Saturday, 30 January 2016

The Mindful Nurse

It is 5.30pm on the last Friday in January. I am driving through heavy rain, the velvety darkness looming ever closer as I edge my way through rush-hour traffic to get to work, 26 miles from home. Storm Gertrude is fully embracing the thrill of the moment, her blustery vengeance rocking my car along the bypass. As I arrive at work and walk to the entrance, I am peppered with hard rain, so that by the time I get into the hospital corridor, my face and head are wet; the contrast of the dry, warm air is like standing in front of a recently-used, warm oven, devoid of a freshly-baked cake that was there before: slightly comforting yet tinged with melancholy, as I remember it's a Friday night and I am at work instead of spending time with my children.
As a bank nurse, I am employed by the NHS trust I work for, but don't have a permanent contract. I choose to work on the bank because it suits my life as a single parent. There is only so much help I can comfortably ask for, and I feel that I should be present in my children's lives as much as I can be. It also slots into my commitments to running my business as a mindfulness tutor. But I do miss being a part of a team, and I miss being given the responsibilities I used to have.
Tonight, I am assigned to work in the Emergency Department (ED), where I work regularly, and somewhere I enjoy. It is the busiest, most intense place to be at times; very fast-paced, with anything and everything coming through the doors at all times of the day.
I scamper to the canteen to grab a sandwich, eating it quickly on my way back to the ED, as I have only 5 minutes before I start work. At 6 pm I walk into the department and see the queue of patients on trolleys, waiting to be handed from paramedic to the hospital. There are no beds to assign them to at the moment, as the wards are waiting to discharge patients or wait for clinical decisions to be made. The nursing and medical staff are busy; very few have had time for a break. I am asked to go to help out in "minors", where people who self-refer come to be seen, and where the GP referrals come in to be assessed or assigned speciality beds.
This area has been short-staffed all day, so there is only one nurse triaging and handling the GP referrals. I am given a list of patients to get to ward beds as soon as possible, in order to free up cubicles for the other patients coming in through the doors.
I spend an hour or so transferring patients to wards, handing over to a wide stress-spectrum of staff. All of them are tired, busy, hungry, some are finding it more difficult to hide than others. I then return to the ED to help with triage.
A couple of hours later I am asked to perform a procedure I have been trained to do but haven't done for a year or so. I feel slightly under-confident but fairly sure I can remember how to do it. I begin well, and then I feel the doubts creeping in. My stomach tightens and my confidence wavers. Having already talked it through with a senior colleague, I then ask her to come to supervise me. She takes over, doing the procedure exactly as I would have done it. I feel stupid. Why didn't I believe in myself? I try to explain this, but it's too busy, and the colleague is also due to finish her shift. My feelings of stupidity continue to niggle away at me for the rest of the shift.
4 and a half hours later, I head to the staff room for a 20 minute break. I sit alone, half-aware of some rubbish on the TV that someone had forgotten to switch off before leaving. I hear the rain and the howling wind outside, I check the time and I feel tinges of emotions coming up. I reflect and ponder on the events of the shift so far, then head back out to carry on. More patients coming in, more to take to wards, more to triage. I try to work as effectively as I can. Stock hasn't been replaced during the shifts due to business, so it means going off to re-stock whilst seeing patients. This slows everything down - especially when I don't know where something is kept, and can't find a member of staff to ask.
My shift is supposed to finish at midnight. At 11.55pm I realise this is unlikely. There is still a fair amount of things that need doing on the patients I have been preparing for the wards and have been clerked by the doctors. They are important things like giving intravenous antibiotics, administering analgesia, performing procedures. My colleague has taken over triaging, and she is busy. It would make things more difficult for her and the patients if I left. I decide to offer to stay for another hour, to try to tie up as many loose ends as I can. My offer is taken up. I spend the next hour getting things as organised as I can, before leaving at 1am. This was a good shift.
My drive home is even more perilous than the journey in, not least because I am feeling tired. I am feeling frustrated, too. I mull over the events of the shift, conversations, reflect on what I could have/should have done, I try to see events from the perspective of the other parties, and conclude that we, as an NHS body, are stressed. We, as an NHS workforce, are at capacity and beyond. We, as people, are not valuing ourselves enough, we are not giving our own self-care, we lack self-compassion, not just individually but as a whole. I know this to be true of me, because my inner monologue on the way home was twenty-five miles of negative self-talk, and one mile of self-appreciation. An unusual ratio for me, as I was holding on to feeling stupid about the failed attempt at the procedure I was asked to do.
We spend so much of our working lives engaged in processes, care, standards and unrealistic, target-driven restraint enforced by madmen in suits, who sit in the upper echelons of political power, exercising what seems to me to be some form of delusional magnanimity whilst bankrupt of integrity. These are the people who are slowly but surely dismantling health care workers like a six year-old plays with Lego characters. Metaphorically speaking, bits fall off, bits get re-attached, torsos and heads are changed about, some are thrown back into the bucket, others are trodden on. Some are super heroes and carry on, intact, others are strong and many are simply doing their job as best they can, coping with whatever comes their way. These nurses I worked with tonight are heroes in their own way, as they are doing their job as best as they can. They are feeling the pressure. I felt sympathy for them; there is so much more good stuff to them. If only they could see that within themselves, too. I try to have sympathy with government and ministers, but I find it difficult.
So as I mindfully work my way through shifts, I remind myself of the importance of making sure I feel a connection with everybody I work with; but I feel such a need to reach out to the staff I work with, teach them mindfulness as a form of self-resilience and in care delivery. I understand. I get it, because I know the anger, the stress, the fatigue, the food and drink-deprived headaches and full bladders and achy legs and backs.
 I love being a nurse, not for the pitfalls - for the privilege - and there are so many.  It's just not always easy to see.

