Empathy

Abstract

The scenario in which I will discuss within my paper consists of an LPN student and a preceptor working a busy 12 hour shift on their acute care practicum. Both Patty (student) and Mary Lou (preceptor) worked very hard one evening and had not had a break when a patient requested some pain medication. They discussed their options with regards to pain management and later Patty administered Morphine 7. 5 mg SC into injector port in Mr B’s leg. At the end of the shift it was noted during a narcotic count that there had been an error with Morphine.

Patty had given the wrong amount as per order. Therapeutic Communication- Nurse Relationships as Part of a Team Before Mary Lou can organize a meeting with Patty the LPN student, she must first ensure the safety of the patient as paramount. Then she must decide the best way to approach Patty, an appropriate location to interview, the factors to consider while interviewing and the communication skills that would benefit their interview. Also she needs to determine whether anybody else should be involved. After careful consideration and all the facts gathered, Mary Lou calls Patty in for a interview.

Discussion Mary Lou decided to call a meeting in a neutral setting that would be non- confrontational and non-threaten to Patty. A place they could sit comfortably across from each other and make eye contact. It is important for Mary Lou not to attach blame and her approach will include sensitivity and respect, after all Patty is a student and still quite vulnerable. Mary Lou wants to make it clear an error has been made and that it needs to be addressed, rectified and reported without demoralizing or belittling Patty. The methods by which it is reported or addressed should be thoughtful, maintain confidentiality, and be directed toward the appropriate person, agency, or regulatory body. ” ( Burkhardt, Nathaniel, Walton, 2010, p 200) Some factors Mary Lou considers while interviewing Patty are any possible underlying reasons for the error: what happened. It is important for Patty to comfortably clarify in her own words and for Mary Lou to actively listen to the accounts of the day. This helps both parties understand completely where the error might have occurred and they can take steps to avoid a reoccurrence.

While Mary Lou realizes Patty ultimately administered the wrong dose of medication, it is very important that Mary Lou states her role as preceptor and her accountability in the incident. The Canadian Nurses Association notes in its Code of Ethics that as a part of being accountable, ( Burkhardt, Nathaniel, Walton, 2010, p 200) “ Nurses share their knowledge and provide feedback, mentorship and guidance for the professional development of nursing students, novice nurses and other health care team members. (CNA, 2008, p18) Mary Lou also offers empathy as she was once a nursing student as well and while we strive for perfection, human error can not always be avoided. The last issue to be considered and implemented is if anybody else needed to be involved? Mary Lou decided as long as they clearly identified the issue at hand and recognized they both had an ethical and professional responsibility to report the incident and rectify their shortfalls as student and preceptor, no other entity need to be involved.

Conclusion

In conclusion I think Mary Lou did an excellent job of identifying and addressing the issue of medication error ensuring dignity and respect to Patty. Mary Lou showed empathy and understanding while focusing on responsibilities of both parties to be more accountable in their daily care of patients, which at the end of the day is their main goal. One area of improvement that I noticed of Mary Lou after viewing the recording was she could have offered more open ended questions and let Patty express herself more. While I did feel Mary Lou actively listened to Patty, the opportunity for Patty to give feedback was not fully utilized.

Over all I found this to be an interesting experience on therapeutic communication that I enjoyed completing.

References

1. Arnold, E. C. & Boggs, K. U. (2011) Interpersonal relationships: Professional Communication Skills for Nurses, sixth edition (6th ed. ).
2. St Louis, MO: Elsevier/Saunders Burkhardt, M. , Nathaniel, A. , Walton, N. (2010)
3. Ethics and Issues in Contemporary Nursing (1st ed. ) Toronto, ON: Nelson Education Ltd Canadian Nurses Association (2008)
4. Code of Ethics for Registered nurses. Author If you need to type anything after the reference list then start it on this page

Dear mentor, Emotional intelligence has become a major tool in effective human interactions at home in school and within every organization, because of its usefulness in utilizing the powers of emotional on thoughts. According to Daniel Goleman, there are five components, which include self-awareness, self-regulation, motivation, empathy and social skills [Goleman, 1995]. Each component employs the self-understanding and appreciation as a foundational tool to discover ways to improve every relationship one has within others.

Self-Awareness is the ability to recognize and understand personal moods and emotions. Self-Regulation: The ability to control or redirect disruptive impulses and moods and the propensity to suspend judgment and to think before acting.. Motivation: A passion to work for reasons that go beyond money and status; a tendency to pursue goals with energy and persistence. Empathy: The ability to understand the EMOTIONAL makeup of other people. Social Skills: Proficiency in managing relationships and building networks and ability to find common ground and build rapport [Goleman, 1995].

Having taken a personal survey of these skills, I believe there are ways |I can apply to suit my status quo, so that the desired results can emerge. My main challenge has been to connect with other members of my team as individuals.  What I have decided to do is to first evaluate my personal skills with respect to this matter. I also want to do a self-portrait so that I can ascertain my current status. This would the stating point. This would afford me to know my positives and negatives in communication and human relationships [Goleman, 1995].

Besides, I would also undertake a dutiful effort in understanding every member of the team. This includes finding details about their lives such as date of birth, location of residence, their likes and dislikes. Having known this, I would pay visits, set mails regularly as inspirational tools fort their daily challenges. Within the lint of resources I have, i would also appreciate every effort in cash [gift] and kind. My motive is not to know so that we can relate better but to be a part of their life.

I believe that organizations can do certain things to help develop the emotional intelligence of their managers as well as other employees, first is the education on the components and intricacies of this; this can be done through training /retraining session for both leaders and employees.  Seminar, workshop and case studies are methods that can be adopted for this training. Apart of this, there can be a constant review of employee or manager skills in the company that employs emotional intelligence as tools in human resource management, such efforts could be identified and rewarded accordingly. This is another way emotional intelligence can become a useful tool in any organization.

Sir, I believe if you can work on these things, I would improve tremendously and build a viable working team.

REFERENCE

Goleman, D. (1995, November/December). Emotional Intelligence. Harvard Business Review.

Goleman’s Emotional Intelligence. http://www.12manage.com/methods_goleman_emotional_intelligence.html

Goleman’s model. www.businessballs.com/eq.htm

http://www.businessballs.com/emotionalintelligencecompetencies.pdf

What are the most relevant factors to be aware of when assessing a child or young person’s development? All children and young people are different and have different needs. Similarly, a family’s ability to respond to and meet all their needs may also differ. In some circumstances, professional assessment may be required to identify strengths and needs, to ensure that all children, young people and their families receive appropriate support.

Assessment may take place in a wide range of situations and for a variety of purposes, for example:

• A teacher’s assessment of a child’s educational attainment at key stages of the national curriculum, to determine future learning plans.
• A paediatric assessment to ensure that a child has reached the appropriate developmental milestones and to monitor progress.
• A Connexions personal adviser’s assessment of a young person’s strengths and barriers to participation in learning to provide feedback and motivation.
• An educational psychologist’s assessment of a child or young person’s special educational needs to identify their educational strengths and needs.
• A social worker’s assessment of a child’s home situation, to determine if they are at risk of harm. Each of these types of assessment has a clearly defined purpose and it is important to note that the role and function of assessment may vary according to the context.

