Set-Up or Up-Set?

An essential part of being mindful is being present with your thoughts and feelings at any given moment. Some people regard mindfulness and meditation techniques as having to be clear of thoughts, have an empty mind, and be at peace. Whilst there is an element of this involved, this tends to come about as a result of practice. Even then, learning to be at peace with your thoughts and feelings in the moment, rather than having an empty mind, is key to being mindful.

It is not always possible to have an empty mind! The difference between being preoccupied with the thoughts and emotions buzzing within you, and the ability to observe the thoughts and emotions you are feeling, lies in how you perceive them. Learn to tap in to your feelings in a situation. Ask yourself if you feel that this is a healthy state; do you need to reset; or if there is an emergency brewing:

healthy: Being at peace in the moment – feeling calm, in control, happy with what’s going on within/around you

reset: Noticing that you are feeling uncomfortable, agitated, stressed or other emotions which are having a negative effect on you or those around you, and taking mindful steps to set up to a healthy state of mind again

emergency: have you hit the “panic button” – feeling out of control, scared, angry, or other emotions that are making you feel on high alert, impacting on your behaviour and thoughts

Being in the healthy state doesn’t necessarily mean having an empty mind: it means being able to accept the thoughts that you are experiencing, without allowing the attachment of emotions to dominate how you react to these thoughts. In other words, learn to separate the feelings associated with a negative thought. See the thought as a cloud, or imagine you are looking at the picture as an observer, rather than being drawn into the drama of the image or thought. Learn to feel at peace with the thought.

If you sense that your peace is becoming upset, pay attention to how you have set-up the situation. What do you need to change to feel healthy in your mind, again?

Don’t hit the red button: Hit the reset button, instead!

Nikki Harman is a nurse working in the NHS; and mindfulness and meditation tutor to adults and children. Contact innerspaceproject1@gmail.com for more information about courses or sessions either face to face or over Skype.

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.

MIndful NHS

I have been practising mindfulness techniques in my work as a nurse in the clinical environment for a while, now. I am finding it works well. So much so, that I am beginning to measure its effectiveness and outcome in my patients. I have also run some introductory mindfulness sessions for staff, to help them de-clutter for a while before heading back into their work. I am keen on developing this much further: I have so many ideas to put into practice. Models and clinical plans to develop, deliverable in a variety of methods. I am so excited about what I can do. But I need investment. The NHS, as we all know, is in a critical period, with a possible £2.5bn deficit looming over the nation’s health service. I am so passionate about what mindfulness can do to help patients and staff, and how it can help improve the service at national and local level.
So it was exciting to read how doctors should be taught mindfulness during their training. As someone who knows the NHS from the inside, works with a variety of patients and has undertaken mindfulness training, I couldn’t agree more. The all-party parliamentary group on well-being economics recognise a need to train doctors (and teachers) in mindfulness. But it needs proper investment, it needs to be done carefully, considerately; and with the patient and staff’s best interests at heart. I believe I am able to deliver training and support to both staff and patients. I’m chomping at the bit to get going on this project, knowing that my methods have shown positive results; and that staff need the help to deal with the workload and manage stress every day. Mental health and mindfulness is the tip of the iceberg: I want to embed mindfulness into NHS culture. There is so much potential here, who can afford to ignore it?

Nikki Harman is a mindfulness tutor to adults and children; and a nurse who works in an acute NHS trust in England. All enquiries to innerspaceproject1@gmail.com

Human-Kind?

Last summer, I decided to spend some time really engaging in the world news. At the time, I read about the latest reports on what’s happening in ebola-hit countries; the conflict in Gaza; Syria; Ukraine and Russia; the misguided/greedy/clueless politicians around the world making decisions affecting their country and not listening the the masses;  the rising obesity, cancers, poverty, famine, the global economy; the death of Robin Williams. All of the above articles were interspersed with adverts trying to influence what car I should buy, what I should be wearing, where I should be holidaying, and how to be thin. There was the usual social commentary on facebook/twitter about the news. No wonder I’m feeling glum. In the time it’s taken me to even type this list, I’m feeling lower than before I started.

This can’t be how life is supposed to be…is it? Are we all hard-wired to strive for our own individual wants, over and above what others needs are? At what point did the human race move from looking after their basic needs – as being satisfactory to a happy life – to tearing apart someone else’s to satisfy one?

I know this is not the case: the outpouring of grief over Robin William’s apparent suicide was immense: why? Because he was a fantastically funny human being, who demonstrated his ultimate fragility. A fragility which exists inside all of us. His death struck a chord with many.