Friday, 29 January 2016

Five Mindful Tips For Running


Admittedly, here in Dorset I have rich-pickings as far as scenic running routes are concerned, which turns a mostly enjoyable experience into a heart-warming thrill (although it should be noted that I am easily pleased). If I take my running shoes away somewhere urban, I find it much harder to enjoy pounding the pavements and inhaling fumes, than I do to slip-slide through mud or sand and inhale fresh, clean coastal air.

That said, I find it immensely difficult on some days to go for a run, especially when it is pouring with rain, blowing a gale, or when I'm tired or feeling a bit below par - not ill, particularly - but that kind of "meh" I get when I can't quite generate enough enthusiasm to get into my gear and venture into a field full of cowpats and mud.

Or, when I do get out, This Happens:


But then, isn't life like this? There are those days when it is sunny, dry and the pace of life is just right; then there are the days when some sort of challenge appears and it has to get dealt with, even if things get messy.
 At times, when I'm training for an event,  I'd rather be tucked up at home in the warm, dry cosiness - instead of jogging through howling wind, the rain lashing like piercing rods. So I run mindfully. I let the frustration, the begrudging feelings surface, and I "run it out". I use the energy to power me further, I buy into the pain of the moment and then leave it a few steps behind me as the feelings pass.
So if you're training for any kind of running event, whether it is your first 5k or a marathon, here are some of my mindful tips to add to your training regime, whilst staying safe and listening to your body.



1. Enjoy the view. Whether your vista is a ragged coastline, emerald pastures or cracked pavements through housing estates or busy cities, take everything in. Soak up your environment. 
If you're looking down at the ground, you may not see the birds collecting twigs for nesting, the dolphins in the bay, the changing colours of the leaves; the neighbour's cat that has been missing for days five miles from home, the broken swing in the park, the elderly man on his daily walk to the newsagent for his paper, the latest Banksy masterpiece, or the lamp-post you're just about to run into. LOOK UP! It's worth saying at this point, that whilst you're running, always pay attention to your body. If it is hurting, listen to it. Learn to distinguish between pain that is your body adjusting to new strength; and pain that is damaging you.


 2. Set a challenge. If you're training for something, add in a little curve-ball to each of your runs, even early on in the regime.  It could be to vary your route to include running up the hill that you are trying to avoid, for example. In this case, as you're running/walking up,  your legs and your lungs might feel like giving up, so pay attention to what your body is telling you - slow down, hear and feel everything, but continue until you get to the top. Then turn around and look down, to see your progress. Even if you didn't get the whole way up without stopping or walking, you made it - you set a challenge, and you rose to it. Remember this next time you come across a problem you need to solve, and apply the same principles. And keep going: if you keep on keeping on, the next time you run the same hill, you will probably find you go a little further.

