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!

The Code

Earlier this year,  new changes were made to The Code for nurses and midwives. The Nursing and Midwifery Council (NMC) has set updated standards that all registered nurses and midwives must apply to their practice.

There has been mixed discussion today from healthcare professionals and from the public, some of whom are in favour of the updated code of conduct and revalidation process; others who believe it to be somewhat condescending towards nurses and midwives. After the Francis Report and the Keogh Report highlighting flaws, concerns, dangers and poor practice across poorly-performing trusts, I find it puzzling that there is so much variation in care delivery across what should be a well-performing, unified organisation, theNational Health Service. Will updating a code of conduct for some of its workforce be enough to drive up standards of care delivery, or is there Something Missing?

I’ve worked in several different trusts as a nurse – both in primary care and secondary care – as well as in the independent sector for a while. Wherever I have worked, there have always been various issues ranging from money shortages, poor standards of care, mistakes, anger and disenchantment, to job dissatisfaction and stress with burnout. I’ve seen the best and the worst of care; with some incredible, caring staff who will go the extra mile for their patients. I’ve heard people say that the NHS runs on the goodwill of those who work within it. I’ve always done my best as a nurse to work to the best of my ability, for the benefit of patients. And if you were to ask any other nurse or midwife or healthcare worker, they would almost always say the same.

I have always said that if I ever stopped caring about my job or my patient, it was either time to change job or leave nursing. I often wonder if standards of care delivered by the NHS workforce reflect the standards of care delivered by the trusts and by the government…if as healthcare professionals we are expected to uphold standards and codes; if NHS Trusts are expected to comply with statutory regulations, targets and standards; what targets, standards and compliance are in place for the top governing bodies and government which control the NHS from the top down? Where does this drive for improvement, delivering high standards of care, behave compassionately and respectfully to the patients begin – the individual, the government – or both? Where does it begin for the staff? Why are staff bullied? Why are there failures in care? Will a code of conduct be enough to ensure that dreadful things don’t happen in the NHS, any more, or is there Something Missing?

I believe there is: one of the fundamental elements of mindfulness practice is based on connection. Connection with the Self. This connection, in the form of reflection or a moment to sit still and contemplate a situation or event that has taken place allows a more meaningful experience. Regular mindfulness practice and other forms of meditation, such as Metta meditation has a positive impact on ourselves: it makes us “nicer”. This connection within, when practiced regularly, can enable us to connect, empathise and act with compassion towards others. I would like to see this connection embedded with everyone, including patients, staff, trust boards, local and national government. The connection works both ways, though – even I struggle with that bit – I find it difficult to have compassion for the current political mess the NHS is faced with, at the moment.

So, this new code…I hear (and connect with) all those who have positive and negative experiences in their care delivery or as a patient; I understand and agree with much of the revised code; but  I also see that mindfulness deserves a high profile space in clinical care, starting with training student healthcare professionals. Influencing our thoughts towards ourselves and how we relate to others begins within. If this happens, who knows: perhaps others will begin to be influenced positively, too – including the public having a greater sense of trust and empathy for what NHS staff face on a daily basis.

Nikki teaches mindfulness and meditation to adults and children, and works as a nurse in an acute NHS hospital.

The Seventh 'C'

The more I embed my use of mindfulness into my nursing care, the more strongly I feel about how important it is that as nurses, we make a meaningful connection with our patients.

I started nursing back in 1993. I took a gap year before starting my training, to work in a nursing home. I wanted to develop my basic nursing skills, to begin to learn the art and science of being a nurse.

To me, nursing was about caring. I wanted to care for people. I wanted to make my patients comfortable. I wanted to understand what they were experiencing, as well as empathise with them. I wanted to know everything. I was an eager beaver, keen to do the best I could, but was still very wet behind the ears, completely naive, but full of enthusiasm.

Working in the nursing home was a shocking experience. Standards were poor: the home smelt awful. The residents were not properly looked after, but although I knew at the time the things I was witnessing was wrong, I did not know what to do about it. The company I worked for didn't pay us on time each month (once they arrived at the home to pay us by cheque at 5pm on Christmas eve); they didn't pay the bills on time, so at one point the phone line was disconnected and if we needed to make a call one of us had to leave the home and run 5 minutes up the road to the nearest phone box. The bill for incontinence pads was left unpaid for months, so the new orders were not delivered. We were told to cut up towels to use as pads, or dry the used incontinence pads on the radiators. No wonder the place smelled. No wonder, either, that most of the poor resident's pressure areas were breaking down. I, along with some others, refused to do either of these things, much to the chagrin of the company director.

