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Using poetry writing to help students explore empathy

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Dr Kirsten Jack has developed an online community that helps student and qualified nurses reflect on their practice in a creative way

The seminal work of Carper (1978) reminds us that there are four fundamental ways of knowing in nursing; empiric, aesthetic, ethic and personal, and each are of equal importance.

However it has been suggested that in contemporary undergraduate nurse education, there is too much emphasis on the scientific model and less time devoted to the aesthetic and personal aspects of nursing practice.

This can lead to a focus on task completion which can cause problems, not only from the patient’s perspective, but student nurses might be left feeling disillusioned about the care they provide.

Traditionally, reflective learning has been utilised as a way that considers the more personal aspects of nursing practice, and remains a familiar concept to most nurses.

Reflective practice is an educational and professional requirement and involves the nurse looking at things that have happened and thinking about them differently, which leads to a change in practice (Jasper, 2013).

”Recently reflective practice has been criticised for its overuse and misuse”

This can be particularly helpful in developing emotional awareness and sensitivity to our own needs and those of other people.

However, recently reflective practice has been criticised for its overuse and misuse (Coward, 2011). Reflective templates might be viewed as restrictive rather than encouraging writing about our thoughts and feelings, especially if the pieces are assessed as part of programme outcomes.

Taking the tenets of reflective practice and developing them more creatively, for example, through poetry writing, can support our exploration about important nursing issues.

Poetry writing

Writing poems enables students to articulate their feelings more easily than traditional methods of learning (Chan, 2014).

It supports understanding of challenging concepts such as empathy and compassion and encourages thinking about areas we might not normally consider (Speare & Henshall, 2014; Jack, 2015).

”Writing poems helps us to see beyond the medical model and enables us to empathise with others”

 

Writing poems helps us to see beyond the medical model and enables us to empathise with others (Davis, 1997), writing as if we were in the patient’s position rather than that of nurse.

Sharing poetry supports our skills in dealing with other people and the often confusing nature of nursing practice (Charon 2007). Listening to poems helps us to understand the stories we hear in practice, thereby supporting our relational skills development.

In 2012 I designed the Caring Words website www.caringwords.mmu.ac.uk a site hosted by Manchester Metropolitan University (MMU) to create an online poetry community to support students in thinking about relational care.

The website is freely available to any health professional wanting to share their creative work.

”It provides an opportunity for students to read poems written by other students, which lessens feelings of isolation and loneliness”

It provides an opportunity for students to read poems written by other students, which lessens feelings of isolation and loneliness. It supports educators by explaining the ideas behind the innovation and describes ways to write poems, the site having been jointly developed by W. Terry Fox, a creative writing colleague from MMU.

Educators can search the site for poems, which they can use in their own teaching practice to support exploration of important health care issues. Alternatively the poems can be used as examples when inspiring others to write creatively.

Advantages

Our students report that writing poems prompts them to explore practice situations in creative and imaginative ways, encouraging them to express their feelings in ways they might not have done before.

It helps them to slow their thinking down as they consider the most effective way to express themselves through their poem. As mentioned above, listening to poems written by their peers supports the development of empathy when they hear the various ways their peers experience similar situations to themselves.

Working creatively boosts confidence which is a required attribute in clinical settings. Importantly, writing poems helps nurses see things from the patient’s perspective, and encourages them to consider how it feels when somebody is placed in a care setting. This encourages thinking about relational, rather than transactional care provision.

To whet your appetite for writing, the following poem was written by a first year student nurse on the BSc (Hons) Adult Nursing programme at MMU. The poem is written from the perspective of an older person and explores her thoughts and feelings during a hospital stay:

I’m Alone

The tick of the clock,

The drip of the tap.

The click of a heel; clack, clack, down the hall.

The beep of the machines,

The buzz of the lights.

This hospital never stops, so I can’t sleep at night.

 

There’s a man crying out in pain upstairs,

In the waiting room, there is a woman sobbing for the loss of her brother.

The lady on my right has had her hip replaced,

On the left her breasts are gone, ‘it’s inherited from my mother’.

 

The creak of the door,

The ring of the phone.

The whimper of a patient; a howl and groan.

The streams of doctors,

The rustle of paper.

This hospital is full, so I’m just a number.

 

The doctors are pleasant enough,

The nurses are always busy, rushed of their feet, but they aren’t to blame.

There’s patients galore in here,

One in, one out. It’s never the same.

 

I lie in my bed,

I’m watered, I’m fed.

I’m sheltered and clothed; how can I moan?

But I’m scared.

But I’m frightened.

But I’m alone, Nurse. I’m alone.

 

I never know what’s happening until its begun,

They smile politely, and talk so nicely, but I don’t understand.

Can’t they see this is all new to me,

Can’t they see I’m afraid, I just need a friend, I just need a hand.

 

I lie in my bed,

I’m watered, I’m fed.

I’m medicated and cleaned; how can I moan?

But no-one here knows me.

But no-one knows my life.

But I’m alone, Nurse. I’m alone.

 

The nurses are good at their jobs,

They get the work done; they make people healthy.

But I can’t help to think,

They don’t often see the human, the person, in here,

They don’t see me.

 

I lie in my bed,

I’m watered, I’m fed.

But I feel like I’m dying; I feel like I’m dead.

 

Have you considered writing a poem about your experiences as a nurse or health care worker? You might like to visit the website to get some inspiration:

www.caringwords.mmu.ac.uk

Remember your poem does not have to rhyme or be a particular length or style. Feel free to browse the poems on the site to get a feel for what people have written before.

Dr Kirsten Jack is senior lecturer in adult nursing at Manchester Meteropolitan University

 

References

Carper, B. (1978) Fundamental patterns of knowing in nursing. Advances in Nursing Science. 1 (1), 13-23.

Chan, Z.C.Y. (2012) A systematic review of creative thinking/creativity in nursing education. Nurse Education Today. 33 (11), 1382-1387.

Charon, R. (2007) What to do with stories. Canadian Family Physician. 53, 1265-1267.

Coward, M. (2011) Does the use of reflective models restrict critical thinking and therefore learning in nurse education? What have we done? Nurse Education Today. 31, 883-886.

Davis, C. (1997) Poetry about patients: Hearing the nurse’s voice Journal of Medical Humanities 18, 2, 111-125

Jack, K. (2015) The use of poetry writing in nurse education: An evaluation. Nurse Education Today 35, 9, e7 – e10

Jasper, M. (2013) Beginning Reflective Practice. Hampshire: Cengage.

Speare, J. and Henshall, A. (2014) ‘Did anyone think the trees were students?’ Using poetry as a tool for critical reflection. Reflective Practice: International and Multidisciplinary Perspectives. 15 (6), 1-14.

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