What’s happening in the middle east has its peaks and troughs in the world’s news stage. Last summer, it was a prominent news feature every day, but after a while it seemed to have less of an impact. I remember that whilst eating breakfast in a hotel dining room, the TV was showing the BBC news and weather. As the news items rolled, it reported the latest death toll of the Palestinians: nobody moved. Nobody watched the item. Heads remained down, whilst the dining room collective continued to eat their breakfast. A moment later, and the weather forecast came on the screen: heads swivelled to watch in anticipation of how hot it was going to be, and whether raincoat or sunscreen would be required, for the day. A hush fell in the room. As soon as the report had finished, people went back to eating. How can this be? Is this English-ness? Is this apathy? Is this a tolerance thing? Is it tolerable to hear how children are dying because of an arguement over land and religion as a means to power and control? I feel the answer to this is “yes” – because we are flooded with the news all the time. We are becoming hardened to war atrocities, because it is something happening far, far away, and it doesn’t affect us, at all. Does it?

You know what? It does! Why?

The fact that someone is more bothered about the weather in their town than fighting and killing going on in another part of the world, is a worrying symptom of how our societies are becoming disconnected with each other. My ability to continue to empathise and feel the need to help relies on my emotional intelligence, that which lights me up inside. How would I feel if I were in a refugee camp in Syria with my children? Not being able to go back to my home. How does it feel to be too scared to leave the house for fear of being raped, killed, or arrested? How does it feel to bury a child? How does it feel to lose everything in the blink of an eye? How does it feel if I forget my umbrella and it rains because I didn’t listen to the weather report that day? I get wet: so what?

The news this week that Jeremy Clarkson has been sacked from Top Gear despite a petition to reinstate him reached a million signatures, last week, has shown how the public can be motivated when they feel something is directly affecting them. One million people appear to condone a physical assault from one person; yet only 100,000 people signed a petition asking for world leaders to step in to help the refugees of Syria. What’s going on?! Does anyone else find this ever so slightly concerning? I understand that Syria is far away and Jeremy Clarkson is a public figure, but people are willing to ignore the finer, essential details in order to maintain the status quo?

The thing is, it seems that there are more people who are willing to loudly complain about getting wet before they go home to shower and change into something warm and dry, than those who are shouting about the injustice in the world, and who are prepared to hold out their hand to help a fellow human being. A disproportionate power, some of whom want to seek revenge and kill, in comparison to those who are prepared to connect with themselves and others, and find out what has made them feel that urge and make a change. That’s why we are all affected by apathy or a lack of empathy. I know that there are movements, campaigns, and positive ways in which social media is helping to influence societies and governments and those in power, but we need to make more of a connection with what’s going on in the world, and pay attention. We are all affected in some way by the actions of others.

I was waiting to pay for my food in the supermarket a while back, where the store is being refurbished. It was quite busy, and there was an older couple behind me getting really cross and complaining about having to wait to pay for their trolley full of items, despite a free till which was for “baskets only”. “So what?” I thought. “The man at the till is doing his job. There are a number of people walking around with baskets, and a larger number with trolleys stacked full of food”.

The woman started to raise her voice in annoyance at this, referring to the “stupid idiot” at the till who had refused  to serve her. I wondered whether the young assistant had heard her, and if so, how he would have felt to be insulted like this. I made eye contact with her. The woman continued to complain. I smiled as I listened, then said, “Ah well…never mind. Let it go! There are worse things going on in the world, right now! A few extra minutes queueing won’t do you any harm.” She stopped in her tracks, took a step back from me, then whispered, “You’re right. Of course not.” She was so wrapped up in her own head, thoughts, irritation, that everything else had become insignificant. But given an opportunity to see another view, she made a connection with her own feelings, and realised that it didn’t really matter, in the grand scheme of things. After I’d paid for my food, I went up to the woman, and wished her a lovely weekend. She smiled back at me and wished me the same. Ta-da! Connection made: spark turned into sparkle. Job done!

This is what this blog post is really about: taking a moment to step back from a situation and connect with your self. Just a moment to feel into what’s going on – go back to the “spark” – and decide whether it is a sparkle to light your inner glow (that which makes you shine and lights up those around you); whether that spark starts an unstoppable fire (that which provokes a sense of a need for revenge or retribution); or whether that spark should be extinguished before it causes any damage (the awareness of negative feelings and acknowledgement  before letting them go without consequence). And if it isn’t gonna make you shine brightly enough for others to see and share their light with yours, then don’t set the sparks off in the first place. As Ghandi said, “You must be the change you want to see in the world”.

