Professional Documents
Culture Documents
The mindful
Improving processes and outcomes;
restoring joy to nursing
By Teri Pipe, PhD, RN; Kate FitzPatrick, DNP, RN;
Jeffrey N. Doucette DNP, RN; Amy Cotton, MSN, RN; and
Debra Arnow, DNP, RN
N
urses are highly regarded by healthcare
colleagues and patients/families for their
knowledge and competence. A skilled and
efficient clinical nurse can juggle answering call
lights, administering medications, documenting m c]
[ uf-uc muu
care, admitting and discharging patients, and much more. Nn [ ] =
But when a nurse is able to embrace an aware, focused, and no mu = mcc + ttr w - 3u
u er
present state that transcends the execution of tasks, he or she
is practicing mindfulness. In the mindful space, seemingly
small moments become profound experiences and intimate
human connections exceed tasks.
In the Moment: Stories of Mindfulness in Nursing was
an action learning team project developed as part of the
authors Robert Wood Johnson Foundation Executive Nurse
Fellowship experience. It was designed to increase under-
standing about the power of mindfulness in nursing prac-
tice by providing real-life examples of how nurses employ
mindfulness and teaching mindfulness techniques to nurses
at all stages of their career (including students) to build
resiliency and foster their own health and wellness.
Whats mindfulness?
Mindfulness means intentionally paying attention to the
present moment with a nonjudgmental attitude of acceptance
and awareness. It sounds simple, right? Although easily
taught, mindfulness is a challenging practice to maintain and
strengthen, particularly when stressed and challenged. Com-
passion toward self and others is often a byproduct, if not an
intentional effect, of mindfulness practice. As the participant
becomes more accustomed to force lacking the necessary skills to knowledge in mindfulness work
accepting the present moment navigate repetitive critical incidents, that when nurses pay close attention
as is, nonjudgmental acceptance death and dying, dynamic and to patients, with intention and pur-
begins to extend to the self and changing teams, and, most impor- pose, theyre more likely to detect
others. This type of acceptance tant, the ability to focus on patients early warning signs of a change in
isnt meant to negate ambition, and families unique preferences. To condition. Likewise, nurses with
goal-achievement, or productivity; date, most nursing curricula dont a deeper awareness and focus are
rather, it builds a realistic picture include ample focus on human more likely to be stronger advocates
of the present that can then be connection skills that allow nurses for patients and colleagues.
used to propel performance. In this to engage with patients in a mean- Theres increasing awareness
sense, mindfulness, presence, and ingful, undistracted, unhurried that creativity, productivity, and
compassion are often interrelated. manner while developing personal extended high energy arent the
Research has demonstrated the strategies for self-care and resil- result of prolonged engagement
positive effects of mindfulness on ience. Likewise, healthcare work with stressful mental frameworks,
sleep, anxiety, depression, pain environments are seldom designed but rather of a more balanced, car-
management, and overall resil- for reflective, mindful approaches to ing approach to the management of
ience.1 As attention is rooted more patient care and staff resilience. personal energy and ones responses
firmly in the present and less on In fact, stress in the healthcare to the environment and situation.
the past and/or future, depression, workplace has generally been Its been shown that individuals and
rumination, and anxiety decrease.2 accepted as just how things are; groups can be taught to process their
The resulting effect is energy that some say being able to withstand responses to stressful conditions
was once spent clinging to the past ever-increasing stress is a badge in productive ways that support
or worrying about the future can of honor. Interruptions, distrac- well-being, resilience, and long-term
now be spent in the present. Some tions, competing priorities, time health.2 Thats why healthcare lead-
refer to this as learning to live by pressures, information overload, ers recently added a fourth aim to
design rather than by default. fatigue, stress, anxiety, feelings of the Institute for Healthcare Improve-
Cultivating present moment focus sadness, and fear of missing out ments Triple Aim: restoring joy and
preserves energy for what can be are often considered the normal satisfaction to healthcare employ-
acted upon. Additionally, mindful- experiences of living in the mod- ees.4 A resilient, compassionate, and
ness practices help the participant ern world. However, prolonged present nursing workforce is critical
objectively observe automatic or exposure to high levels of stress for to delivering healthcare value.
habitual behaviors, coping patterns, extended, unremitting periods can
thought processes, and stories, lead- lead to physical illnesses, such as The leadership need
ing to a more deeply considered cardiovascular disease and auto- Similar to clinical practice, leader-
response. For nurses, this may mean immune conditions, depression, ship is both an art and a science,
being able to fully focus on patients insomnia, and general malaise.1 with healing, nurturing, and bring-
and care requirements when at These responses can contribute to ing about optimal states of being for
work and replenish themselves nursing stress, burnout, and com- individuals and/or organizations at
when away from work. The push passion fatigue, which may lead to its core. Leadership can be defined
and pull of work and life becomes compromised patient safety.3 as behaviors and ways of being that
less tense as mindfulness allows The frenetic nature of the health- inspire a positive, enduring impact
the participant to manage personal care environment and high stakes on those whose lives are influenced
energy, which can lead to a feeling outcomes combine to form a partic- by ones presence.5 No matter the
of less urgency or time sensitivity. ularly important clinical challenge: breadth of influence, much of the
paying mindful, laserlike, yet healing potential of leadership is
The nursing need dynamic, attention to whats most grounded in a deep sense of authen-
Nurses are an integral part of important with focused presence ticity and integrity. Strong leaders
todays dynamic healthcare deliv- and deep compassion. When this are courageous and guided by what
ery team, working in practice set- challenge is fully met, patients are they believe is valuable, meaningful,
tings that are increasingly sensory safer and nurses are more engaged and true. Excellent leaders follow
rich, complex environments. Many and less likely to suffer burnout and their inner compass to inspire, coach,
professional nurses enter the work- compassion fatigue.3 Its common and guide others with compassion,