Practice Mindfulness for Personal Wellness
This month’s blog theme is personal health and wellness and this post is about being present in the moment — whether you are sharing that moment with family or friends or having some time to yourself — being mindful of the moments of our lives leads to greater satisfaction and greater retention of memories later in life. Mindfulness, on the part of the nurse, also benefits patients (Brass, 2016; Howland & Bauer-Wu, 2015; Zeller & Levin, 2013).
I want to talk about mindfulness in general and point you to some apps that you might find helpful in training yourself to be more mindful.
Mindfulness is Paying Attention on Purpose
Mindfulness is a state of being present in the moment. It means being intentional. Being engaged and acutely focused on everything around you, including on your physical and psychological reactions to that moment. Brass (2016) quoted Jon Kabat-Zinn who described mindfulness as “paying attention on purpose” (p. 21) – I love that definition!
The Google dictionary defines mindfulness as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique” (emphasis added).
A therapeutic technique — hey, that sounds like nursing language! And, indeed, mindfulness training has been used as a therapeutic technique to teach patients and families – and healthcare providers – how to harness the physical and psychological benefits of mindfulness.
There are many healing modalities that use “self” as a part of the healing process. Therapeutic Touch or Reiki massage are examples.
“Centering” is a practice used in these healing modalities and is a process the practitioner goes through to mindfully focus on the patient before the beginning of the therapy session. The idea is that this centering activity allows the practitioner to connect more fully with the patient to meet his/her needs. Think about it — you are not thinking of what to pick up from the grocery store; instead, you are focused on the client/patient.
What are the practical outcomes of centering? Really listening to what the client is telling you (and reading between the lines), asking probing questions, reading body language, noticing a grimace or a flinch, and therefore, more apt to pick up on areas of concern. “Developing your intention” is another commonly used phrase with similar meaning.
Centering is also common in psychotherapy, stress management, and competitive sports. Centering is defined as “any method used by a person to calm himself physically, mentally, or emotionally, usually in preparation for performing an activity requiring concentration—e.g., meditation, an exam, or a sports competition.”
So you can see that centering, developing intention, and mindfulness are similar phenomena.
Benefits of Mindfulness
There is evidence that mindfulness provides mental health benefits, such as a sense of wellbeing, as well as symptom relief from chronic conditions (Gotink et al., 2015) and increased stress (Howland & Bauer-Wu, 2015; Jayewardene et al., 2017; Zeller & Levin, 2013). Research studies have examined mindfulness interventions delivered online (Jayewardene et al., 2017) and mindfulness training (Zeller & Levin, 2013) and showed positive outcomes (less perceived stress and more mindfulness) from mindfulness practice. There are quite a lot of studies on mindfulness and mindfulness training in the literature.
Ever feel really stressed? Maybe the day is full of errands and running about and you think, “I just need to sit down for a few moments.” So you sit down, close your eyes, and breathe. Slowly. Breathe in. Slowly. Hold. Breathe out. Slowly. Do that a few times consciously thinking about your breathing, the slow rhythm, the feeling of air expanding your lungs. You will be amazed how paying attention to your breathing will create a stillness, a calmness, that just may carry you through the rest of your day!
In my posts on productivity, one of the strategies I talked about was on focusing your work efforts for a set amount of time (15, 20, 45, 50 minutes, whatever, your choice) and then taking a break to refocus and refresh. You are mindful, focused on the work you are doing for that first period of time – the benefit is the progress toward that work project. Then you take the 10 or 15 minutes you have scheduled for a short break. The idea is to not think about work, but give yourself a chance to clear your mind for the next stint. Being mindful of how you spend your downtime – 5 minutes of meditation, coloring in your adult coloring book (yes, this is a thing!), 10 minutes of yoga, a walk around the block – will leave you ready to tackle the next work session.
Mindfulness and Nursing Presence
I want to connect this concept to your nursing practice. As I noted earlier, there are research studies of the benefits of mindfulness training for nursing practice (Howland & Bauer-Wu, 2015). Better assessment skills, enhanced listening, more effective communication, less clinical errors, less perceived stress, fewer signs and symptoms of burnout, increased attention and relaxation, more compassion for self and others, and improved family relationships are cited benefits (Howland & Bauer-Wu, 2015).
Ever hear the term “nursing presence?” In nursing, the expectation is that nurses should “be present” with their patients — but what does that really mean?
I used to think that nursing presence was obvious – I mean, we are there in the room with the patient, so we’re present, right? Wrong, sort of. That is one definition of presence, actually! The definition of presence is the act of existing in a specific setting. So yes, being in the room is being present in the room. But I’m talking about something deeper. You can be in the room and not be really present with the patient. That’s something that happens all too frequently in these days of short-staffing and complex patient situations.
