In their shoes: An ontological perspective on empathy in nursing practice.

AIMS AND OBJECTIVES: To present an enquiry into empathy as part of nursing ontology. The work aims to improve understanding of how empathy is developed and used in practice.

BACKGROUND: Empathy is the ability to grasp the frame of reference of another. As such, empathy is a key feature of nursing practice involving self-awareness and the use of emotion in interpersonal understanding.

METHOD: As part of a larger study into the commonality of emotion in nursing, thirty-three nurses across a range of settings talked exhaustively about their experiences with empathy in the context of their relationships with service users. The interviews were audio-taped and transcribed verbatim. The transcripts were analysed using Grounded Theory Method.

RESULTS: Empathy was experienced as a libidinal entity motivating care dependent on a number of allied skills which formed a process: listening and echoing, knowing another's circumstances, imagining and representing the imagined perception within the self. Empathy was viewed as a tool for person-centred care with two distinct levels: phenomena related and biography related. Sensitivity to care context in the use of nurses' life experience also enabled empathy in an emotional kinship. Person-centred care and empowerment were inhibited where empathy could not be achieved.

DISCUSSION: The findings confirm the place of empathy in the hierarchy of embodied nursing skills and add to the current bank of knowledge on the sharing of emotions and the value of emotion to professional judgement.

CONCLUSION: Empathy is a tool with which to ascertain the cognitive and emotional perspective of others. Empathy's libidinal properties mean that shared understanding enhances care. Emotional kinship means that life experience can be harnessed for empathy in practice.

RELEVANCE TO CLINICAL PRACTICE: Insight into the ontology of empathy provides a basis for the construction of teaching tools and learning objects for character and skill development in practice.