A growing body of evidence points to the powers of mindfulness and meditation as practices that might help tame nurse stress and the risk of burnout.
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Susan Taylor[/caption] "Health professionals are exposed to situations of emotional vulnerability by being in continuous contact with patients and their suffering, which can cause conditions such as compassion fatigue," according to a review article published Sept. 9 in the International Journal of Mental Health Nursing. "To address this issue, therapies such as mindfulness are being used to reduce stress and promote self-compassion." Mindfulness and meditation take practice and knowledge to strengthen the nervous system in its response to stressful situations. It's much like how an athlete trains for a sport, according to Susan Taylor, PhD, who leads the Relias Focused CE series, "Focused Awareness: Bringing Mindfulness Into Focus for Healthcare Professionals." The goal is to help clinicians learn how to use mindfulness and meditation to stay centered, become less stressed and help care for patients.
"What happens is the mind is this field of energy," said Taylor, director of educational programs and founder of the Center for Meditation Science. "When we're outward driven and being bombarded with issues -- everyone's in panic and fear and worry -- it's learning how to tap into your own resources. We tap back into our own center of being. Meditation allows you to do that, if it's done systematically, with precision, skill and in a systematic way."
Mindfulness is awareness, according to Taylor. "We have to bring that awareness into ourselves, so we can make the changes that we need to so we're not disturbed," she said. "In essence, we build resilience."
Reduce nurse stress by building resilience
Nurses often can't change what's happening around them, but they can change themselves from the inside and project those changes to the outside world, according to Taylor. She tells people to remain CALM -- Consciously Aware Living in the Moment. That could apply to the nurse in a busy emergency department who is surrounded by chaos. But applying the CALM approach, according to Taylor, is something the nurse would have had to learn and practice at home to strengthen the nervous system and harness strength in stressful situations. "It's the nervous system that reacts when you're in the work field," she said. "If that nervous system is balanced and strengthened, then when you get into that situation your brain is not going to be wired for reaction."
Taylor continued, "You're going to be able to step back. You're going to stop, observe, detach and then do whatever you need to do to make those changes without saying 'Oh my God, what's going to happen!' The nervous system is not going to get into the alarm state that drains us. It drains us so fast and readily. That's what aging and disease is all about."
There are different approaches for achieving better awareness and clarity. Researchers wrote about focus meditation for healthcare providers in a paper published Sept. 9 in the Swedish healthcare journal Lakartidningen. Providers can practice the attention skill when facing an emergency by remembering a "STOP sign" -- Stop, Take a breath, Observe and Priority first. Another approach, called insight meditation, helps providers observe their thoughts, then lets them pass and bring clarity. The authors wrote insight meditation can be practiced during emotional distress as SOAL -- Stop, Observe, Accept and Let go. "When we're aware of our thoughts, we can then focus our life to where we want," Taylor said.
Learn to breathe
Nurses should learn how to breathe to reduce nurse stress, according to Taylor. The breath regulates the parasympathetic and sympathetic branches of the nervous system. By focusing on the breath, nurses can strengthen the nervous system.
Taylor recommended focusing on breathing for five minutes each day. To do that, nurses have to learn the basic foundation of diaphragmatic breathing. Cleveland Clinic offers a resource on how to do that.
"Once you learn how to do that, then you bring that breathing up to the base of the nostrils and you focus on that for five minutes a day. You can use a counting practice of one to five and five to one," Taylor said. Breathing through a situation can lessen the toll it takes by taming nurse stress. "The breath is what regulates the thought process," she said. "When we get a feeling, it creates a change in our breathing pattern, which then creates the thought. What we want to do is be able to balance ourselves so breath always stays regulated. When that breath stays regulated, then we're able to monitor our thoughts and feelings so while we're heading north, we don't end up going south."
Practice makes more peace
Another important aspect of being aware and meditation is the ability to relax. But that, too, is a learned response. Nurses can't tell themselves to relax and expect nurse stress to disappear. It just doesn't work, according to Taylor.
"Meditation is not easy, but I also don't water it down in the sense that there's a very large spectrum of mindfulness practices," she said. "I teach people an authentic, systematic approach because they can then have it as a core to what they're doing."
Reaping the benefits of becoming more aware, breathing correctly, meditating and relaxing takes learning and daily practice, according to Taylor. "It's something that has to be built up," she said. "We're conditioning the nervous system to be more resilient. For conditioning, you need to do it every day."