The unborn, infant, child or young person’s current health condition (for example, conditions of relevance to an infant, child or young person, including growth, development, physical and mental well-being). Also includes consideration of: * health conditions or impairments which significantly affect everyday life functioning whether chronic or acute, including obesity; unborn child is not developing adequately; * access to and use of appropriate health services (by mother in case of unborn), uch as those provided by a GP/dentist/optician, immunisations and appropriate developmental checks; * number and frequency of hospital admissions and accidents (of mother where unborn); * Access to and use of appropriate health advice and information, for example, diet, sexual health and management of any health condition such as diabetes or asthma (where unborn, mother is following advice). Physical Development: “Physical Development” refers to the infant, child or young person’s means of mobility, level of physical or sexual maturity/delayed development.

Also includes consideration of:

• preferred means of communication;
• use of first language;
• ability to gain attention and make contact, access positive relationships, be with others, encourage conversation;
• the impulse to communicate, exploring, experiment, labelling and expressing, describing, questioning, representing and predicting, sharing thoughts, feelings and ideas;
• listening and paying attention to what others say, making playful and serious responses, enjoying and sharing stories, songs, rhymes and games, learning about words and meanings;
• vision and hearing; ability to communicate meaning, influence others, negotiate and make choices, understanding of others;
• language for communicating and thinking;
• linking sounds and letters;
• reading and writing;
• willingness to communicate;
• articulation skills and language structure;
• vocabulary and comprehension;
• fluency of speech and confidence;
• appropriateness of social and communications skills, for example, body language, excessive use of expletives or inappropriate language.

Emotional and Social Development The emotional and social response the infant, child or young person gives to parents, carers and others outside the family.

Also includes consideration of:

• the importance of being special to someone, being able to express feelings, developing healthy dependence, developing healthy independence;
• nature and quality of early attachments;
• self-harm or risk of self-harm;
• phobias or psychological difficulties;
• fears or psychological difficulties such as persistent sadness or tearfulness;
• temperament, coping and adjusting abilities for example, after experiencing domestic violence, bereavement or family relationship breakdown;
• disposition, attitudes and motivation to change.

Behavioural Development The behaviour of the child or young person and whether behaviour occurs in a particular setting or all settings. Also includes consideration of:

• lifestyle and self-control (including participation in reckless activity and need for excitement);
• behaviour in class or other environments where the child or young person comes into contact with their peers;
• whether undiagnosed conditions may be impacting on behaviour (eg. earing or visual impairment);
• substance misuse (includes alcohol and volatile substance misuse and controlled drugs under the Misuse of Drugs Act 1971);
• anti-social behaviour for example, destruction of property, aggression towards others, harm or risk of harm to others;
• sexually inappropriate behaviour and attempts to manipulate or control others;
• early sexual activity, unprotected sex, lack of reflection or positive decision making about sex and relationships;
• offending behaviour and risk of re)offending;
• violent or aggressive behaviour at home or school;
• attitudes to offending;
• over activity, attentiveness, concentration and impulsive behaviour Identity, including self-esteem, self-image and social presentation

Also includes consideration of: * growing awareness of self, realisation of separateness and differences from others, recognition of personal characteristics and preferences, finding out what they can do; * importance of gaining self-assurance through a close relationship, becoming confident in what they can do, valuing and appreciating their own abilities, feeling self-assured and supported, a positive view of themselves; * knowledge of personal and family history; access to recognition, acceptance and comfort, ability to contribute to secure relationships, understanding they can be valued by and important to someone, exploring emotional boundaries; * sense of belonging, being able to join in, enjoying being with familiar and trusted others, valuing individuality and contributions of self and others, having a role and identity within a group, acceptance by those around them; * race, religion, age, gender, sexuality and disability – may be affected by bullying or discriminatory behaviour; understanding of the way in which appearance and behaviour are perceived and the impression being created.

Family and Social Relationships The ability to empathise and build stable and affectionate relationships with others, including family, peers and the wider community. Also includes consideration of: * stable and affectionate relationships with parents or caregivers; * sibling relationships; * involvement in helping others; * age-appropriate friendships; * association with predominantly pro-criminal peers or lack of non-criminal friends; * understanding of others and awareness of consequences; * association with substance-misusing friends/peer groups.

Give examples of how you can assess a child or young person’s development in the following areas. Physical development- When we refer to physical development we are looking at factors such as gross motor(which indicates large muscle development such as walking or swinging our arms) and fine motor (more intricate movements such as picking up objects or writing). This is a relatively easy assessment to carry out. If we have regular contact with the child or young person we can usually measure and weigh that individual on a weekly or bi-weekly basis. Over a short period of time it would soon become apparent if there was any cause for concern.

We can also observe children as they play and interact. For example can they climb, skip, use a rope and coordinate their hand to eye movements. Communication and speech development: By speech we mean * The speech sounds children use to build up words, saying sounds accurately and in the right places. * Speaking fluently, without hesitating, prolonging or repeating words or sounds. * Speaking with expression and a clear voice, using pitch, volume and intonation to support meaning. By communication we mean the way in which language is used to interact with others * Using language in different ways; to question, clarify, describe and debate. Using non-verbal rules of communication: listening, looking, knowing how to take verbal turns and how to change language use to suit the situation. * The ability to take into account other people’s perspectives, intentions and wider context This can be assessed by observing the way in which a child or young person interacts with us, their parents or their social groups. We can also spend time with younger children by getting them to repeat words or have short, fun conversations with them.

When assessing them we can look out for any irregularities such as stutters, speech impediments or factors that may be affecting listening skills etc. Cognitive or intellectual development Cognitive development is the construction of thought processes, including remembering, problem solving, and decision-making, from childhood through adolescence to adulthood. It was once believed that infants lacked the ability to think or form complex ideas and remained without cognition until they learned language. It is now known that babies are aware of their surroundings and interested in exploration from the time they are born.

From birth, babies begin to actively learn. They gather, sort, and process information from around them, using the data to develop perception and thinking skills. Cognitive development refers to how a person perceives, thinks, and gains understanding of his or her world through the interaction of genetic and learned factors. Among the areas of cognitive development are information processing, intelligence reasoning, language, development and memory A broad range of assessment measures should be used to gain a full understanding of a pre-schooler’s functioning (e. . , parent and teacher reports, behavioural observation, detailed developmental history, and play-based assessment, in addition to traditional cognitive tests). Social/behavioural/emotional development Healthy social-emotional development includes the ability to:

• Form and sustain positive relationships
• Experience, manage, and express emotions

Explore and engage with the environment Children with well-developed social-emotional skills are also more able to:

• Express their ideas and feelings
• Display empathy towards others Manage their feelings of frustration and disappointment more easily
• Feel self-confident
• More easily make and develop friendships
• Succeed in school Social-emotional development provides the foundation for how we feel about ourselves and how we experience others.