3. Acknowledge your freedom of choice. You could have stayed in bed, gone to the pub, or watched TV. But you made the decision, whether you really wanted to or not, to get out and run. Congratulate yourself on this, and accept that your choice has given you the freedom to experience your self. This might sound a bit hippy, but think of it another way: you get to do something healthy and good for your body and your mind, and you get to spend some time alone, out and about. As you're running, even if you are disliking the experience so much that you wish you were lying in bed under warm covers, relish the fact that you chose to be your own best mate, for a while. You will thank yourself later as your endorphins kick in, or you lose a few pounds as a result.


4. Work through a problem in your mind. One of my favourite running techniques when tackling a big hill, is to pick out something that's been bugging me for a while, to pick it apart and problem-solve as I run up the hill. I start at the bottom, whilst considering the whole problem. Then, as I move upwards, and as the gentle burn in my legs begins to heat up, I confront the problem. I allow the frustration, anger or other emotions to power me up the hill; before I know it, I'm at the top, over the worst of it, and ready to take on the challenge in my mind. It works for me every time. Try it! 


5. Give yourself a little treat at the end of the run. For me, knowing that I can get into a hot shower and have a cuppa is enough to get me through anything. One weekday morning I found myself on a 10-mile run with a friend. It was a cold winter's day on a route into high ground, which took us into thick fog and icy cold rain. It was a rural village where everything was closed; even the sheep looked cold. A farmer, passing in his tractor, looked at us as though we were mad as we ran along the road, heading further into the fog, waving at him to thank him for slowing down for us. We realised at this point that we were probably far more eccentric than we'd previously thought, but carried on regardless. There was no alternative! 
What got me through that run was the thought of getting home into a warm shower, a cup of tea and feeling all pleased with myself for getting through a tough 10 miles. Nothing beats that feeling!


So, whatever your running style, make some space for mindfulness during your run, keep it in the moment (don't wish the miles away), focus on one step at a time.

 Enjoy!

I run my own mindfulness courses throughout the year. Contact me at innerspaceproject1@gmail.com to book a place. innerspaceproject.com

Saturday, 23 January 2016

Are you feeling SAD?

*Now we are in the midst of the winter months, the nights are drawing in earlier; warm, light summer evenings are a faded memory. Those evenings spent outside enjoying the warm sunshine have been replaced with dark nights in, huddled under blankets and thick jumpers, the lights being switched on at 3pm, and the heating being our source of warmth. Most of us would agree that the summer months make us feel happier, but for some, the Autumn months herald the onset of  Seasonal Affective Disorder (SAD). SAD, sometimes known as Winter Depression, has symptoms which include lethargy, low mood and changes in patterns of sleep, behaviour and energy. These symptoms of depression start off mildly in the autumn months and worsen as the winter progresses.
SAD is thought to be caused by the lack of sunlight during the shorter days in the year which affect the production of certain hormones in the brain which help to regulate mood, sleep and energy levels. To help treat this, light therapy can be used, where the user sits in front of a special lamp which emits a bright light. This light is thought to work on the part of the brain which regulates our mood, appetite and sleep patterns. SAD can also be treated with Cognitive Behavioural Therapy (CBT) or anti-depressants.
Mindfulness has also been shown to help with depression and anxiety, by helping to reduce the activity of the part of the brain which causes symptoms of stress, fear and anxiety. It is so effective, that the National Institute for Health and Care Excellence (NICE) recommend it as a form of treatment, available in the NHS. By learning to focus on each moment without placing any judgement on thoughts or feelings as they arise, the individual can reduce the chances of those feelings "snowballing" into bigger feelings or emotions.
So  as the darker winter months progress, getting help by going to see your GP is vital if you have symptoms of SAD.
 Personally, as a non-SAD sufferer, I work on the basis of living  mindfully. By adjusting my perception of my experiences I change the way I feel about them. So I enjoy being cosy in my warm blanket in the evenings; I enjoy the feeling of the crisp, cold morning on my face as I walk to school with my children;  I love to curl up with a hot chocolate and a good book on a dull, rainy Saturday, or watch a film with my children on "duvet days" when it is cold outside. Equally, I love getting muddy and cold during a run, to then enjoy a hot shower and a cup of tea. I spend time thinking about  how the highs and the lows of the previous months have made me feel; and make plans and lists of what I want to do in the months ahead.
I run my own mindfulness courses throughout the year. Contact me at innerspaceproject1@gmail.com to book a place. innerspaceproject.com

