Inspired by Boston attorney Ken Schwartz, who died of lung cancer at the age of 40 in 1995, the Schwartz Center for Compassionate Healthcare was created more than 20 years ago in an effort to “put compassion at the heart of healthcare through programs, education and advocacy,” according to the organization’s website. In his writings, Schwartz noted that what made the “unbearable bearable” during his own personal healthcare experience was the compassion shown to him by his doctors, nurses and other health professionals.
Since then, Schwartz’s vision has helped create a powerful movement within contemporary health care, in part through the Schwartz Rounds program, which “offers healthcare providers a regularly scheduled time during their fast-paced work lives to openly and honestly discuss the social and emotional issues they face in caring for patients and families.” Schwartz Rounds programs are now up and running in more than 550 healthcare organizations in the United States, Canada, the United Kingdom, Ireland, Australia and New Zealand—and thanks to generous community philanthropy provided through the Martha Jefferson Hospital Foundation, Schwartz Rounds are now taking place at our hospital as well.
After more than a year of planning and preparation, Sentara Martha Jefferson launched its first Schwartz Rounds in September 2019 to an interactive audience of nurses, allied health professionals, physicians and representatives from administration. The topic for the inaugural session, “When Compassion and Safety Collide,” focused on how best to help patients, families and hospital staff navigate the challenges of disruptive patient behaviors, which can range from confusion and agitation to actions bordering on physical violence directed toward staff or a patient’s loved ones. The session engendered heartfelt sharing and, at times, intense, emotion-packed discussion.
Our second Schwartz Rounds, which took place in November, focused on working with patients who have advanced cancer. The discussion centered on how best to support patients, families and medical staff when treatment shifts from curative therapies to palliation and, eventually, end-of-life care.
A Safe Place for Sharing
I became involved in the Schwartz Rounds project at Sentara Martha Jefferson when Peggy Bishop, ANP-BC, ACHPN, Palliative Care Service Team coordinator, asked hospital chaplain Tammy James, RN, MDiv, BCC, and myself if we would like to assist in getting the initiative up and running. Having been a hospital-based physician for nearly all of my 25 years in health care, I felt there was a clear need for healthcare workers to talk about many of the tough situations we often face. Professionals in our field often keep strong emotions bottled up inside them, even to the point where they’re unable to share with family or friends.
Although the topics covered in Schwartz Rounds can be difficult to confront, as healthcare workers we face many such scenarios on a daily basis—so getting our shared experiences out in the open is key. With that in mind, these forums provide a safe place to share, giving staff an opportunity to reflect upon their own responses to challenging situations, hear the perspectives of others, and learn how more effectively to remain compassionate in the midst of frustration, fatigue and emotionally weighty situations. The discussions also help staff members connect with a larger network of support—not only for each other, but also for the patients and families we have the privilege of caring for during critical times in their lives.
Benefiting Caregivers and Patients
The format of the Schwartz Rounds is fairly straightforward. After the session topic is introduced, a small panel—usually made up of a physician, a nurse, an allied health professional and others who can provide perspective—will give a summary of their personal experiences regarding the topic. The remaining time, which accounts for the greatest portion of each session, is open for all those in attendance to engage in discussion and share their perspectives.
Based on survey responses, the first two Schwartz Rounds at Sentara Martha Jefferson appear to have been well received. Below are a few of the written comments staff members in attendance submitted on their post-session surveys:
- “This is a great forum for all staff to share and commiserate together, to know we are not alone in our feelings.”
- “I have a better understanding of the doctor-patient relationship and end-of-life care.”
- “Find support in coworkers.”
- “Always meet patients where they are.”
- “I am more aware of my colleague’s views.”
- “Understand that everyone (staff, family, patient) has a story.”
Nationwide evaluation of Schwartz Rounds reveals that the program improves teamwork and staff retention, reduces caregiver stress and isolation, and helps cut down on burnout. At Sentara Martha Jefferson, the program gives us another tool not only to care for our patients and their families, but also to care for one another as we strive to communicate effectively with, support and work alongside one another.
Going forward into 2020, Sentara Martha Jefferson plans to host a Schwartz Rounds every other month (a planning committee staffed from multiple frontline services in the hospital is charged with selecting the topics). Participants likely will leave not only with a stronger sense of community, but also with enhanced understanding and compassion for our patients and our colleagues “in the trenches” who strive every day to provide the best possible health care.