This foundation begins the day we are born and continues to develop throughout our lifep. The greatest influence on a child’s social-emotional development is the quality of the relationships that he develops with his primary caregivers.

Positive and nurturing early experiences and relationships have a significant impact on a child’s social-emotional development. We can assess the emotional, social and behavioural development of the children who are in our care by recording behaviour patterns such as temper tantrums, physical confrontations and playful interactions. These findings can be recorded on charts and in diaries on a regular basis. Moral development Moral development focuses on the emergence, change, and understanding of morality from infancy through adulthood.

In the field of moral development, morality is defined as principles for how individuals ought to treat one another, with respect to justice, others’ welfare, and rights. In order to investigate how individuals understand morality, it is essential to measure their beliefs, emotions, attitudes, and behaviors that contribute to moral understanding. The field of moral development studies the role of peers and parents in facilitating moral development, the role of conscience and values, socialization and cultural influences, empathy and altruism, and positive development.

The interest in morality ps many disciplines (e. g. , philosophy, economics, biology, and political science) and specializations within psychology (e. g. , social, cognitive, and cultural). Moral developmental psychology research focuses on questions of origins and change in morality across the lifep Essentially it is the process in which children learn right from wrong, this is learned behaviour as a child will learn from its primary carer. We can assess what a young person or child is learning with regards to their morale’s by observing their behaviour towards thers. It is also possible to present certain dilemma’s under controlled circumstances to that child. Example: “Who is Naughtier? ” Piaget determined that younger children judge bad behavior by the amount of damage caused by a person’s behavior. He would tell children a story with a moral dilemma. He would ask them to tell him “who is naughtier:” a boy who accidentally broke fifteen cups or a boy who breaks one cup trying to reach a jam jar when his mother is not around.

Younger children attributed the “naughty” behavior to the boy who broke the most cups regardless of the other child’s intent. This type of moral reasoning was called Objective Morality or Moral Realism. Older children attributed bad behavior to the boy who broke only one cup because his motives where bad. This, more advanced form of moral reasoning was called Subjective Morality or Autonomous Morality. Piaget did not feel that children fully achieved this stage of moral development before the ages of twelve or thirteen.

Intercultural Communication Studies XV: 1 2006 Hara The Concept of Omoiyari (Altruistic Sensitivity) in Japanese Relational Communication Kazuya Hara, Meikai University, Japan Abstract It is essential to explore Japanese concepts in Japanese languages as intellectual tools for future studies in Asia. In order to develop Asian theories of communication, therefore, Asian communication scholars ought to engage in this important task.

This paper presents such an attempt by conceptualizing the concept of omoiyari for a Japanese theory of relational communication. In social psychology, the Japanese concept of omoiyari has been examined in terms of altruism, sympathy, empathy, and prosocial behavior, and a variety of cognitive models of prosocial behavior arousal have been proposed. In the field of communication studies, however, the concept of omoiyari has not attracted much scholarly attention, although aspects of harmonius Japanese communication are well documented.

By synthesizing the relevant literature on omoiyari across disciplines, then, this paper formulates a definition of omoiyari for Japanese communication research, lays out its basic assumptions, and characterizes it in light of four major semantic areas of omoiyari: (1) prayer, (2) encouragement, (3) help, and (4) support. Introduction “Cast your bread upon the waters and it will return to you. ” –a saying reflecting omoiyari When Japanese people feel another’s kindness toward them and see someone’s warm-hearted feelings, thoughts, and behaviors, they appreciate that person’s omoiyari.

The primary meaning of omoiyari is “an individual’s sensitivity to imagine another’s feelings and personal affairs, including his or her circumstances” (Shinmura, 1991, p. 387, translated by Hara). Omoiyari has attracted non-Japanese scholars’ attention as one of the most important ideas in Japanese cultural value and communication (e. g. , Lebra, 1976; Travis, 1998; Wierzbicka, 1997). The word omoiyari is often seen on signs bearing a school motto and at police stations. In many surveys of public opinion, Japanese people have listed omoiyari as a key concept on which they put high value.

Although omoiyari -based behavior and activity are seen across cultures, Japanese people are the ones who put the highest value on omoiyari all over the world (Kikuchi, 1988; Akanuma, 2004). This humane omoiyari concept has been emphasized in moral education at schools in Japan as the guiding principle to communicate with others (Ito, 1998a; 1998b). In educational psychology in Japan, the importance of omoiyari has been emphasized with its developmental views of children (e. g. , Kikuchi, 1988).

Recent inhumane crimes such as ill-treatment bullying or indiscriminate murder on the street are caused by the lack of omoiyari, and the importance of omoiyari has undergone a reevaluation in terms of education in the schools (Kanno, 1988). Psychological aspects of omoiyari such as empathy and sympathy have been studied, 24 Intercultural Communication Studies XV: 1 2006 Hara and its behavior has been studied as prosocial behavior, altruistic behavior, and helping behavior in social psychology (e. . , Harada, 1991; Kikuchi, 1998; Matsui, 1991). Although the term “omoiyari behavior” is not generally used as a technical term in social psychology (Matsui, 1991), the titles of several studies on these concepts are comprehensively translated into Japanese using the word omoiyari (e. g. , Eisenberg & Mussen, 1989; Hoffman, 2001; Jones, 1993). Additionally, cultural psychologists Uchida and Kitayama (2001) developed a measurement scale of omoiyari from the viewpoint of sympathy.

In the field of communication studies, although aspects of harmonious communication have been well-researched, only a few studies have focused on omoiyari as an important factor of Japanese harmonious communication. For example, Donahue (1998) argues that omoiyari is a psychological factor in Japanese indirect communication. In health communication, Kakai (2002) argues that Japanese prefer ambiguity or not disclosing of cancer to their family members. Behind such indirect communication and style is the psychological and cultural background of omoiyari.

These studies refer to the study on Japanese empathy by anthropologist Lebra (1976) and her definition and observation of omoiyari. Although previous studies have contributed to pointing out the importance of omoiyari in Japanese mental culture and behavioral culture, there are three points to be further considered. First, many psychological studies based on Western concepts have not proposed clear conceptual definitions of omoiyari, so there is no consensus on its definition.

Second, studies on omoiyari in other fields have only argued one aspect of omoiyari with its case contexts; we might be able to explore multi-aspects of omoiyari, taking various communication contexts and levels into consideration. Third, negative aspects of omoiyari have not been referred to adequately in previous studies on omoiyari. For example, there are cases when omoiyari toward others might not be appreciated or accepted by others. In order to develop future studies on omoiyari in Japanese communication, this paper attempts to concisely conceptualize Japanese omoiyari across disciplines.

