the "Each Amazing Breath - Executive" collection:
Capacity, Resilience and Becoming More Mindful
Serving hospital staff with practices that build mindfulness is a good long-term strategy. While becoming mindful—being aware of as much as possible in the present moment—is a worthy goal, the steps to get there must be grounded in safety, risk mitigation and cost effectiveness. Mindfulness practices that do not account for very specific needs of hospitals, staff and patients run the risk of being too focused on outcome, and less focused on process.
The best paths to becoming more aware are those that empower staff to better meet their own needs, and better meet the needs of people in their care. It must be balanced with smart, on the ground steps that are trauma smart, that promote resilience and build capacity, and can be largely run by local and on-site staff.
Mindfulness—being aware of as much as possible in the present moment—is especially tricky for hospital staff. Many frontline nurses, doctors, therapists and technicians are responsible every day for the life and sometimes death, of a large number of patients. The demands on these team-members is extensive, and requires constant effort just to stay current with changes in practice, policy and status. As such, it is important to introduce mindfulness education in measured, conservative steps.
practical mindfulness in hospitals
To be useful to hospital staff, four criteria must be met:
- it does not require a lot of time to perform
- it can be done anywhere,
- it can be done with a high degree of safety
- is is useful.
The life of workers in hospitals—much like that of other frontline professionals—is filled with multiple stresses which take a significant toll on well-being: that of the workers, their patients or clients, and that of the hospital or organization itself.
Specifically, staff experience many, if not all of the following:
- high stress due to intensity of work (dealing w/ life and death decisions every day)
- working under high caseloads with seemingly insufficient staff
- strenuous physical exertions such as lifting and extensive walking (very common w/ nurses)
- increasing complexity of care standards, treatments and protocols
- feeling of competing interests between staff and administration.
Standing Strong capacity-building practices do not magically meet, and fix each of these needs. But, they do give all participants greater clarity, greater ease in the physical body, greater sense of groundedness, increased stamina, and better executive functioning. Even when these benefits are realized in tiny increments, the regularity of increasing capacity and reducing stress every day has profound, long-lasting benefits.
the Standing Strong family of body-based mindfulness offerings are deeply rooted in building practical resilience in every person involved in the hospital environment: staff, patients, families as well as administrators, funders and trustees.
Resilience is an organisms capacity to overcome extreme and trying situations with minimal destruction, and maximal positive growth. Every person—and by extension every family and every organization—has innate resilience factors, qualities that have evolved over tens of thousands of years.
Resilience is, according to the American Psychological Association, "the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means "bouncing back" from difficult experiences."
Different communities have different skills and capacities at being resilient. The Standing Strong practices are devised to support and amplify local resilience skills, without imposing specialist or outside dictums.
To be useful, the practices must:
- cause no harm
- save people time
- help patient outcomes.
Resilience-focused, trauma smart mindfulness practices help promote these aims by providing staff members with common sense tools to help navigate the complexities of any given day. This helps immeidately with:
- more positively engaged employees, and hence
- better outcomes for patients, and the hospital both.
These practices serve as stepping stones for longer-term mindfulness practices, and lay out a context for any such future endeavors.
how it works
These practices are designed to meet people where they are in their busy lives, and to help them build and nurture daily actions that increase well-being. The practices are simple enough that they can be woven into a busy day, by busy staff, without negatively impacting required productivity.
Senior management can support these practices with minimal shifts in policy—for example, by allowing five minutes before every staff meeting for breathing and self-care.
The practices work by addressing the multitude of small stresses that build up over the work week, stresses which accumulate and eventually sap effectiveness and diminish patient and staff safety.
Working with hospital staff requires an attention to secondary (vicarious) trauma, which commonly interferes with work in intensive care, emergency, oncology and high-risk obstetrics. These workers most exposed to loss and death possess special skills which can be enhanced with pragmatic awareness and breathing practices, and which can also serve to help with any instances of loss experienced by people working w/ the most vulnerable patients.
The practices themselves are relatively straightforward, comprised of breathing, standing, walking, sitting, communicating and letting go—all core skills for handling intense life situations.
consequences and implications
hospital care for the sick, recovering and dying is built on an understanding of consequences and implications. If you do x, a certain outcome is more likely; if you withhold y, well, the implications can be huge.
being TraumaSmart encompasses not only knowing what's wrong, but what is right. As well, it is an understanding of what could be.
in a medical setting, to act w/o full accord of the nature and effects of trauma in any given population, is deleterious for the desire of attaining the best outcomes possible.
The first understanding is that we are trying to help. The services we provide are intended to better peoples' lives.
|inattention to consequences of trauma (ptsd et al)||people are too consumed w/ survival to engage w/ your service.|
|minimization of somatic nature of post-traumatic experiences||patients do not feel understood, and cannot thereby engage w/ your service.|
|hurried pace||patients feel unsafe, and check-out.|
|diminishment of experience||people feel dis-empowered.|
|over-focusing on the negative||deplete patient's power for their own healing.|
|hurried pace||patients feel unsafe, overwhelmed and they checkout. plus, they associate mindfulness and breathing w/ something scary.|
|unnecessarily narrow viewpoint||failing to account for the incredible variety of humanity—in all its perfection—leaves some people feeling less than well; this reduces the amount of healing that we can foster in their lives.|
|...||what is your plan; people get triggered. people re-experience large swathes of what it was like when the wounds were fresh. If the hurt is present tense, so much more it is for us to show up.|
when you show up to serve other, to serve those who have been hurt, you put yourself in the line of fire (so to speak). You show up and take a few blows on behalf of humankind. Thank you.
Secondary trauma is the state we can get to when we show up hard for others. It's a place where we feel that our efforts are outweighed by the pain being experienced, where we let despair o'er-power Love. Dangerous territory.
2° trauma creeps up in the midst of our do-gooding, and infers complicity w/ the lies.
Reject that. You showed up to Good, and that matters.
Training staff is only part of the work; hospital administration must take steps to ensure uptake of the trainings, in ways that directly support employee morale and confidence.
take five in healthcare
The Take Five in Healthcare branch offers direct training to workplace health champions, senior leadership, clinical supervisors and unit managers. The training focuses on mindfulness practices that work within the particular constraints of an NHS Hospital Foundation Trust, and creates simple protocols to measure on the ground effectiveness, across a number of departments.
The core training consists of two foundational modules, followed by a tailored offering depending on the level of criticality in terms of patient service provisioning.