It was a diabolical place to live and work. Most of the care staff did care about the residents, and wanted to make a real difference. We all knew of each individual resident's likes and dislikes (Betty loves cheese sandwiches, but Ethel hates cheese; Sam likes to listen to classical music in the morning with his porridge but Mabel prefers silence to eat hers; Rose always has to sit by the window, to see who is coming in and out of the front door - but everyone of us knew that she sat there each day in the hope that she would see her family walk into the home to visit her - but tragically, that event only took place a couple of times each year; partially-sighted Anne has to have her clothes laid out in a certain way each evening, so that she could find them in the morning). We all knew the routines and we followed them as much as we could, each day. But this did not take away from the fact that dreadful things were going on in that home, things that I could not bear to see. I felt a real connection with the residents, and that was the thread that weaved in the compassion, the care, the (attempted) competence, and the commitment, which led to the courage to communicate the terrible goings on to the authorities.
It was the connection with one or two in particular, that led me to write poems about the struggling, elderly bodies that tortured their fiery minds each day. One lady, on waking each day, would cry, because each night she prayed that she would die, rather than wake in pain each morning, her arthritic joints agonisingly taunting her heart, which longed to walk hand in hand with her husband on the beach, or hug the grandchildren she loved, who smiled at her from their gilded frames on the windowsill. I would try to be in her room before the others, to help her get dressed. Why? Because she insisted on wearing her tight-fitting satin blouses each day, which were almost impossible to bring her tense, creaking arms through. But I had found a way of being able to do so, unlike some of the other staff, who would take out their annoyance of the perceived inconvenience as they wrestled and tugged at the poor lady's arms, roughly pulling and tutting as she winced and cried out in pain. I couldn't bear to see it, so would try to get to her room first and gently, slowly ease her arms out as straight as I could, one at a time, apologising repeatedly, but knowing that the smart, pink blouse the lady wanted to wear, along with her matching lipstick, would make her feel just a little bit better about being alive, a little bit more "in the pink" than she really felt: quite simply, it made her feel human.
In the end, a good year or so after I left and started my training, the home was closed down after several serious complaints from relatives. There were staff there who were deeply caring and concerned about the treatment of the residents, as well as the living conditions and the mismanagement of the company (who subsequently found themselves in the position of being broke, forcing the closure of the other homes they owned, too), but 22 years later, I am still very saddened by the thoughts of the events I witnessed. I wish I could have done more to change the circumstances. I wish I could have stood up to the company and banged my drum louder for more to hear, so that changes could have been made. But I was green, I was naive, and I didn't know what I needed to do to make things better.
Ironically, when I started my training at a London teaching hospital, it was comparative luxury to be able to walk to the cupboard when I needed soap, incontinence pad, sheets or clothing, to see shelves full of everything I needed to be able to provide the basic nursing care required. It was bizarre to me that NHS staff were complaining of a shortage of equipment and resources. On reflection, it showed me just how bad things were at the nursing home I worked in.
On my first night in my nurses digs, I put up the poems I had written about the residents I had looked after on the wall next to my door. I read them each day, to remind me of the sorrow and pain these folks had suffered, in order to do the best for my patients. These and many, many more patients over the years are the connection within me to each one of those I have seen suffering, in pain or anguish, in fear or terror. 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.

So, 22 years later, I am no longer green or wet around the edges. I still love my job. I still make mistakes, each one leaving its mark for me to learn from and grow. I have seen so much heartache and pain, like other clinical staff; I have seen miracles, I have seen the fragility of the tiniest life to the vulnerability of the mightiest of men, anguish and grief in many; and joy, pride and acceptance in those too numerous to count.

But now is different. Now I am using my skills in mindfulness to help my patients across a wide spectrum of age, illness and diseases. I am discovering how best to use the connection I can make with my patients, to help them connect with themselves to understand that they can help to ease their discomfort. I am seeing results, sometimes instantly, just with a tweak to the way I work with each individual. So in my clinical practice the six 'C's have another recruit. Who wants to connect with me?