Additionally, the author believes that it is essential to explore Japanese concepts in Japanese languages as intellectual tools for future studies in Asia. In this paper, first, the author will review the relevant concepts in Western psychology which have been argued as omoiyari in Japan. Then, he will articulate Japanese omoiyari with its translation, definition, and major characteristics. Finally, using a diagram, he will propose four semantic areas of omoiyari, taking its communication levels and contexts into consideration.

Omoiyari and Its Relevant Concepts The idea of omoiyari has been argued from the standpoint of the concepts of altruism, sympathy, empathy and prosocial behavior. Although the causal developmental relationship among these concepts is controversial (e. g. , Eisenberg, 1986; Hoffman, 1982; Toi & Baston, 1982), each concept in itself has been regarded as one aspect of omoiyari in Japanese social psychology and communication studies. This means that these concepts are seen as elements of omoiyari, and conversely that omoiyari can be conceptualized with a combination of these concepts.

The foundation of omoiyari feelings can be covered with the concept of altruism. Altruism is other-oriented and self-sacrificial (Kerbs, 1975). According to Cohen (1978), altruism refers to an act or desire to offer something gratuitously to others when needed. Cohen indicates that there are three components of altruism: (a) giving, or the desire to do so; (b) empathy; and (c) the absence of any motives of reward from doing the altruistic behavior. 25 Intercultural Communication Studies XV: 1 2006 Hara Essentially, altruism lies in the motivation to help others and to aid others in their behavior.

As this conceptual definition shows, altruism is the source that produces more concrete omoiyari feelings and behavior. Based on altruism, omoiyari seems to comprise both sympathy and empathy (e. g. , Kikuchi, 1991, 1998; Matsui, 1991). Sympathy refers to a concern for another person, agreement with and consideration for the feelings of others, or compassion (DeVito, 1986). It is generally conceived as a reaction to particular contexts such as the sadness or disappointment of others. Another view is that sympathy refers to a feeling for another person, while empathy refers to actually feeling as that person does (DeVito, 1986).

Empathy in omoiyari is described in Bruneau’s (1995) definition as “‘feeling into’ another’s feelings with one’s own, vicariously, and attempting to achieve some I-thou congruence” (p. 87). Empathy implies understanding of others through imagining the situation of others (Travis, 1998). Psychological aspects of altruism, empathy, and sympathy are reflected in prosocial behavior. Prosocial behavior generally refers to “voluntary actions that are intended to help or benefit another individual or group of individuals” (Eisenberg & Mussen, 1989, p. 3).

Wispe (1972) suggests that prosocial behavior refers to behaviors that can be described as sympathetic, altruistic, charitable, and so on. Furthermore, prosocial behavior benefits others without anticipating external rewards, and is done under the conditions that it is done either for its own end, or as an act of restitution (Bar-Tal, 1976). Also, as Bar-Tal argues, prosocial behavior should not be carried out as a result of external threat, enforcement, or obligation, but should be due to an individual’s freedom to decide to act in a certain manner or not.

Reviewing altruism, empathy, sympathy, and prosocial behavior in human communication, on the basis of altruism, people seem to have feelings of either empathy or sympathy at the stage of intrapersonal communication. Additionally, in the context of communication activities with others, when such feelings are seen in behavior, the behavior is regarded as prosocial behavior. As the findings in Uchida and Kitayama’s (2001) survey indicate, omoiyari as sympathy had a positive relationship with emotional empathy and prosocial behavior. The combination f these concepts seems to help conceptualize aspects of omoiyari. However, since each concept cannot individually cover omoiyari in a comprehensive sense, we need a conceptual definition of omoiyari before applying these concepts to aspects of omoiyari. The Concept of Japanese Omoiyari In Japanese communication, it is often seen that people say “show omoiyari toward others” when a person does not do so. The word omoiyari is directed toward anybody of the same generation and status, or toward younger people with regard to both in-group and out-group members.

To say “have omoiyari” to elderly people, on the other hand, sounds arrogant, although the person is thinking “omoiyari” in his or her mind. In such a situation, it seems appropriate to use the word “itawari”(caring consideration with respect) instead, even though the person has the word “omoiyari” in his or her mind. In this section, the author attempts to propose an expedient translation of omoiyari into English which is comprehensible to both Japanese and non-Japanese people. Then, the author will define omoiyari in Japanese communication.

Translation of Omoiyari into English It is impossible to translate Japanese omoiyari into English with one word or phrase 26 Intercultural Communication Studies XV: 1 2006 Hara which is comprehensible to both Japanese and non-Japanese people. Even words such as compassion, consideration, thoughtfulness, mercy, and benevolence cover only one aspect of Japanese omoiyari. There seem to be two reasons for this difficulty. First, there are different views of omoiyari across cultures.

For example, Yamagishi (1995) argues that for Westerners, omoiyari is not “thoughtfulness” to others, which is occasionally perceived to be unnecessarily imposed by others depriving one’s own right to choose his/her own behavior. Easterners, on the other hand, believe that thoughtfulness-based omoiyari is essential to living a group-oriented life. Secondly, as Travis (1998) points out, English words such as “considerate” and “thoughtful,” which are related to omoiyari, do not involve the same kind of “intuitive” understanding. This intuitive way of communication is also cultivated as intuitive listening and empathic understanding in

Japanese ways of communication (Barnland, 1975). As for a neutral and comprehensible translation term, Yamagishi (1995) points out that “sensitivity” can represent the feelings of omoiyari that are common to Westerners and Easterners and which do not have the connotation of imposing one’s thought on others. Therefore, in this paper, the author uses his own tentative and expedient translation of omoiyari as “altruistic sensitivity” taking the definition of altruism, “concern for the happiness and welfare of other people rather than for your own ” (Sinclair, 1987, p. 2) into consideration, regarding altruism as the psychological foundation to produce omoiyari-based feelings such as empathy or sympathy. Defining Omoiyari Omoi in omoiyari means considerate caring for others, while yari is the noun form of the verb yaru, which means sending something to others. Therefore, “omoiyari ” literally means sending one’s altruistic feelings to others. The difference among omoiyari, empathy, and sympathy is that omoiyari implies intuitive understanding and includes behaving in that way (Shinmura, 1991; Travis, 1998; Uchida & Kitayama, 2001).

Consideration toward others is not always received, and omoiyari does not expect any reward. If any reward is expected, it is not omoiyari but business-like helping behavior. One of the definitions of omoiyari which is frequently referred to is the one by cultural anthropologist Lebra (1976), which describes omoiyari as “the ability and willingness to feel what others are feeling, to vicariously experience the pleasure or pain that they are undergoing, and to help them satisfy their wishes…without being told verbally”(p. 38).

Historical anthropologist Akanuma (2004) states that omoiyari is to guess others’ feelings and pay careful attention to their feelings, accepting what has happened (or will happen) to others as what has happened (or will happen) to myself. Social psychologist Ninomiya (1991) defines omoiyari as voluntary behavior for others’ benefit. The common assumptions underlying all these definitions are that omoiyari is voluntary and that people put high value on sharing feelings with others. As such, intuitive understanding is necessary.

