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Analysis

Nurse Champions Compassionate Culture With 'The Pause'

By Jennifer Thew RN  
   May 22, 2018

Pausing for a moment of reflection after a patient’s death reconnects caregivers to the mission of healthcare.

It's no surprise when leaders are lauded for action that moves an organization forward. But Jonathan B. Bartels, RN, BSN, CHPN, palliative care liaison nurse at the University of Virginia Health System in Charlottesville, is being credited for encouraging others to be still.

Bartels' concept of "The Pause," where care teams take about a minute after a patient's death to stop and honor the life that has left them, has garnered national and international interest. 

This week, the American Association of Critical-Care Nurses will honor Bartels with the 2018 AACN Pioneering Spirit Award at the 2018 National Teaching Institute & Critical Care Exposition in Boston. The award recognizes significant contributions that influence high-acuity and critical care nursing and relate to the association’s mission, vision, and values.

"As an [emergency department] nurse, Jonathan created The Pause to help deal with his own feelings and help his colleagues after the death of a patient. That moment of reflection and compassion has grown into a movement that has profoundly impacted caregivers around the world," says AACN board president Christine S. Schulman, MS, RN, CNS, CCRN-K, in a news release.

Pause and Connect

The practice, Bartels says, gives healthcare providers permission to stop and honor loss, and it's a movement away from what he describes as "the industrialized/scientific/professional detachment" that healthcare practitioners have been trained in.

In short, it reconnects patients, family members, and providers with the essence of healthcare: humanity.

The ground for The Pause was laid around 2010, after Bartels attended a retreat that focused on developing resilience. Participants were challenged to go back to their healthcare facilities and create changes. At the time, Bartels was working in the emergency department, and he noticed how staff handled an unsuccessful resuscitation.

"During one of our intense resuscitations, I had noted that when we were done, we kind of just walked away from the situation," he says. "I realized that we had lost a ritual of honoring, so I knew that's where I could possibly [have] influence."

After losing a patient, Bartels took inspiration from the actions of a hospital chaplain who once requested the care team stop and pray after an unsuccessful resuscitation. "I emulated what a chaplain had done, but instead of offering a Judeo-Christian prayer, I asked that the room stop and honor the patient in humanistic language."

His example of such language: "Could we stop and honor this patient who was alive prior to coming in here, who was loved by others, who loved others, who had a life—and also take the moment to honor all the efforts we put into caring for the patient? I ask that we hold the space, to honor this patient in your own way and in silence." This allows staff to own the practice and honor a patient's last rite of passage when a chaplain is not available, he says.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.


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