It was over a decade ago that Elaine C. Meyer, PhD, RN, MBE, FSSH presented her TEDx Talk On being present, not perfect. Her message remains crucial, relevant, universal especially within maternal child health.
Dr. Meyer’s powerful piece incorporates personal and professional examples which bring life to the importance of holding space for compassionate communication and difficult conversations in healthcare.
She notes the essential ingredients of these conversations: Courage, Brains, and Heart, a clever Wizard of Oz mnemonic, and she emphasizes that “Practice makes better”, not perfect, as alluded to in her title.
Reflecting back, Dr. Meyer reports that we’ve accrued more awareness about these conversations. Compassionate communication is no longer a nice-to-have-it item; it has become an essential part of healthcare. Overall, Dr. Meyer has noticed that patients are more empowered, expecting this connection and level of care. Online rating tools have allowed for patients to evaluate providers specifically on their bedside manner.
Across the globe, On being present, not perfect has been incorporated into nursing and medical school curricula placing value on providers’ relational capacity early on in their careers.
In a culture where health care providers are often massively stressed and burnout can be of real concern, Dr. Meyer makes clear that honoring conversation is not only of benefit to the patient.
“… Being in relationship with the patient can be very fulfilling,” she begins. “This matters. At the end of day, a healthcare provider can say What I did matters. It can be the words that we speak, just being present, and showing up in all of your humanity. This doesn’t necessarily require extra time.”
Take for instance the personal vignettes she shares in On being present, not perfect: a nurse who held her hand, squeezing back in reciprocity, an anesthesiologist who told her “I will be with you the whole time. I will watch over you. We’ll get you through this.” Simple yet profound, words and actions that sustained her during harrowing procedures. “Gestures of humanity,” Dr. Meyer calls them.
What’s more, when this kind of respect and communication are established, patients have significantly better health outcomes and provider job fulfillment and retention increases.
“If a clinician feels like I did a good job today, I connected, that buoys the clinician. The clinician feels more efficacious,” she explains.
These conversations matter across the lifespan in any specialty, of course; however, the perinatal period is of special importance, because perinatal experiences have generational physiological and psychological implications. This time period influences the mother-child relationship for a lifetime.
Having endured multiple pregnancy losses and IVF, Dr. Meyer shares that when her son was born, her initial focus on breastfeeding was primarily nutritional.
“The connection and attachment that breastfeeding can foster wasn’t as much on my radar,” she says. “But after rising from the ashes of infertility, being able to nurse my baby boy was restorative and healing.”
Though she and her son were not up against monumental feeding challenges, she consulted a lactation professional as a support person. She says this was immensely helpful to have someone who believed in her, someone joining her in the journey, someone to fortify what was important to her.
As a provider, Dr. Meyer recalls a few highly distressing stories related to birth and infant feeding when she needed to show up with Courage, Brains, and Heart. She shares one in particular:
There was a preterm newborn who was admitted to the Intensive care unit with severe birth complications and prolonged anoxia. The baby’s mother was determined and dedicated to breastfeeding her baby. The baby was unable to nurse because she was sustained on life support with a ventilator. Dutifully and with great care, the mother pumped her breastmilk and the baby received the milk through a small nasogastric tube. As a psychologist, I had the great privilege of meeting with the parents to listen to their story, to bear witness to their fledgling parenthood, and to offer support….Those were tender and difficult conversations. We held several family meetings with the team to help determine the baby’s treatment. Given the infant’s devastating brain injury, and poor prognosis, the parents and team agreed with the difficult decision to withdraw life support treatment. After the ventilator was withdrawn, the baby passed away peacefully in her mother’s arms with the father at their side. In a final act of love and dignity, as the parents left the hospital for the last time, the mother left a little bottle of breastmilk at the nurses’ station counter. Testament to a mother’s love, it was a most precious parting gift. The parent-child relationship transcends death. The lactation consultant offered ongoing education and support to the mother who went home without her baby- to pump for comfort and to stand in a warm shower with her back toward the shower head, so as to ease any discomfort. Courage, brains and heart….
As she concludes her Tedx Talk, Dr. Meyer offers some final inspiration: “Once upon a time you wanted to change the world. You still can, one conversation at a time.”
Learn more about Dr. Meyer’s efforts here.