In this study, the author will define omoiyari as an intuitive understanding of others’ feelings that will occasionally lead us to conceive what to do or what not to do to others. Taking the conceptual issues of omoiyari into consideration, the author will further argue major characteristics of omoiyari in the following section. Major Characteristics of Omoiyari To have a sense of omoiyari and to behave with omoiyari are regarded as ideal communication in Japanese society. For example, according to a survey by the Ministry of 27 Intercultural Communication Studies XV: 1 2006 Hara

Education in Japan cited in the Yomiuri-shimbun (1994), elementary and junior high school teachers in Japan answered that they put the highest value on omoiyari in moral education. Additionally, in a survey on child-birth in Japan by the Yomiuri-shimbun (2005), 86. 7% of the parents expected their children to be a child with omoiyari. As these data show, to have omoiyari is essential in Japanese relational communication across contexts. In this section, the author will begin to argue major characteristics of omoiyari based on its psychological, behavioral aspects, along with the assumptions of omoiyari in previous studies.

Then negative aspects of omoiyari will be briefly mentioned. Finally, four context-based semantic areas of omoiyari in human communication will be proposed. Psychological Aspects of Omoiyari Omoiyari has been considered altruistic feelings or emotional participation in others’ mindds (Eisenberg & Mussen, 1989; Kikuchi, 1988), and there are three characteristics which occasionally lead to actual prosocial behavior. The first is that omoiyari does not include the concept of “otherness” (Akanuma, 2004). This means that omoiyari means to understand the other’s feelings, not taking one’s self-concept into consideration (Otsuka, 1991).

In this assumption, there is a Japanese interpersonal view that puts high value on oneness with others. For example, Hamaguchi (1985) argues that Japanese people think that since affectionate mutual aid is essential, people should read mutual true intention, and the relationship once established must be respected as valuable. Oneness with others gets reinforced through mutual omoiyari. The second is that omiyari is neither based on pity from superiority nor on mechanistic give-and-take relations (Otsuka, 1991).

The motivation of omoiyari is voluntary, and does not expect gratitude from others (Kikuchi, 1991). If a person expects any reward when they help others, that is not omoiyari. Such a reward-expecting behavior will not be respected but rather despised, and is against the virtue of omoiyari. The third is that the value of omoiyari is evaluated based on purity of consideration of others. It goes without saying that the purer the consideration is, the more appreciated it is. However, such pure consideration of others occasionally contradicts its behavior.

A commonly cited example is that physicians and family members are reluctant to directly disclose terminal diagnoses to patients because of omoiyari (Kakai 2001; Paton & Wicks, 1996). Such communication, which might be regarded as deception, will not be criticized by others because they know the family’s true feelings. Behind this type of communication, there is an unspoken assumption that true and honest feelings will be understood by others even though one’s behavior contradicts his or her psychological feelings. Behavioral Aspects of Omoiyari Omoiyari in behavior has been studied as prosocial behavior in social psychology.

Kikuchi (1998) provides four common characteristics of omoiyari based on its psychological assumptions. The first is that omoiyari as prosocial behavior includes the idea of an action which is helpful for others. However, this does not necessarily mean that the prosocial behavior will be willingly accepted by others. The second is that omoiyari as true prosocial behavior is not done with the expectation of a reward from others. This is not a matter of whether a person receives or rejects a reward, but rather the premise that the person had no desire to receive a reward in the first place.

The third is that omoiyari-based prosocial behavior is accompanied by a kind of cost or risk of self-sacrifice. The final condition is that omoiyari as prosocial behavior 28 Intercultural Communication Studies XV: 1 2006 Hara should be voluntary. This means that a person is not bound by any sense of duty to others, but is willing to behave prosocially as a choice. Japanese omoiyari behavior is uniquely seen in conflicting situations. For example, it is often stated that Japanese prefer to avoid conflict rather than to try to resolve it. In such a situation, the Japanese are inclined to use mbiguous or euphemistic expressions with their bokashi (ambiguous) logic (Nayayama, 1986), and to use honne (true intentions) and tatemae (public principles) properly (Doi, 1985) so as not to hurt others’ feelings. Such a linguistic feature can be described as “the language of omoiyari,” and it is listener-oriented (Ando, 1986). Even to enemies, they do not tend to deliver a fatal blow. Such communication styles are represented in proverbs such as teki ni shio wo okuru (to show humanity even to one’s enemy) or bushi no nasake (samurai-like mercy). Omoiyari, however, is not always performed desirably.

In the following section, negative aspects of omoiyari will be mentioned with cases that are against its psychological and behavioral assumptions. Negative Aspects of Omoiyari Omoiyari does not always function as we hope. For example, overly imposing omoiyari on others might be a psychological burden or, even worse, an annoyance. This is called osekkai (meddlesome) and is the antithesis of empathetic understanding (Lebra, 1976). Especially when the elderly want to meddle in younger people’s affairs, the younger people cannot say “Please mind on your business. This type of omoiyari could be considered osekkai. In the worst case scenario, when omoiyari is not accepted by the receiver as the source expected, the source might blame the receiver in his or her mind. This is called sakaurami (to think ill of a person who meant to be kind). At the point when the source feels sakaurami, however, his or her kindness to others is no longer regarded as omoiyari. Four Context-Based Semantic Areas of Omoiyari in Human Communication As argued above, omoiyari consists of both affective aspects (altruism, sympathy, empathy) and a behavioral one (prosocial behavior).

Using these concepts, the author will attempt to conceptualize four semantic areas of omoiyari. The following figure representing the four areas of omoiyari is based on intrapersonal communication (Areas A and B) and interactive level (Areas C & D). [See next page. ] The fundamental assumption is that Area A and Area B are at the level of intrapersonal communication and cover one’s cognitive and affective aspects. Area C covers the interaction stemming from Area A, and Area D covers the interaction stemming from Area B. Area A and Area C are based on sympathy, while Area B and Area D are based on empathy.

Every feeling and behavior by a communicator is based on altruism and with intuition. Area A is the situation where a person is worrying abut someone’s undesirable situation and praying that it will be improved. The feeling is based on altruism and sympathy. In this context, examples such as praying for the recovery of another’s health or sympathizing with the struggle of others are included. In contrast, in Area B, the communicator has a feeling of encouragement in his or her mind, and the feeling is based on altruism and empathy.

For example, praying for the success or health of others is included in this area. Area C and Area D cover people’s behavioral aspects in their relational communication and social activities. In these areas, verbal and nonverbal interaction is exchanged, and helping behavior is added when necessary. Area C, which stems from the psychological feelings of Area A, stands for prosocial behavior based on altruism and sympathy. 29 Intercultural Communication Studies XV: 1 2006 Hara Communication activities such as helping behavior or volunteer activities are included in this area.

