Caring Conversations: The SNF as Locus for a Novel Cross-Discipline, Humanism in Medicine Curriculum

Session Year: 
Joshua Schor, MD, CMD

How do you create a culture in the skilled nursing facility (SNF) where compassion, respect, and empathy are at the core of health care? The busy, non-stop workloads of all disciplines in the SNF encourages the breakdown of cross-discipline sharing of information. Employees including doctors, nurses, aides, kitchen and housekeeping staff voice that they have only enough time to get 'their own' work done and rarely share their ideas and experiences and even fears with others. We applied for and received a small demonstration grant that helped establish a 'humanities in medicine' program in our SNF, the Daughters of Israel in West Orange, NJ. The radical change was to apply this to the SNF setting and develop a true cross-discipline approach rather than the more typical acute care attendees at the executive/leadership level. We met monthly for six months. Each session lasted one hour and focused on a unique video, poem, photo, or short reading that addressed different phenomena of aging or nursing home care such as loss, bereavement, overwork, life satisfaction, and advanced care planning. The facilitators used surveys to gather data on staff participation, reaction and changes in practice going forward. We will re-enact 'caring conversations' with the attendees which will be low-pressure and great fun.