The Role of Relationship-Based Care in Developing Empathy Through Vulnerability: Visual Cues for Conversation and Change.

Empathy is a word that is showing up in conversations across health-care organizations as we explore how to establish relationships with our patients to improve quality of care. According to researcher Brene' Brown, empathy is a connection with the heart, and cannot be expressed without touching our own vulnerability. In an increasingly complex and demanding health-care environment, with patient volumes and acuities impacting workflow and prioritization, it is important to explore vulnerability not only as a concept present in patient populations and our individual experiences as health-care professionals, but also as an unspoken and changing element in the entire clinical milieu. In a health-care world where focus is necessarily placed on quantitative metrics and outcomes, addressing concepts such as vulnerability can create a real challenge. Fear is an inherent by-product of vulnerability. As an aid to conversation and culture revision, this article presents a series of diagrams showing how focusing on the three relationships of Relationship-Based Care (RBC) (care for self, care for colleagues, and care for patients and families) can help shrink the fear associated with vulnerability. Fear initiates and perpetuates protective behaviors to keep us from feeling the uncertainty of vulnerability; those behaviors work against the development and nurturing of the RBC relationships. The three relationships of RBC provide a structure with which to explore vulnerability, allowing their principles and practices to help us open our hearts and lead us to the empathy we seek when serving our patients, ourselves, and each other.

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