Mindfulness: Leveraging its benefits during healthcare crises

Healthcare is experiencing a dramatic shift on so many levels: patients are frightened and hesitant to seek care unless they think it is an urgent issue, the world is dealing with a pandemic that has many unanswered questions, and healthcare providers are growing increasingly anxious about their own risk of exposure. To name just a few of the challenges! Of course, while the pandemic represents a crisis of unequal proportions, not all urgent situations are pandemic-related. It just adds to the stress of dealing with non-COVID-19 emergencies. Needless to say, the time is ripe for significant psychological impacts on healthcare providers. Just being aware of this increased risk of the deleterious impact of stress is the first step to improving one’s ability to cope. It is important to be aware that you, your staff and your patients are probably all experiencing heightened levels of stress.

Ironically, it is during emergency and other high-stress situations where we need to be on top of our game in terms of cognitive functioning, decision making and attention, that we are at greatest risk of having our amygdala’s grab more of our focus, and can significantly affect emotional and mental well-being, both in the short-term and over time¹.  Not only do emergency situations call for thinking quickly on one’s feet and making timely (and often life or death) decisions, but the ability to be aware of how one is relating to self and to others, is also critical. That requires a degree of self-reflection, a willingness to engage in self-care, an ability to stay focused on the task at hand, and being capable of adapting to quickly changing circumstances–all this while staying tuned in to how one is relating to others so that they can stay focused and engage in effective decision-making and cognitive processing. As physicians, you are often required to step into a leadership role–making your ability to self-regulate, to communicate and to interact with others vital to successful healthcare outcomes.

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There are strategies for developing your ability in all these areas–practicing mindfulness would be at the top of that list. As scientists and healthcare providers dedicated to evidence-based practices, mindfulness deserves a place in your toolkit–but not just for your patients–for you too! Recent meta-analyses point to the many psychological and physical benefits of mindfulness practices for healthcare providers^2,3. 

So, what exactly do we mean by mindfulness? Perhaps the most widely cited practitioner of science-based mindfulness, Dr. John Kabat-Zinn, gives us this definition: “Mindfulness means paying attention in a particular way, on purpose, in the present moment and nonjudgmentally)⁴.  What does this mean in practice? It means that we are intentional about where we focus our attention; that we observe what is going on internally and externally) without making an evaluation or judgment (especially about ourselves); and that we stay committed to repeatedly bringing our attention back to the present moment. Why is this a useful practice? Because it has been shown to improve one’s ability to cope when experiencing distress (such as fear, anger, and anxiety), to sharpen one’s focus, and to intentionally direct attention where it is most needed⁵. The key to success is simple–practice mindfulness. Like any other skill, the more you practice, the better you get. And if you think you can’t afford the time, think again. Mindfulness can be practiced anywhere and for any period of time. All it requires is an intentional, nonjudgmental focus on the present moment, regardless of what’s going on in that moment. Having an anchor (the most common one being the breath) helps to bring your attention back to the present, over and over again. The more you do this, the better you will get at staying focused and present during any situation. Think of it as a form of stress-training–preparing your mind to focus awareness during a time when it is likely to be most distracted (think crisis or emergency). And like any form of training (be it for a sport, learning a language, or engaging in some form music/art), first you learn the skill and then you practice over and over. There are many resources available for learn mindfulness–such as Kabat-Zinn’s website or any of a number of phone apps. And practicing just 15 minutes throughout the day is enough to make a difference. So, give it a try. You might just find that not only does your mindset and ability to cope at work improving, but other aspects of your life as well. And there is an added benefit–research finds that people who spend more time focused on the present, rather than engaging in mind wandering, are happier. 

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Ready to practice? Take a quiet moment (the more the better) and focus on your breath, where-ever you notice it in your body. When you find your mind wandering, gently bring it back to the breath. Whenever you find yourself experiencing negative emotions, observe what you are experiencing without judgment, and bring your focus into the here-and-now. It’s that easy. 

Catherine Hambley, PhD, is CEO of Brain-Based Strategies Consulting, where she specializes in executive coaching, leadership and team development and organizational transformation. Catherine has an extensive background in healthcare, where she works with physicians, nurses and hospital executives to create cultures of learning, collaboration and engagement. Check out her website at www.brainbasedstrategies.com

References:

1. Harvey, S., Milligan-Saville, J., Paterson, H., Harkness, E., Marsh, A, Dobson, M. & Bryant, R. (2016). The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. The Australian and New Zealand Journal of Psychiatry, 50(7), 649-58.

2. Gilmartin, H., Goyal, A., Hamati, M., Mann, J., Saint, S., & Chopra, V. (2017). Brief mindfulness practices for healthcare providers–A systemic literature review. The American Journal of Medicine, Vol. 130(10), 1219.e1-1219.e17.

3. Westphal, M., Bingisser, M., Feng, T., Wall, M., Blakley, E., Bingisser, R., & Kleim, B. (2015). Protective benefits of mindfulness in emergency room personnel.  Journal of Affective Disorders, Vol. 175, 1: pp. 79-85.

4. Kabat-Zinn, J. (1994), Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

5. Zanesco, A., Denkova, E., Rogders, S., MacNulty, W. & Jha, A. (2019). Mindfulness training as cognitive training in high-demand cohorts: An initial study in elite military servicemembers. Progress in Brain Research, 244, 323-354.