Also, Area D, which stems from the psychological feelings of Area B, is based on altruism and empathy, and includes situations such as supporting other people’s success with one’s own will or participating in activities to share happiness with others. Prosocial Behavior Area C: Help Area D: Support Sympathy – – – – Area A: Prayer Intuition –––– Empathy Area B: Encouragement Altruism Figure 1. Four Context-Based Semantic Areas of Omoiyari in Human Communication Concluding Remarks The primary purpose of this essay was to onceptualize Japanese omoiyari (altruistic sensitivity) with its psychological and behavioral characteristics, and to propose four types of omoiyari (prayer, encouragement, help, and support) from the viewpoint of communication. Although the author was only able to review a portion of the previous literature on omoiyari, he hopes that the essence of omoiyari conceptualized in this paper will contribute to further studies of Japanese relational communication. Based on the conceptualization in this paper, the author expects future studies to be conducted in three areas.

First, various communication styles in each of the four semantic areas of omoiyari (prayer, encouragement, help, and support) should be further examined and discussed. Secondly, the possibility of combining these four areas should be further examined using empirical studies. Third, based on the emic studies on this type of concept all over the world, to seek commonalities of omoiyari views across cultures is strongly suggested. Based on these studies, derived-etic views of altruistic sensitivity are highly anticipated. References Akanuma, K. (2004). Nihonjin wa naze gambaru noka (Why do the Japanese make efforts to anything? . Tokyo: Daisan-shokan. Ando, S. (1986). Nihongo no ronri, eigo no ronri (The logic of Japanese language and the logic of English language). Tokyo: Taishukan. Barnlund, D. C. (1975). Public and private self in Japan and the United States: Communicative Styles of two cultures. Tokyo: Simul Press. Bar-Tal, D. (1976). Prosocial behavior: Thory and research. NY: Halsted Press. Bruneau, T. (1988). Conceptualizing and using empathy in intercultural contexts. Human Communication Studies,16,37-70. 30 Intercultural Communication Studies XV: 1 2006 Hara Bruneau, T. (1995).

Empathetic intercultural communication: State of the art and future potential. Intercultural Communication Studies, 8,1-24. Cohen, R. (1978). Altruism: Human, cultural, or what? In L. Wispe (Eds. ), Altruism, sympathy, and helping: Psychological and sociological principles (pp. 79-98). New York, NY. Academic press. DeVito, J. A. (1986). The communication handbook: A dictionary. New York, NY: Harper & Row. Doi, T. (1985). The anatomy of self: The individual versus society (M. A. Harbison. Trans. ). Tokyo: Kodansha International. Donahue, R. T. (1998). Japanese culture and communication: Critical cultural analysis.

Lanham, MD. University of Press America. Eisenberg, N. (1986). Altruistic cognition, emotion, and behavior. Hillsdale, NJ: Erlbaum. Eisenberg, N. & Mussen, P. H. (1989). The roots of prosocial behavior in children. Cambridge CB: Cambridge University Press. Eisenberg, N. & Mussen, P. H. (1989). Omoiyari kodo no hattatsu shinri (The roots of prosocial behavior in children) (A. Kikuchi. & N. Ninomiya Trans. ). Tokyo: Kaneko-shobo. Hamaguchi, E. (1985). A contextual model of the Japanese: Toward a methodological innovation in Japanese studies. (S. Kumon & M. R. Creighton Trans. ).

Journal of Japanese Studies, 11, (2), 289-321. Harada, J. (1991). Omoiyari no kozo (The anatomy of omoiyari). In Kikuchi, A. (Ed. ) Gendai no esupuri: Omoiyari no shinri, No. 291 (Current espirit: The psychology of omoiyari No. 291. (pp. 48-56). Tokyo: Shibundo. Hoffman, M. L. (1982). Development of prosocial motivation: Empathy and guilt. In N. Eisenberg (Ed. ,) The development of prosocial behavior (pp. 218-231). New York: Academic Press. Hoffman, M. L. (2001). Kyokan to dotokusei no hattatsu shinrigaku: omoiyari toseigi tono kakawariaide (Empathy and moral development: Implications for caring and justice) (Kikuchi, A. Ninomiya, K. Trans. ). Tokyo: Kawashima-shoten. Ito, K. (1998a). Omoiyari no kokoro wo hagukumu dotokujugyo: Shogakkou ni okeru togoteki puroguramu no tenkai (Moral education classes to develop omoiyari mind: The development of programs at elementary schools). Tokyo: Meiji Tosho Shuppan. Ito, K. (1998b). Omoiyari no kokoro wo hagukumu dotokujugyo: Chugakko ni okeru togoteki puroguramu no tenkai ((Moral education classes to develop omoiyari mind: The development of programs at junior high schools). Tokyo: Meiji Tosho Shuppan. Jones, R. N. (1993).

Omoiyari no ningenkankei sukiru (Human relationship skills: Training and self-help). (Aikawa, M. Trans. ). Tokyo: Seishin-shobo. Kakai, H. (2002). A double standard in bioethical reasoning for disclosure of advanced cancer diagnoses in Japan. Health Communication, 14, (3), 361-376. Kanno, J. (1988). Ijime to omoiyari: ijimekko no kokoro no yugami (Ill-treatment and omoiyari: The distorted mind of ill-treating children). Jidoshinri (Child Psychology), 42, (6), 25-32. Kerbs, D. (1975). Empathy, and altruism. Journal of Personality and Social Psychology, 32, 1134-1146. Kikuchi, A. 1988). Omoiyari no hattatsu shinri (Developmental psychology of omoiyari). Jidoshinri (Child Psychology), 42, (6), 18-22. 31 Intercultural Communication Studies XV: 1 2006 Hara Kikuchi, A. (1991). Omoiyari wo kangaeru: Hito to hito tono kakawarigaku (Consideration of omoiyari: Science on the relationship between person and person). Kyoto: Tanko-sha. Kikuchi, A. (1998). Mata omoiyari wo kagaku suru (Another scientific argument on omoiyari). Tokyo: Kawashima-shoten. Lebra, T. S. (1976). Japanese patterns of behavior. Honolulu, HI: University of Hawaii Press. Matsui, Y. (1991).

