"Mindfulness sessions to keep doctors and nurses healthy"

An article in today's Mail Online today reports that NHS England are to offer financial incentives to NHS trusts in order to improve health and well-being of staff.
The focus on improving staff sickness includes targeting mental health, muscular-skeletal problems and obesity by offering a range of programmes, including mindfulness. 
As an NHS nurse I am pleased to see that the well-being of staff is being taken seriously. The NHS is going through a tough period whereby healthcare professionals are feeling the pressure from many different areas. It is taking its toll on all staff who work within clinical and non-clinical roles. 
As a tutor of mindfulness, I am positive that introducing this practice to NHS staff could have a great impact on the mental health of staff. I have drafted a mindfulness programme specifically for clinical staff, which combines my knowledge, qualifications and practice as a mindfulness and meditation practitioner, and from my experience and observations as a nurse with 23 years of clinical experience. I am keen to roll it out to NHS trusts to see how it could impact staff well-being, and how it can benefit patients, both indirectly and through teaching mindfulness techniques to patients, as well.

Nikki Harman is a mindfulness tutor to adults, a Connected Kids™ children's mindfulness tutor; and a registered nurse, working within an NHS trust. visit www.innerspaceproject.com, or contact Nikki at innerspaceproject1@gmail.com

"Me" Time

January has been a hard month. Cancer has affected many of us in different ways. It is almost impossible to not hear this word being spoken, sworn at, whispered, cried over, mourned over, or feared. January, it seems, has been the month that has proclaimed the word over and again; the bitter wind bringing the disease sailing into the conciousness of millions, not just in the public domain, but for those who have lost friends or relatives, too, for those who have been diagnosed, for those who care for others. 

If you have cancer, as a nurse, I can help you with your pain. I can help you feel comfortable. I can listen to you, advise you, find further sources of help for you. I can hold your hand, I can make you laugh. I can let you cry and shed your tears. I don't judge you. I hear you, I'm here for you.

From my experience as a nurse, friend, or relative of someone with cancer, I feel that it is a deeply intense, personal experience to those who are going through it. To me, it seems that life for them has taken on a new meaning. Time seems to change, either slowing down or speeding up. It seems that suddenly, life doesn't "fit" in the way it did, before. 

So as a mindfulness tutor with adults and children, I find that life takes on a new meaning for those who begin to practise mindfulness in their day. Each person takes on a new, deeper, or perhaps even lighter view of the everyday. For anyone going through the stages of dealing with cancer, I perceive it to be this way, too, although with a more tangible, emotionally-attached experience. Everybody has their own way of handling their diagnosis and treatments, as it's whatever feels right for them that is important. Sometimes people don't always know what to feel or do; they see how people change towards them when they tell others about their diagnosis;some they lose as friends, others rally round and gather close. Some just want to be living as normally and fully as possible. 

If you have cancer, the following is for you. Please note that this is a general mindfulness and meditation, and certainly not designed to "fix" you, but for you to give yourself the love and attention you deserve. Be gentle with yourself, and feel the strength in your life.

If you would like a session with me either 1:1 or over Skype, it will be much more specific and tailored to you. Please also consider writing a journal after you do these activities, as it can help you work things through.

For the next week, when you wake up, lie quietly in your bed for a few minutes, and try the following:

·        Focus on your physical sensation – how do you feel?

·        What are your first thoughts?

·        What do you see around you?

·        What emotions are you feeling?

When you have considered these, then take a few moments to practice being in the present:

·        Acknowledge any physical sensations

·        Accept your first thoughts, thank your mind for showing them, and then focus your mind on the very moment you are in (i.e. I am lying in bed, I am warm, I am getting ready to sit up and get out of bed)

·        What can you hear? Try focussing on one sound, preferably one that doesn’t invoke feelings of anxiety or stress!

Next, sit on the edge of the bed:                                                                                                                   

·        Place your feet firmly on the floor, giving you a sense of feeling grounded, or connected to the moment

·        Sit with the spine straight, but not rigidly

·        Take a slow, deep breath in. Breathe into your abdomen. Breathe out slowly through your mouth. Take several slow, deep breaths (but don’t make yourself dizzy!)

·        Rub your hands together, place them over your eyes, feel the warmth from your hands, the tingling on your palms

·        Rub and pat your arms, feeling the tingling sensations. Repeat with your legs

·        Feel the sensations of being “in the moment”

Finally, when you have completed the exercise, say to yourself “I am grateful for being in this present moment, I am calm, I am grounded, and I have connected with myself”. Then, as you stand up, stretch, smile, and start your day!

Here is an exercise to try either during or after treatment:

Begin by sitting or lying comfortably. You may wish to close your eyes, or you can keep them open, focusing on an object or image in front of you, or gaze out of the window.

As you take your next breath in, have a curiosity about how the breath travels into your lungs, and leaves again. Be aware of your breath, taking it slowly and slightly deeper into your lungs, all the way down into your abdomen. Be aware of your shoulders, allow them to relax, lengthening the distance between them and your ears.

After a few breaths, take your awareness to your feet, and as you breathe in, scrunch your toes tight, and relax them as you breathe out. As you take your next breath in, tense your calf muscles, relaxing them as you breathe out. As you move up your body with your breath, be aware of how each part of your body is feeling. If there is pain or tension, breathe into it, hold the breath for a few moments, and then blow or "huff" the breath out, either slowly or quickly, depending on what you would prefer. Move up the body as you feel able, until you reach your forehead. Frown on your breath in, and relax as you breathe out.

Now spend a few moments breathing normally, feeling the chair, floor or bed supporting the weight of your body as you relax into it. Is there anywhere that feels uncomfortable or painful? If there is, try to focus on the area. Be aware of the sensation and feel of the area. Try not to tense up, but remain as relaxed as you can, whilst accepting the sensations. Imagine a colour - it could be any colour you like - see it as a fine, gentle mist, slowly coming into the area you are focusing on, and absorbing into your body. Perhaps it feels warm, or cool, bubbly or fizzy - let it happen without thinking about it. As it moves into your body, see the mist as engulfing the pain or sensation, and gently dissolving it, melting it, or consuming it, somehow. The mist becomes denser. like a fog, then lifts itself out of your body, and drifts away. Notice if you feel any different, now.

Next, imagine the warm sun is shining on you. You can feel the rays on your body. See these rays as coming into your body, lighting up every cell in your body with golden sunshine. Imagine each cell has a smiley face, so that you are filled up with happy faces and a warm glow! Enjoy the peace of this moment, for a while.

When you are ready, take a few deeper breaths into your abdomen. Feel the chair, floor or bed beneath you, and wriggle your toes and fingers. When you feel ready, rub your hands briskly together to generate heat and warmth, and place over your eyes. Blink into the warmth, and then, when you feel ready, open your eyes and feel yourself back in your room. Bring your feet to the floor and feel the connection between your feet and the earth.

Namaste,

Nikki Harman

innerspaceproject.com

innerspaceproject1@gmail.com

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.