Lessons in Stories: Why Narrative Medicine Has a Role in Pediatric Palliative Care Training.

Natalie Lanocha

doi:10.3390/children8050321

Natalie Lanocha

Open Access

https://doi.org/10.3390/children8050321

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Abstract

Narrative medicine is introduced and explored as a potential tool for developing competency in medical training, including reduction of burnout, sustaining empathy, and allowing for reflective practice. Developing cultural humility, communication skills, ethics, community building, and advocacy are also reviewed as domains that may be bolstered by training in narrative. Applications specific to pediatric palliative care are suggested, along with avenues for further research.

Highlights

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He stopped feeding and had not offered a smile since the morning. As antibiotics continued their course through his IV line, lumbar puncture results returned from the emergency room confirming meningitis
Over time I have discovered that emotionally challenging encounters, such as my experience with baby R, are intrinsic to clinical medicine, but it is our response to these events that impacts how we can productively move forward and avoid burnout

Summary

A Need for Narrative

Over time I have discovered that emotionally challenging encounters, such as my experience with baby R, are intrinsic to clinical medicine, but it is our response to these events that impacts how we can productively move forward and avoid burnout. In the Common Program Requirements, the Accreditation Council for Graduate Medical Education (ACGME) acknowledged the high risk of burnout in trainees. In partnership with their Sponsoring Institutions, have the same responsibility to address well-being as other aspects of resident competence” [2] With this acknowledgement, the ACGME emphasizes the importance of building skills for sustainable self-care, and charges graduate medical programs to add resiliency building to their medical education agendas. Narrative medicine is one such tool that provides a framework for processing complex emotion and promotes the development of sustainable methods for self-reflection. As I will describe, narrative competency can be utilized in medical training and practice to sustain empathy, promote resiliency, and build skills for delivery of excellent palliative care. We may consistently and reliably turn to narratives, even in our darkest moments, in order to take care of ourselves and provide the best care for our patients and families

Developing Narrative Competence

Perception and Representation

Reading to Promote Empathy

Writing for Communication and Reflection

Tailoring Narrative Medicine Programs and Research to Our Needs

Conclusions