Omoiyari no kozo (The anatomy of omoiyari). In Kikuchi, A. (Ed. ) Gendai no esupuri: Omoiyari no shinri, No. 291 (Current espirit: The psychology of omoiyari No. 291. (pp. 27-37). Tokyo: Shibundo. Nakayama, O. (1986). Nihonjin no bokashi komyunikeshon ni taisuru rinsho shakaigakuteki kenkyu (A study of the Japanese communication from the viewpoint of socio-clinical psychology). Shakaishinrigaku Hyoron (Japanese Review of Social Psychology), 5, 12-25. Ninomiya, K. (1991). Kodomo no omoiyari, otonano omoiyari (Children’s omoiyari and adults’ omoiyari). In Kikuchi, A. (Ed. Gendai no esupuri: Omoiyari no shinri, No. 291. (Current espirit: The psychology of omoiyari No. 291). (pp. 38-47). Tokyo: Shibundo. Otsuka, S. (1991). Nihon no kokoro, Toyo no kokoro: Omoiyari no hikaku shisoshi kenkyu (Japanese mind and Oriental mind: The studies on comparative philosophical history of omoiyari) Tokyo: Keizai-oraisha. Paton, L. & Wicks, M. (1996). The growth of the hospice movement in Japan. The American Journal of Hospice & Palliative Care, 13, (4), 26-31. Shinmura, I. (1991). Kojien (4th ed). Tokyo: Iwanami-shoten. Sinclair, J. (Ed. ). (1987). Collins cobuild English language dictionary.

London: HarperCollins. Toi, M. & Batson, C. D (1982). More evidence that empathy is a source of altruistic motivation. Journal of Personality and Social Psychology, 43, 281-292. Travis, C. (1998). Omoiyari as a core Japanese value: Japanese-style empathy? In A. Angeliki & T. Elzbieta (Eds. ), Speaking of emotions: Conceptualization and expression (pp. 55-81). Berlin: Mouton de Gryyter. Uchida, Y. & Kitayama, S. (2001). Omoiyari shakudo no sakusei to datosei no kensho (Development and validation of a sympathy scale). The Journal of Psychology, 72, (4), 275-282. Wierzbicka, A. (1997).

Understanding cultures through their key words: English, Russian, Polish, German, and Japanese. New York: Oxford University Press. Wispe, L. G. (1972). Positive forms of social behavior: An overview. Journal of Social Issues, 28, (3), 1-19. Yamagishi, K. (1995). Nichiei gengo bunka ronko (Aspects of Japanese-English languages and cultures). Tokyo: Kobian-shobo. Yomiuri shimbun (1994, May 27). Sofuto ni natta dotoku kyooku (Moral education in Japan became flexible). Tokyo: Yomiuri shinbun-sha. p. 30. Yomiuri shimbun. (2005, July 5). Data: Kazoku (Data: Family). Tokyo: Yomiuri-Shimbun-sha. p. 39. 32

The phrase “the customer is never wrong,” has been attributed to Cesar Ritz, the founder of the Ritz-Carlton empire. Needless to say, the man knew from customer service. How does this luxury hotel keep its customers content—and coming back?

Paul Hemp, a senior editor at Harvard Business Review, stepped into the shoes of a Ritz-Carlton room-service waiter to find out. One observation: Empowering your employees to provide top-notch customer service is not enough. You must also inspire them to exercise that power. by Paul Hemp Reflecting on the experience

One element of the Ritz-Carlton training is a follow-up session, known as Day 21. It typically takes place about three weeks after the initial orientation. The aim is to review the Gold Standards after new employees have had a chance to put them into practice. Though I didn’t work the full twenty-one days, I sit in on the half-day session (which, amidst the frenzy of the hotel’s early months, actually takes place on the 49th day after our orientation). Training director Tim Kirkpatrick starts with another mock lineup.

He discusses the new-employee job certification test that department managers should have administered. He announces a new guest recognition hotline, which employees can use to call in guest preferences. And he unveils an updated version of the company’s principles, now in the form of a three-dimensional pyramid. This supplements the existing Gold Standards with an additional category of seven “key success factors. ” But for staff to delight customers, managers must do more than grant their employees the freedom to do what is necessary; they must motivate employees to exercise that freedom.

— Paul Hemp Employees are asked about their experiences on the job. Erin Garrity, the new front-desk clerk from Johnson & Wales, is disappointed she has been assigned the overnight shift but looks on the bright side. “I get to see a lot of celebrities” at that time, she says. Her goal for the year is to be named one of the hotel’s select five-star employees, and she intends to continue being the “friendliest person I can be. ” John Rolfs reinforces his message from orientation that our sole job is to “make guests feel good so they come back.

“The hotel’s 320 employees have countless interactions with guests, he says, and it takes just one interaction to make a guest feel bad. “If you’re thinking about doing your job well, trying to understand and master your day-to-day routines but not thinking about how guests feel, they’ll have a difficult time forgiving you. They’ll probably forgive us if the air-conditioning fails. But they won’t forgive us for failing to make them feel good—because that’s why they selected Ritz-Carlton. ” Tim’s final announcement concerns the results of the first monthly Gallup survey of Ritz-Carlton guests, released to managers earlier that day.

The Ritz-Carlton/Boston Common leads the company’s hotels in overall customer satisfaction. There is a stunned silence—after all, this is a new hotel still smoothing out the rough spots—followed by loud applause. As I leave the hotel and walk across the Boston Common in the gathering dusk, I reflect on what I’ve learned about teaching and motivating employees to provide truly memorable service. One thing seems clear. Great customer service should be based on dynamic principles rather than a rigid formula.

You don’t demand that employees say, “Certainly, my pleasure,” until it feels right to them. You don’t mindlessly assume every guest wants to be pampered; some people just want to eat their dinners. I also ponder Ritz-Carlton’s efforts to win the hearts and minds of its employees by, for example, making them feel part of a proud heritage. A recent study of hotel workers by researchers at Cornell’s School of Hotel Administration found that, while job satisfaction plays a major role in employee retention, it isn’t the key factor in a hotel’s ability to provide excellent customer service.

Rather, it is employees’ emotional commitment—which is achieved in part through symbols and rituals that enhance employees’ sense of identity with the company—that contributes most to superior performance. Ritz Carlton certainly has an unusually rich tradition to draw on in creating that feeling of identity. But every company, even a two-year-old startup, has traditions and even legends that can be tapped to help build employee commitment. Great customer service should be based on dynamic principles rather than a rigid formula.

— Paul Hemp That kind of commitment serves as a driver of excellent customer service only when employees are empowered to take initiative. And that sort of empowerment has no potency unless employees are motivated to seize it. I am haunted by my failure to point out the confusing bin numbers on the hotel wine list, which led my guest to mistakenly order that half-bottle of burgundy. Certainly, I was encouraged during my time at the hotel to point out problems that needed fixing. Why didn’t I follow through in this case? I’m not sure.

But for staff to delight customers, managers must do more than grant their employees the freedom to do what is necessary; they must motivate employees to exercise that freedom. Doing that depends in part on the kinds of people you hire. Ritz-Carlton has an elaborate system for assessing in job candidates the qualities the company believes are crucial to its success. One night while I was working at the hotel, I went through the basic interview to see how I’d do. I was fairly confident I was just the sort of caring, conscientious person the Ritz was looking for.

