Caring Literacy – Gives Us Words to Describe High Touch

I had a wonderful time presenting at the San Diego Professional Palliative Care Conference yesterday.  Being around likeminded people is always a boost. 

My Talk:  Caring Literacy Changes Everyone.

The hospice and palliative caregivers are the leaders of High Touch in our healthcare industry.  But they too are buried in the logistics of their work— regulations, documentation, ordering supplies and meds and racing around.

So when their burnout and caring fatigue impact their caring, what do they do? what do they need?

The Problem – caring fatigue leads to nurse attrition 

An article on “Professional Love in Palliative Nursing”, written years ago, described the rhythm of palliative caring…

“We Connect, We Love, We Lose, We Grieve”   

Studies show that attrition from nursing is directly related to repeated cycles of loss, ongoing frustrations with systems, and the loneliness (lack of connectedness) associated with clinical practice.

The “Palliative Nursing” article asked for non-judgmental support from the leaders.  That is just one piece of the solution.

The Source of the Solution – caring literacy

The solution to keep nurses in nursing revolves around … helping nurses find meaning and purpose in their work.  

Understanding Caring Literacy gives us strategies that help nurses find meaning and purpose in their work.

Caring literacy = the capacity to obtain, communicate, process and understand the basic information about caring.    The basics include definitions, mechanisms and sources.

The definition of caring:

  • There are 5 levels of caring.  The first 2 are considered non-caring. The 3rd is passive caring- “it’s my job”. The 4th level of caring is a nurse who is kind, concerned, reassuring, responsive.
  • The 5th level is authentic caring and can be transformational.

The mechanism of caring:

  • Most caring is routine, functional and related to tasks. This caring involves levels 3 and 4.
  • The 5th level of caring originates within the nurse, is sparked by a connection between the nurse and other, is sustained by the nurse’s inner resources and recommits the nurse to nursing in the process.
  •  This involves an authentic connection that generates energy that is life-giving and life-receiving for both the nurse and patient.

The sources of caring cultivation:

  • The sources for levels 3 and 4 caring are education and training.
  • The sources for level 5 caring are:
    • Self-care – this opens us up and triggers lifelong learning
    • Authentic caring moments, characteristic of level 5 caring – these moments remind nurses’ of the the meaning and purpose of nursing, and trigger their internal motivation to connect again and again
    • Conversations generated by leaders, with leaders and colleagues about caring that evolve each nurses’ caring literacy and conscious caring. These momentary meaningful interactions trigger growth, self-awareness, introspection, meaning in practice.

The Solution – Led by Leaders – conversations that show meaning and purpose in nurses work 

Routine conversations in the work environment about authentic, conscious caring builds caring literacy among the nurses and evolves a caring language within a unit and/or organization that reflects meaning in nursing and ushers in culture change.

Conversations revolve around the sources of caring cultivation, self-care, authentic caring moments and the benefits of remembering and sharing these moments with each other.

Conversations will grow about self-care— how it works and how it helps— becomes common.

Conversations will grow about authentic caring moments, revealing the patient story, the nurse’s response, thoughts and actions, and the impact on the patient and nurse. Others will reflect on the story.

My experience is that words describing caring thoughts and actions are right there “under nurses’ skin” and in their consciousness and are yearning to be shared—even if they aren’t aware of it yet.  They just need an invitation to talk, or to recall caring moments.  Once they hear a caring literate word, some nurses will  know it immediately,  know the feeling/experience, and will immediately attach their own words to their feelings/experiences.  Once triggered to acknowledge, contemplate and use caring words, nurses’ conversations shift when they talk about what they do.   


Finding my joy in these conversations grows with each conversation.



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