*This blog was originally submitted as an article for Purbeck! Journal , which has been published in the Autumn 2015 edition



Friday, 22 January 2016

Variety Is The Spice Of Life


Your beliefs become your thoughts, 
Your thoughts become your words, 
Your words become your actions, 
Your actions become your habits, 
Your habits become your values, 
Your values become your destiny. 
Mahatma Ghandi

I bought a spice tin, recently. I filled it with my favourite spices, enjoying the sights and aromas of each, as my kitchen began to smell like an Indian restaurant, with rich, heavenly scents wafting (albeit piercing through my heavy cold) as I spooned each spice into the container. I felt uplifted by the golds and reds as the stainless steel tin reflected the colours. 

It honestly doesn't take much to make me happy,  and although I may be considered a little bit eccentric, I am happy to have a spice tin, because every time I use it the colours will make me smile, the aromas will fill me with anticipation for the meal I'm about to successfully make (I hope); and because it reminds me of the well-known phrase,
 "Variety is the spice of life"

To me, the spice tin represents the alchemy, magic, the excitement of what I am choosing to make in my life. It's been a rough couple of years for me. I've had to get right out of my comfort zone and make difficult choices and decisions. The simplest thing would have been to carry on as I was, to continue to think the same way I had been:
 "I can't", 
"It's too hard",
 "I'm no good at this",
 "I will fail"
etc.
Instead, I chose (well, really I was left with no choice but to do something about the situation I was in) to change. Instead of thinking the same thoughts every day, I became motivated by change, by discomfort, by fear. Yes, fear changed my thoughts, because for a long time the fear was in control of these thoughts and about my reluctance to change. But when I mindfully worked through these fears, I realised that I was able to put that fear to good use. I once read somewhere (apologies to whoever it was, but I have forgotten who said it) that "fear is our own potential pushing back at us" - in other words, what holds us back is our own self-limiting beliefs (thoughts) that stop us from moving forwards. 
I used to live each day with this negative monologue in my mind. I never want to go back there! This is so much better:
"I believe in myself"
"I have the power to change"
"I trust in myself and my abilities"
"I have the ability to make things right and good in my life"
"I love life and life loves me"
etc.
Each time I come across an obstacle, I allow the negative self-talk to come up, because it is still a part of me that exists - but instead of buying into it, I acknowledge it, then answer it positively. This is the part of me which exists to reach my potential, and reach my goals, which include believing that we are all intrinsically good, kind people, but there are those who act out of fear, and those who choose to act out of love. We each have a choice every day about which aspects we are going to pay more attention to.

Variety is the spice of life. Why not get out of your comfort zone and find out where you can go?

I am writing a book about finding our own potential through mindfulness and meditation activities; and have started teaching a course alongside it, too. If you're interested, get in touch: innerspaceproject1@gmail.com



Friday, 8 January 2016

The Nurse's Minute


The winter months increases the number of admissions to hospitals, leading to staff being put under huge pressures to see, treat and care for patients. During a busy shift, staff will often miss rest-breaks, opportunities to have something to eat and drink; and not even get time to go to the toilet. They may encounter a range of emergencies, challenges, emotionally-charged situations, verbal abuse, conflict and have to use many skills to deal with whatever they are faced with.
These shifts can last 12 hours or beyond, and be at unsociable hours when fatigue and tiredness can impact on the endurance of those in the middle of everything. Sometimes things can get overwhelming, resulting in not being able to do tasks effectively. I, like nearly every member of staff I've worked with over the years, get to a point where they're hungry, thirsty, tired, aching, have a full bladder, and yet are in the thick of stressful or busy situations with no sign of a let-up in proceedings to grab some time to refresh themselves.