In fact, though, even after fudging my answers to a few questions, I got only ten points out of a possible fifteen in the composite hospitality assessment. Tim said that wasn’t bad—”though, honestly, we’d shoot for someone with a twelve. ” I later discovered that I fell short in my response to a question asking me to cite an instance when I took care of someone else. I said I’d often provided emotional support to my sister during tough times. But the company was looking for something more than this, an “extraordinary” example of caring. “Helping your sister? You better,” Tim said with a laugh.

“Now, if you’d moved out of your house for a month and let her move in, that would be different. ” Since instituting its candidate assessment system in 1991, Ritz Carlton says it has reduced its annual turnover rate from 55%, roughly the industry average, to 28%. Certainly, a genuine concern for the well-being of guests is key to providing superior customer service. But that isn’t enough to truly anticipate customer needs. Another component of the Ritz Carlton’s hospitality assessment is empathy—being able to imagine guests’ emotional responses to their experience in the hotel.

I am reminded of Steve’s care in preparing the champagne setting for the newlyweds that night and how he thought back to his grandparents’ wedding seventy-five years before. To truly achieve empathy, however, I wonder if you need to jettison at least some of your personal perspective. One of John Rolfs’s comments during the Day 21 session—about the dangers of employees focusing solely on the successful fulfillment of their duties—resonated with my experience as a waiter.

If you’re constantly assessing how well you’re doing in your job—even in your genuine efforts to satisfy guests—you, not the guest, become the point of reference. Your self-consciousness, natural though it may be, distracts you from providing superior service. It’s getting dark. And this train of thought risks hurtling far beyond the practical demands of a frenetic evening of room service. But, when you get down to it, my musings don’t seem all that far from the Ritz-Carlton philosophy.

Companies dedicated to providing what might be called “extreme” customer service may need to recognize that—like great military, government, or religious service—it is, in the end, a truly selfless endeavor. They may need to establish such practices as the formal inculcation of a customer-centered credo. They might even consider providing workers with a weeklong immersion in the experience of being a customer! Whatever the means, the aim would be getting employees to leave their egos at the door and adopt the mind-set of the people they’re serving.

Person Centred Care is a major skills acquired by a healthcare providers.Which main target is individual traits of character in doing health care provision. Treat every person as a unique human being disregard his/her age, culture, sex and race.Acknowledge, respect, and take into considerations the choice that every service is entitled to. Set some standards for practice but not so precise to deny the specific application demands of each individual uniqueness. Guidelines might be essential for the care providers to include complex concerns that help the nurses but sometimes leads to apart a patients’ rights.

According to Professor Draper ,getting to know the person behind the illness is the key principle of person centred nursing care.We as the care providers needs to listen diligently to our patients conditions, treat as a unique human being.

Psychologist Carl Rogers, founder of person care centred define as ” structure result from distributing pont of view and assertion of oneself “. It is a positive persuasion belief of our senses, ideas, and valuing of a person capabilities of what he/she can do. It is having assurance to see her actions as interactions made with confidence.

Roger use these therapy in treating individual as a person to improve his quality of life. Carl establish supporting evidence that individual inductive knowledge as the fundamental healthful effect. He also states that the therapeutic process is substantial achievement made by the patient. He strongly believed that his structured analysis should be practice rather than the other way round. His persuasion for the improvement of care is based on sincerely felt or expressed in a genuine emotion in helping patient grief.

Some Psychologist criticised Rogers method for insufficient structure and by Psychoanalyst in providing care relationship , which in some studies, proves to be effective and approved therapy. Carl Rogers optimistic and warmer approach stated that Individuals self concept and understanding modify behavior way and means of letting facilitative attitudes.

The Royal College of Nursing adapted Rogers analysis by using person care centred in all aspect of holistic care system given to patients, colleague, and relatives. It was recommended at all levels of health care organisations from government policy-making to a group of health care providers that they operate. Contributing to the overall idea of excellence care delivered in nursing practice.

By delivering PCC in our practice we combine Rogers method of care a genuinely following the concepts of person centred care by:

Highly consider everyone and by showing them that they are worthy of esteem. Respect and consider their opinions with regards to the whole course of treatment.Listen to their interest, dislikes and honor their views if they refuse to be treated. Respect individual judgment consider it as a challenge for improvement. As a healthcare provider everyone expected to have a different desire and wishes. We hold and accept those attention and disposition into considerations.

Be an open minded with their distinction, dissimilarity, and characteristics quality could adhere corresponds to their needs. Asking for their preference needs could mean a lot in delivering care and building a good therapeutic relationships between them.

According to (Chambo and Amned, 2000), effective communication is versed as a device part of excellence care. Linguistic communication involves knowledge substitute of refining moral and intellectual of a person and cognitive content of individuals.(Gillam and Levenson, 1999).

Continuity and trustworthiness is of great significance vision of nursing care.

(Patmore,2001; Raynos et al., 2001 5WRDU,2007; Francis and Nelten, 2006). It is particularly noted the importance of effective communication towards the whole aspect of care.

Patient security is established in NMC code ( Nursing and Midwifery Council 2008), and the RCN Principles of Nursing Practice (RCN 2010a) as a substantial area of risk of danger every patient in the practice.(RCN 2010b, Principles). Provides updated information about patient safety.

Valuable Things of a Person Centred Care in Practice:

The objective of these study is to transform our knowledge and experience into an excellence accomplishment in in of PCC in our clinical skills. Staff of all levels are expected to use the person centred care as a standard important basis in determinants of the quality care and significantly the client experience of that care. Our contribution as a humane quality of better understanding the sufferings of others and wanting to do something about it. Rogers concept theory was widely used healthcare settings area because it was focus on the humanistic therapies. Better knowledge of ones consciousness rather than external observation.

Person centred care was implemented in nursing practice by taking into considerations client unconditional positive regard.Accept their own personality and characteristics as they really are. To hold and consider their worth and being value regardless of their status in the society. Estimate the true nature of a person is one of the structure model discuss in person centred care. We carefully maintained our positive attitude towards client.

Being empathetic to clients feelings and always participate good communication skills. Understanding truly their feelings. Rogers describe empathic understanding, as an experience of each client, how life was viewed and interpret, but Rogers emphasised that

If you put yourself into their world and truly deeply understand feels to be in their world , without being judgmental you will precisely undesirable believe to be an effective role well in delivering excellence care.

Work as a team by getting assurance, trust, and hope to the people we rendered care. Able to listen and hear what they want and connect to us how we value them. Our positive words with them fully assured with professional confidence. Having the power of positive direction influence our care with our client . Person centred care strengthen our movement in focusing care with them.

Being a role model and implementing person centred care in nursing practice, gives others a chance to follow your acts and play in the same pattern in accordance to NMC code of nursing practice. Inspire and increase everyone confidence to help forward the quality of care in nursing practice. Good motivation and challenges others requires full use of resources in performing most challenging task in delivering care ideality.

To partnerships with families, colleagues and other social care people gives you satisfactory outgrow. Positive relationship and building their trust means a lot to you as a person who gives care with their family. You meet their needs and expectation is already a great contribution in nursing practice.