Nursing fatigue and burnout are common in the nursing profession. When we are fatigued or morally distressed, we can’t be mindful of our patients and do our jobs to the best of our ability. How many times have you told a family member to get some lunch or get some rest, “because you can’t help your loved one if you don’t take care of yourself.” We need to practice what we preach!
The American Nurses Association (ANA) has resources to help nurses take care of themselves. MindfulNurseToday.com is the website and “finding balance in your life” is their motto. There are articles on “workplace civility, exercise and healthy eating, managing stress, rediscovering gratitude and compassion, building a career that meets your needs, and much more.”
“Among healthcare professionals, mindfulness training can reduce psychological and physiologic stress, emotional distress, and burnout while improving empathy, job satisfaction, and sense of well-being” (Howland & Bauer-Wu, 2015, p. 12)
Mindfulness Training Apps
The cool thing about mindfulness is that is can be learned. “Among healthcare professionals, mindfulness training can reduce psychological and physiologic stress,
emotional distress, and burnout while improving empathy, job satisfaction, and sense of well-being” (Howland & Bauer-Wu, 2015, p. 12).
You have probably performed mindfulness exercises if you practice meditation, yoga, or the martial arts, or even if you are involved in competitive sports. These practices use focusing strategies, including deep breathing exercises, to create inner calm, self-awareness, and focused energy.
Biofeedback incorporates mindfulness meditation training, deep breathing, progressive muscle relaxation, and guided imagery. Biofeedback has been taught to many people to lower their blood pressure, heart rate, anxiety, pain, and stress levels. Guided imagery or guided meditation are popular techniques that consist of someone talking you through a breathing exercise or a progressive muscle relaxation exercise or a visualization exercise (“think of your happy place”) – it may be just the person’s calm, soothing voice or the voice may be coupled with music or sounds (waves crashing, rainforest insects, bird calls, rain, etc.).
There are a ton of websites and apps about mindfulness, relaxation, and meditation that you can download for free or buy the paid version for more features. My friend, Melissa Wolak is a speech-language pathologist and has a great post on mindfulness that includes tips to increase mindfulness throughout the day. Check it out!
My favorite app for guided meditation is Insight Timer. This is a free app that has playlists for chanting; Tibetan singing bowl meditations; and guided meditations for sleep, breathing, mindfulness, releasing anxiety, you name it. So many choices are available, with music or without. I love that it tells you how many people are meditating right now around the world with their app – that’s kind of fun. You can bookmark your favorites – I mainly use the meditations for sleep and relaxation. This app is available on the AppStore and on GooglePlay.
Meditation Timer – Simple Insight and Zen Timer is another free app I use. It features Tibetan singing bowls and other musical instruments (chimes, bells) for timed meditations. There is no guidance on what to do during your meditation time (i.e., no person talking you through the meditation steps), so this is a good app if you can guide your own thoughts and breathing or just want some quiet time. The interval bells let you know how much time has passed. It has a fairly simple interface and you can customize the settings to meet your needs. You can save your customized settings also. This app is available in the AppStore. I don’t see it on GooglePlay.
“Meditation made simple” is the motto for Headspace is another popular app. There are preformatted meditations for theme packs, single topics, and minis (1-3 minute sessions) for free. The paid version “unlocks” the Headspace meditation archives; you can subscribe monthly, yearly, or pay one price for lifetime access.
What apps or online websites do you use for mindfulness, meditation, or relaxation? Let me know in the comments!
Brass, E. (2016). How mindfulness can benefit nursing practice. Nursing Times, 112(18), 21-23. Retrieved from http://www.breathworks-mindfulness.org.uk/images/040516_How_mindfulness_can_benefit_nursing_practice.pdf
Gotink, R. A., Chu, P., Busschbach, J., Benson, H., Fricchione, G. L., & Hunink, M. (2015). Standardised mindfulness-based interventions in healthcare: An overview of systematic reviews and meta-analyses of RCTs. Plos One, 10(4), e0124344. doi:10.1371/journal.pone.0124344
Howland, L. C., & Bauer-Wu, S. (2015). The mindful nurse. American Nurse Today, 10(9), 12-13, 43. Retrieved from https://www.americannursetoday.com/mindful-nurse/
Jayewardene, W., Lohrmann, D., Erbe, R., & Torabi, M. (2017). Effects of preventative online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials. Preventative Medicine Reports, 5, 150–159. doi: 10.1016/j.pmedr.2016.11.013
Zeller, J. M., & Levin, P. F. (2013). Mindfulness interventions to reduce stress among nursing personnel: An occupational health perspective. Workplace Health & Safety, 61(2), 85-89. doi:10.1177/216507991306100207