teach mindfulness meditation in hospitals!

I believe that we are in the midst of a changing culture within the NHS. At work, I see burnt-out staff, stress levels as high as ever and clinicians struggling at times to deliver the care they really want to give to their patients. At the same time I see a high demand of patients who are urgently in need of care, but are also sometimes not prepared to take ownership of their health. Some see that it is up to the NHS to "fix" them. This belief contributes to the pressures the NHS faces and so it sometimes appears to resemble a tug-of-war between staff and patients set within the political arena, stoked up by the media and fanned by disillusionment, thereby increasing frustration and stress within the workforce and fear and unrealistic expectations from patients. This has to change in order for the NHS to survive into the future. Notice I am not going to get into the politics, here - that's for another post! :)
For me, as a nurse and as a mindfulness coach, I want to help facilitate positive change within the clinical environment. I passionately believe that teaching staff to connect with themselves through mindfulness meditation will benefit not only the individual, but their colleagues and the patients, too. Teaching mindfulness meditation to patients to help them with anxiety, pain, phobias or other emotions in a clinical environment could have far-reaching benefits for them and create a different atmosphere at ward level, which will have a positive effect on others.
I have written a one-day course as part of my Connected Kids™ training for healthcare workers who work with children in the clinical setting (ward, outpatients, theatres). This course will teach staff about mindfulness, meditation, how to apply to their practice as a tool for implementing care and will teach them how to write and deliver their own scripts to their patients.
If you are interested, please get in touch with me at innerspaceproject1@gmail.com.
Please do share with your NHS friends, family and colleagues!

Mindful NHS

A relaxing mindfulness session I led for NHS staff 

This week a report presented at The Mindful Nation launch revealed that if Mindfulness-Based Cognitive Therapy (MBCT) was practised by those suffering with chronic pain and depression, there could be a saving in the NHS of £15 for every £1 spent. The Mindfulness All Party Parliamentary Group (MAPPG) recommend mindfulness as a treatment for patients. This surely must be welcomed into a National Health Service at a time when so much change and disagreement is taking place? 

The thing is, that each time I read about the benefits of teaching mindfulness to patients I get a little frustrated (so I mindfully work through this, of course). To be honest, the crux of my frustration can be pin-pointed to these things:

1. I want to make people feel better. That's my job. That's my nature. I have seen the benefits of what I teach first hand, to adults and children. It seems that I am having trouble convincing the powers that be that I can have a positive influence on patient care and the well-being of staff. This is something I need to continue to work through in my own space. The whole process is teaching me more about who I am and how I react in my inner and outer worlds.

2. I want to be given the opportunity to develop a programme for staff to learn for themselves and then to teach with patients. I have it. I can do it. At the moment, nobody can hear me! I'm reaching out but the offers aren't forthcoming. What's going on? 

I feel that the NHS needs to change its culture in order to work forwards and make progress. In 2014-15, 39% of NHS staff had time off because of work-related stress. That's nearly 1 in 4 members of staff. I believe that before we can begin to teach patients mindfulness, we need to focus on staff well-being. I'm here. I have drafted a whole programme for NHS clinical staff to teach them mindfulness techniques. Hello!

As a nurse who qualified in 1997, I have seen many changes, and yet so much has stayed the same. It's time to look after ourselves, to give ourselves compassion, to listen to our inner fears and stressors, to learn how to adapt these into positives and reflect this in our professional relationships and in our delivery of care. I know what stress feels like, I work in demanding clinical areas, I've been in more senior roles in the past, so I get it. I now see things from an all-round perspective, so I do really understand the problems staff face. But I can also see ways to change the way the problems are perceived. 

I believe it begins with connection, what I call the seventh C of compassion in practice.The connection of human spirit within the nurse and patient relationship is what weaves the sometimes achingly beautiful compassion, care, courage and commitment into the art of nursing. Connection is the thread that holds everything else together. Without connection, the most basic, yet most complex circumstance is flawed. Mindfulness involves making that connection with ourselves, as well as with others. 

How many reports and recommendations will there be, in order to influence change? 

Nikki Harman, RGN, is a nurse working in an NHS trust. She is also a Connected Kids™ tutor and a mindfulness tutor to adults. Nikki is writing a book about mindfulness and teaching her new course, The Gem In The Dust. Contact Nikki at innerspaceproject1@gmail.com

Releasing Anger, Sadness or Fears With Children

Sometimes I find myself telling my children to “calm down” when they’re upset or crying. When I do, I remind myself that they might not want to be calm. They might be feeling so totally overwhelmed by their worries, anger, fear, sadness, that calming down is the last thing they want to do.
Sometimes, it’s easier to let them release everything by having a really good cry. Crying releases a stress hormone called cortisol, which is contained in tears, so this can be a great stress-reliever.

Mindful activities which aim to release emotions are a healthy way of allowing a child to express themselves, especially if they can’t articulate these feelings to others.

This evening I took my restless children for a walk along the beach. We all collected sand to form into a ball, whilst focusing our emotions into the shape forming in our hands.

Then we stood at the edge of the water, and told all of our worries, sadness and any anger to the ball of sand. As we threw the sand as hard and as far as we could into the sea, we shouted into the cool sea air, releasing and letting go of everything we had been holding inside. Then we asked the sea to dissolve the sand balls and anger, washing away the feelings we didn’t want to hold on to, anymore. We all felt better for doing so…I recommend this activity for the whole family, not just children, as I felt the benefits, too! Don’t worry if you’re not by the sea – you could do something similar with a pebble into a river or a lake, or even throw a pair of socks against the bedroom door! Safely channelling anger and difficult emotions can be far healthier than holding it all in, when trying to be “calm” is the opposite of how a child may want to feel.

