"Why are we doing this?": clinician helplessness in the face of suffering

J Palliat Med. 2015 Jan;18(1):26-30. doi: 10.1089/jpm.2014.0115.


Background: When the brutality of illness outstrips the powers of medical technology, part of the fallout lands squarely on front-line clinicians. In our experience, this kind of helplessness has cognitive, emotional, and somatic components.

Objectives: Could we approach our own experiences of helplessness differently? Here we draw on social psychology and neuroscience to define a new approach.

Methods: First, we show how clinicians can reframe helplessness as a self-barometer indicating their level of engagement with a patient. Second, we discuss how to shift deliberately from hyper- or hypo-engagement toward a constructive zone of clinical work, using an approach summarized as "RENEW": recognizing, embracing, nourishing, embodying, and weaving--to enable clinicians from all professional disciplines to sustain their service to patients and families.

Publication types

  • Case Reports

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Burnout, Professional / prevention & control*
  • Emotions
  • Female
  • Hospice and Palliative Care Nursing / organization & administration*
  • Humans
  • Male
  • Middle Aged
  • Nurse Clinicians / psychology*
  • Nurse-Patient Relations
  • Physicians / psychology*
  • Stress, Psychological
  • Terminal Care / psychology*