Whilst the All-Party Parliamentary Group on Well-being Economics recommend Mindfulness as a treatment for patients, there is less focus on helping NHS staff using mindfulness. I am keen to utilise mindfulness techniques for staff to help overcome some of the problems faced each day. I believe it could have a significant positive impact on staff and on patients, too.

At a time when you feel relaxed, ask yourself what your stress symptoms are, even run a scenario at work where you felt overwhelmed and take note of what you feel in your body as you do. Then, during the course of your work, be aware of these symptoms being triggered, and give yourself one minute or so to just step away from the phone/bedside/bay or the area you are working (as long as it is safe), to run through the Red, Amber Green stress-relief points I have written. Remember that by slowing down and deepening the breath, you are helping to reduce your heart rate, which will impact on your blood pressure. When we are stressed, our heart rate, blood pressure and respiratory rate increase, reinforcing the stress response. Breaking the cycle can help to regulate your levels again, and allow you to feel calmer and more relaxed.

So, if you are an NHS worker, I invite you to print my Nurse's Minute (without altering it in any way; please retain my website details) to use whilst you're on shift.

I'd love to hear how you get on with this!

Nikki Harman, RGN, is a nurse working in an acute NHS hospital trust. Nikki is also a mindfulness tutor to adults and is a Connected Kids™ children's mindfulness tutor. Nikki is keen to work with NHS staff teaching mindfulness. Please contact The Inner Space Project: innerspaceproject1@gmail.com


Saturday, 2 January 2016

Bring Out Your True Colours And Shine!

www.innerspaceproject.com
innerspaceproject1@gmail.com

Here I am, talking about getting out of your comfort zone for 2016. I have written a six-week mindfulness course and an accompanying book which is in progress, based on six aspects of ourselves to focus on each week, with mindfulness and meditation activities and reflections.
I am available to do this course over Skype as a 1:1, meaning you don't have to live in my town to complete the course!

Please have a look at the video, and get in touch with me if you'd like to find out more, or to book. And of course, as always, please do share this post!

Nikki

Friday, 1 January 2016

First Mark of The Year


I welcomed in 2016 watching the fireworks in London on TV, the dying embers of the fire and drinking a glass of refreshingly cold water. 
On my own. 
I admit to feeling a bit pants about this, especially as the TV announcer urged everyone to find someone they love to count in the new year together. I looked around where I sat, on my sofa, in my pyjamas, with a blanket over my knees, and for a moment considered bounding up the stairs to wake my children, before realising that it would be a rude awakening for me to do so. 
Then I heard the wind whistling down the chimney, and looked around at the cosy warm room I was in, and suddenly felt a surge of gratitude. 
As the first strikes of midnight chimed from Big Ben on the TV, I closed my eyes and concentrated on each "bong" as a representation of each month of the year passing by, allowing the flashes of memories, pain, stress or joy to boom out through my heart and into the ether. As the first fireworks exploded into the night skies of London, coupled with the fireworks in my town, I concentrated on the silence and the stillness within me. There was no further feeling of sadness, or joy, or stress: I felt free. A blank sheet of paper fluttered into my mind, as if by invitation, asking me to make some marks on it.
So, here is my first mark of 2016. 
It did matter to me that I was not celebrating with friends or family, last night. It did matter that I felt some tinges of sadness when I blew out my tea lights and went to bed, hearing the revelry going on outside and all around me. But I was OK with feeling the sadness. Sometimes, a client will tell me how hard they find it to switch off the sadness and make themselves feel positive. I say that it's not a question of turning off the emotions we don't want to feel, as this is not being truthful with ourselves. It is about being able to accept our emotions without judging ourselves or chastising ourselves for not being positive. It's what you do, how you choose to focus on these thoughts that matter: either you accept them, and accept that this is who you are - much like how you feel differently when you have a headache, but you know that you can take steps to clear the pain - and then when the pain disappears you feel back to yourself, again. 
So this year is going to be great for me, because I accept who I am, I believe that I am going to be making great progress, life will have its ups and downs and I will deal with them, mindfully, emotionally, intelligently, and with love for the life I wish to lead.