Should Doctors and Nurses Be Compassionate?

This was the question on Radio 4’s programme Beyond Belief, earlier this year. Anna Smajdor, a medical ethics lecturer at the University of East Anglia, put the point across that it is not necessary within the role of the health care professional to provide compassion for their patients. Anna says,

“we find it very difficult to know or control what people are feeling”, explaining that it “would be nice if every time I went to the hospital, the doctor or nurse would love me as much as my mother does, but do I have the right to expect or demand that? I don’t think I do. Compassion is about what people feel for you, and you cannot demand that people provide you with an emotion as part of your due…in the health service I think that’s going too far”

What?!

I couldn’t imagine providing care for my patients without giving compassion. It’s not in my personality to shut off my human side, and I believe that is the case for most people.

Many years ago I looked after a young man who sadly died. He was from another country. His parents, who were acrimoniously separated, were informed just as they boarded the plane to see their son in our hospital, that their only child had died. They had to endure a several-hours flight in the worst of circumstances, to arrive in a country where they could not speak the language, to confirm the identity of their child to the police. To say that this was an horrific experience for anyone was an understatement.

His mother broke down when she saw her son. Her wailing, grief-stricken cries cut deeply into everyone who heard her. Unable to communicate with her, all we could do was offer her our arms and our shoulders to share her anguish, the crevices of our necks warm and wet with grief. This mother and her estranged husband, consumed with grief and the horror of their situation, did the only thing they could in that moment: they lashed out at each other. Even in another language, we could feel the conveyance of hatred, anger, shock and bitterness in their voices. But there was little any of us could do. We didn’t understand what they were saying. As a 23 year-old new-ish nurse, I  lacked the experience to deal with this as a professional, but I felt every ounce of their pain.

Later, as I sat with the mother and father in the relatives room of the mortuary, a police officer asked them a few identifying questions. They were able to answer through an interpreter who we had managed to find, although at the time we could only find an inexperienced nurse on another ward, who was clearly traumatised by the details, because she was getting the full impact of the parents’ grief.

The officer handed the mother a clear plastic bag, containing her son’s large, leather-strapped watch, his wallet with a few foreign notes mingled in with the British £10 notes, and his passport. I felt this to be so impersonal that the property was handed to her in this way. She broke down again as she took the bag from the officer. I saw her son’s passport photo, and I too began to cry. He looked so different in his photograph, so handsome and the same age as my younger brother. It was the most intense, sad and loneliest place I have ever visited as a nurse. Grief following death is an all-consuming, exhaustive and potentially destructive place to be. To professionally help a patient or relative in any situation without the connection of humanity, compassion and care is impossible, in my eyes.

Here is where mindfulness can assist the professional in dealing with these kinds of situations. As nurses, we see the most vulnerable people deal with the most challenging of situations in the strongest ways they know how. We support them through these experiences in the most sensitive, compassionate manner and with fortitude, in the ways we are taught, the ways we are shown, and in the ways we would want to be treated if we were ever to find ourselves in the similar circumstances we are exposed to in our work. This is the key to being able to do our job. I know that on days when I have been rushed off my feet, when help is thin on the ground and I haven’t been able to give my best care to my patients, I go home feeling that I have failed to do my job effectively, and I know many friends and colleagues who feel the same. But mindfully working through these situations, by making that meaningful connection with patients and their relatives can make a big difference both in the delivery of care and the way the healthcare professional feels when they leave work.

It is okay to empathise with the relative about how difficult they are finding their grief.  “I know how hard you are finding this, and I feel how overwhelmed you are, this is tough but I am here to help you.”  Sometimes it’s not about finding the most effective way to provide care, but it is about making the emotional connection in a mindful way.

As I said goodbye to the mother and father of the chap I had cared for, all I could do to convey my empathy to them was to place one hand on my heart, and hold the mother’s hand, with the other. I know we couldn’t verbally communicate, but I know that she felt what I meant, and I felt the understanding between us. I hope that my compassion was felt and understood. The health service is made whole by compassion, and to deny anybody that in their time of need would be to deny their humanity.

Are You Sitting Comfortably?

Which way round do you fold your arms? Which foot or leg goes over the other? If you carry a bag over your shoulder, which side do you favour?

There are two reasons for asking this. The first is about habit. We develop our own little preferences about how we carry ourselves, which then become habitual.
The second reason is that these habits become comfortable. If something is of comfort, why change it?
Some habits, though, can be altered by re-training your own perceptions.
I’d like to suggest a mindfulness exercise for you to practice, to help you realise the potential of how you can be in control of your habits. Next time you go to fold your arms or cross your leg, tell yourself to go the opposite way. Whilst doing so, notice any thoughts or feelings, even an awareness of thinking “I don’t like this” but not holding any self-judgement of this. Try this for a couple of weeks and see if you notice any differences in how comfortable you feel, and how you feel about changing a habit.
Once you’ve done this, you could try applying these mindful techniques to other areas of your life where you have fallen into a habit that maybe you’d like to change.
I’d love to know your thoughts on this, and your experiences, so please post your comments!