title: "Why are we doing this?": clinician helplessness in the face of suffering.
abstract: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: 1 Department of Medicine, University of Washington , Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Back
authors.forename: Cynda H
authors.initials: CH
authors.lastname: Rushton
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Kaszniak
authors.forename: Joan S
authors.initials: JS
authors.lastname: Halifax
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002055:Burnout, Professional / Q000517:prevention & control*; D004644:Emotions; D005260:Female; D064946:Hospice and Palliative Care Nursing / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians / Q000523:psychology*; D009723:Nurse-Patient Relations; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological; D013727:Terminal Care / Q000523:psychology*