental level strategies including incorporation of a specifically designed ‘compassionate care’ toolkit into handover/pre-arrival checklists.
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