Analyzing Professor Vivian Bearing 'From The Film Wit'

From the Lens of Another
This paper will critically analyze the personal experience of Professor Vivian Bearing, a character from the film “Wit” (Bosanquet & Nichols, 2001), from a theoretical and empirical perspective. This writer will explore various methods of verbal and nonverbal communication. Empathy, as the dominant relational concept, and how it impacts a therapeutic relationship between healthcare provider and patient will be examined. Three Registered Nursing Association of Ontario (RNAO) best practice guidelines will be selected, and their relevance to the experience explained, with the support of scholarly nursing literature. Finally, three ways to improve patient care will be identified with rationale to support this writer’s

choice.
In the case of Professor Bearing, it becomes evident at an early stage of the film that she is highly intellectual, and reluctant to admit both physical and mental weakness.

BACK THIS PART UP WITH FACTS. Dr. Jason Posner, a former student of Professor Bearing, presents as an enthusiastic doctor, driven by his passion for his cancer research. Dr. Posner speaks about his patient as though she is nothing more than an interesting medical case, showing little to no interest of her emotional and psychological wellbeing. In a study on the qualities of a compassionate nurse, Kret (2011) found, “A better understanding of the patient must be reached in order for the nurse to care for the patient in an effective, meaningful way”. Jason’s lack of interest and empathy toward Vivian as a human being greatly affects his ability to foster a therapeutic relationship. Dr. Posner often chats excitedly with his colleagues about Professor Bearing’s medical condition and progress, without speaking to her directly; with the exception of the obligatory “How are you feeling today, Professor Bearing?” (Bosanquet & Nichols, 2001) a question often muttered in passing. Dr. Posner pays no attention to the tone of Vivian’s universal, and often pained response, “Fine.” (Bosanquet & Nichols, 2001). By being unable to identify with his patient and share her experience, Dr. Posner is lacking the key components of empathy. This lack of empathy is impeding the development of a therapeutic relationship between

patient and healthcare provider.
Registered Nurses Association of Ontario Best Practice Guidelines
Therapeutic Relationships
The ability to participate in reflective practice is paramount in establishing a therapeutic relationship; Reflective practice includes self-awareness, self-knowledge, empathy, awareness of boundaries and limits of the professional role (RNAO 2002). Dr. Posner had barriers in establishing a therapeutic relationship with Professor Bearing on several levels. By leaving the patient on the exam table, exposed to the hallway, Dr. Posner is disregarding professionalism, and not taking into account how the patient feels in the uncomfortable situation. According to the RNAO best practice guideline for establishing therapeutic relationships, “empathy is the ability of the nurse to enter into the client’s relational world, to see and feel the world as the client sees and feels it, and to explore the meaning it has for the client”(RNAO, 2002). While Jason, as a male, cannot directly relate to how Professor Bearing feels while having an internal pelvic exam, he should be able to recognize that a woman being exposed in this way can be embarrassing and take necessary measures to ease discomfort as much as possible. In a study on personal influences that affect motivation in getting routine pelvic exams, Ackerson (2010) “found the gender of the provider contributed to feelings of embarrassment.” Jason could not have changed his gender, but he could have been more prepared, and ensured that Nurse Susie be in the exam room for the duration of the encounter, rather than leaving the room, frantically searching for her with a gloved hand.
Client Centered Care
Throughout the film, it is evident that Professor Bearing’s voice is not being heard, and her autonomy being compromised. “Client centred care involves advocacy, empowerment, and respecting the client’s autonomy, voice, self-determination, and participation in decision-making” (RNAO, 2012). During the pelvic exam, Vivian’s shoes are hastily removed and discarded, and her legs clumsily forced up into the stirrups, despite her being perfectly capable of doing this herself. “Patients can be self-caring and they learn to value the autonomy in their own care” (Sadala, Miranda, Lorençon, & de Campos Pereira, 2010). This seemingly small issue is a preliminary manifestation of a patient’s autonomy being conceded.
While discussing the dosage of Vivian’s chemotherapy drug, there is little discussion or consultation with her directly; Dr.

Posner and Dr. Kelekian swiftly agree that she will maintain the “full dose” (Bosanquet & Nichols, 2001), and insist that she is “tough” (Bosanquet & Nichols, 2001). Though Professor Bearing does not dispute the full dose, it is unclear if this is her actual preference. By making this assumption, Dr. Posner and Kelekian are denying Vivian the opportunity to participate in her care, and in the decision making process. In a study by Heffines et al., (2013) it was discovered that increasing patient participation in the decisions that affect their health care greatly increases patient satisfaction, and contributes to an overall more positive

experience.
End-of-Life Care
As the end of the movie, and subsequently Professor Bearing’s life nears, it is evident that the RNAO best practice guideline of end of life care comes into effect. “Care of individuals who are dying is an integral part of health care” (RNAO, 2011).