Wondering is a state of mind characterized by curiosity, openness, and acceptance—a joyful not-knowing and an intentional elimination of our own agenda. Wondering is supported by the actions of
- becoming empty,
- using wide eyes (ongoing assessment rather than resting on early conclusions),
- listening and watching with curiosity, and
- purposefully eliminating all barriers to the above.
Wondering happens when we have a devotion to the principle that the patient always has something to teach us, without which we cannot really do our jobs.
Followingis a series of intentional acts of devotion to being lead and taught by the patient and family. Following is supported by the actions of
- listening to, respecting, and acting on what we learn from our patients about who they are and what they want and need,
- paying attention not only to the patient’s words, but also to voice tone, body language, facial expression, and gaze (including eye contact or lack thereof), and
- continually adjusting our next caregiving act to align with what we are learning from the patient.
When we practice following, the patient experiences him- or herself not on a production line, but in the hands of people who are interested in learning how to provide specific care for each individual patient according to his or her needs and desires.
Holding is a conscious decision to lift up, affirm, and dignify that which the patient or family member has taught us, resulting in intense focus on the patient or family member, while treasuring both the information and the person. It means creating a “safe haven” for healing; one in which the person feels accepted and held with dignity and respect. Holding is supported by the actions of
- keeping confidences as needed and appropriate,
- remembering in specific acts of care, that which has been learned about the patient, the family, the culture, and the history,
- speaking of and writing about the patient and family—at change of shift report, in the hall, in notes—with dignity and an eagerness to transmit treasured information, and
- being a steady and nonjudgmental presence even in the face of strong emotional responses.
Each of the therapeutic practices, when practiced within a container of presence and attunement with the patient and family, creates the therapeutic relationship. Where we find presence, attunement, wondering, following and holding, we find authentic human connection. Where clinicians connect authentically with patients and their families, we have therapeutic relationships.
We are honored that you are participating in this vital work!