Finding peace in the ER

We count on nurses for a lot of things — to be a calming presence, a helping hand, a source of knowledge. Filling those roles is demanding enough, and with the added pressure of a nursing shortage on the horizon, already tired, overworked RNs may not be getting a break any time soon.

As dean emerita of ASU’s College of Nursing and Health Innovation, Teri Pipe knows all about burnout in the health care field. As the director of ASU’s Center for Mindfulness, Compassion and Resilience, she also knows about a potent antidote.

For Pipe’s final project for her Robert Wood Johnson Executive Fellowship, she created a video featuring nurses telling stories of how they used the practice of mindfulness to help them through difficult situations. “In the Moment: Stories of Mindfulness in Nursing” was recently accepted to the National Academy of Medicine’s new art collection on clinician well-being and resilience.

ASU Now asked her to share more of her insights about the practice and how it is beneficial for both nurses and patients alike.

Dean of ASU's College of Nursing and Health Innovation Teri Pipe

Question: What does mindfulness in the health care field look like? How is it practiced?

Answer: In health care, mindfulness at its best is often practiced as a focused presence between the health care provider and the patient. Mindfulness is focused awareness to what is happening for that particular patient in the moment; it is linked with patient safety and quality of care because providers are able to filter out unimportant distractions and care for the patient. It is an unhurried, empathetic way of being with someone, listening carefully not only to the words that are said, but also to the underlying meaning and emotional tone. 

Q: How is the practice of mindfulness beneficial to nurses and other health care providers?

A: Mindfulness can be an excellent way of preventing and addressing burnout, exhaustion and compassion fatigue. By focusing on the present moment, nurses and other health-care providers can keep the mind from being pulled to the past (rumination, depression) or the future (worry, anxiety) and stay focused on the reality of the present. In this way, people are more able to live by design rather than by default, making more considered choices rather than simply reacting automatically. Once an individual learns to practice mindfulness, it is often the case that they feel more “awake” and alert to all of life, personally as well as professionally.

Q: Can it also be beneficial to patients?

A: Patients often face uncertainty, fear and pain. Mindfulness can’t change the situation, however it can help change the response to the situation, which turns out to be quite powerful. When patients practice even a few minutes of focused breath awareness or a mental scan through the body, they often feel calmer and less likely to create a cognitive narrative of what is happening. By staying with what is real and true in the present moment, the anxiety of the future and the regret of the past are less powerful, and the patient can more effectively allocate attention and energy to what is actually true. They are able to shape their experience a bit more.

I once taught a mindfulness class to a group of patients with cancer. One of the gentlemen was receiving daily radiation treatments, so he decided that instead of just lying passively on the radiation table, he would use his treatment time as his meditation practice time. He said it totally changed his experience into one of active, well-being supportive attention rather than feeling like something was being done “to” him. His situation didn’t change, but his experience of it did. He showed up so differently that his health care team actually remarked on the difference!

Q: Why is the practice of mindfulness gaining traction in the health care field?

A: Jon Kabat-Zinn brought mindfulness to patients at UMass Medical Center as early as 1979, and his eight-week training program, Mindfulness Based Stress Reduction, is the gold standard in terms of the emerging research in the area of mindfulness and health. Mindfulness practice for nurses, physicians, veterinarians and other health-care professionals is being more widely recognized as a preventive strategy for anxiety, depression and suicidal thoughts. The rate of burnout, depression and suicide in these sectors is high and receiving more attention than in the past. The Institute for Healthcare Improvement recently published an entire module in their Open School about mindfulness in health care, including the link between mindfulness and patient safety and mindfulness and workforce burnout prevention.

Q:  How is ASU’s College of Nursing and Health Innovation incorporating mindfulness into its philosophy?

A: The college leadership has implemented mindfulness practices in some meetings and in individual classes. There is a CONHI major in integrative health that has a component of mindfulness, but mostly the integration of mindfulness depends a lot on the individual faculty member. We want to make mindfulness an opportunity, but not a mandated approach. Like many innovations, it is best met with an open mind and healthy skepticism, and it is a very personal practice. Across ASU we are finding that faculty are integrating mindfulness practices into courses in most disciplines, including health, engineering, design, dance, psychology, sustainability and athletics. It is relevant to virtually any field.

Top photo courtesy of Pixabay.com