Mindful of the stress
Marybeth Meservey, NP, left, and Donna Feeney, RN engage in the listening exercise.
Nurses move at a nonstop pace and that can take a toll both physically and emotionally. In a nursing week, lunchtime grand rounds session Tuesday, palliative care physician Heidi Blake, MD and integrative medicine fellow, Michelle Dossett, MD, PhD, introduced the concept of mindfulness as a way to ease the impact of daily stresses, especially those related to the suffering nurses so often encounter.
Dossett described mindfulness as a way of purposely paying attention in the present moment, non-judgmentally. "As nurses, as clinicians, we're all juggling a lot, and mindfulness can be used to bring focus and help us with this juggling act," she said.
Studies have shown that employing tools like yoga and meditation can have shared benefits across the patient-provider relationship. Former BIDMC cardiologist, Herbert Benson, MD, showed that the "stress response gets turned down during mediation," Dossett said. Other studies have shown that these tools can help health care workers lower anxiety and work-related burnout and increase empathetic responses.
"Over time, practicing mindfulness can help care givers develop qualities that are relevant to better patient care," said Dossett. "And one study of clinicians who practice mindfulness and meditation reported improved treatment outcomes for their patients."
According to Blake, generally, at least 10 minutes of daily meditation is recommended for lasting change, but "taking any amount of time to center yourself is valuable." She led the nurses through a five minute guided mediation where they were asked to let go of everything else and focus only on their breathing.
"I was really fighting it. My mind kept wandering to what I have to do this afternoon," said Katherine Brideau, RN. "When my mind wandered, I liked that I could come back to concentrating on my breathing."
After the focusing exercise, Blake and Dossett asked participants to pair up and take turns sharing a story about a time when each was truly present with a patient or family who was suffering. The listeners were asked not to speak or give advice, but simply to be mindful and present.
"It was amazing to experience the stress in her voice," said one participant. "I could really put myself where she was. It's exactly what I have felt before," said another.
"We should do more of this kind of thing. It's something they don't teach you in nursing school," said Marybeth Meservey, NP. "You just have to go through it and learn once you're on the floor."
Blake and Dossett left participants with a simple, informal refocusing tool that anyone can use at home, with colleagues or before entering a patient room. The tool is called STOP where S asks a person to Stop; T means Take an intentional breath; O is a reminder to Observe the thoughts and feelings that are happening in the moment; and P stands for Proceeding with non-judgmental awareness.
Over time these simple mindfulness exercises, say Blake and Dossett, can have benefits at home and at work, reducing stress, anxiety and depression and helping individuals become more compassionate care givers.