Pain, Relief

I used to work as a nurse practitioner in a GP surgery. I would see patients who were complaining of pain which had lasted anything from several hours to several weeks or more. In each case, I would ask what they had tried to help settle their pain. Often, the patient would explain that they hadn’t tried anything, not even a paracetamol. Often, this would then be followed up with “I don’t like taking tablets”, or “nothing works”. I would make suggestions about painkillers, ice, rest, activity, suggest exercises to ease back pain or refer on as required, depending on what type of pain the patient was experiencing, as well as other symptoms.

It is interesting to reflect with patients how they perceive their own pain, how they manage it, and what action they take to relieve it. Examples include those who stoically carry on without taking pain relief or other steps to manage their pain; others, who have tried lots of different medications but found that nothing works; and those who are reliant on their analgesia to get them through the day. As someone who has suffered with chronic back pain resulting from a car accident years ago, I used to fall into the “nothing works” category. I found that my life was dominated by the pain in my back: I had lots of time off sick (working in a hospital as a nurse is hard-going on the spine and one of the worst jobs for back pain and injury), which eventually led to surgery which required more time off, more pain, more medication, subsequently led to me being made redundant and then a subsequent  bout of depression, before finding a job I could manage comfortably. Gradually, I came to the realisation that I could control my pain through the meditation I practised, as well as yoga. Over time my pain management improved through a combination of painkillers, exercise, and meditation, as well as visits to an osteopath or chiropractor.

What I also find interesting is the way in which our NHS and healthcare system is dominated by pharmaceutical interventions to manage pain. In an article for the Mail Online, Dr Mark Abrahams explains the various options for treating pain with medicine and different medical interventions such as spinal blocks for relief, and discusses the dangers of over-reliance on medication to treat pain. He also suggests mindfulness as a method of managing pain. In my job I spend a lot of my time dispensing various pills and administering injections to patients in pain, but recently I have started to teach mindfulness to help with their pain, too. I have found it a very useful and successful tool in helping patients manage their pain, whether it is acute or chronic. I have also discovered that the exercises I teach my patients has altered the outcome of medicated pain relief, because the time I spend with them talking them through the exercise has reduced their pain score and their subsequent medication. I would never advise anyone to completely swap medication for meditation, but I do find that in the ward environment, spending five minutes teaching some simple mindfulness work with a patient who is not due pain relief according to their drug charts, has eased their pain. I see no reason why we can’t use mindfulness as well as painkillers.

As for my own experience, I can say with absolute certainty that mindfulness has helped me overcome pain. I don’t know where I would be without it!

Be Brave!

Last summer, whilst out running in the woods, I headed towards a path I tend to feel wary of. It was a gloriously warm summer morning, and as I ran along the sunlit-dappled path, I became mindful of looking out for Adders. Now I used to be terrified of snakes as a child; and even as an adult, I’m really not that fond of them.
Despite my fear and dislike, I have never seen a snake anywhere other than behind a plate of glass at the zoo: a sanitised, safe environment – perhaps not so much for my benefit – as for the snakes themselves.

I reflected upon this as I left the woods and entered an open space, that the fear I have of meeting a snake on my own well-travelled path, has little basis. Why must I place the emotion of fear into a situation I have never encountered, and may never face? Surely it would be better to experience the fear and react accordingly if need be?

As much as I love being amongst woodland, I do tend to run a bit faster in the areas where I am likely to encounter an Adder. This might knock a couple of seconds off my time, but if I run too fast, I may miss the beauty all around me – even that of the adder itself.

To confront a fear allows us to learn something deeper about ourselves. If we permit the fear to control our decisions on, say, which paths to take in our life, we restrict our choices, and may inhibit our own growth. Although it might feel easier to avoid anything scary or unknown in order to protect and preserve – to sanitise – our comfort zones, these seemingly easy decisions can prevent us from learning more about ourselves, and forming a deeper connection within.

By facing our fears, we can begin to open up to what it is that has influenced our decisions and perceptions. If we fully experience our fear, we can then see the beauty of our deeper selves, learn as we conquer our fear, and evolve on a spiritual level.

So look for your own strength and courage in your heart, and allow the light within you to be the sun dappling upon your path less travelled.

The Mindfulness of Love

This post encourages you to ask yourself what love, in its implicit sense, means to you. Can love be implicit, or is it more fragmented, than that?

Suppose I declare: “I love chocolate”. But when I really think about it, it isn’t the chocolate I love: it’s the sugar rush I experience whilst eating it. It’s the moment I allow myself to sit quietly and relax whilst I am enjoying the sugar rush. It’s the reward I give myself, like I’ve given myself that permission to enjoy the chocolate. It isn’t the chocolate itself. This might be a different experience to the next person, but it is my perspective.

So do I love chocolate? Maybe; but not as much as I love listening to the radio on my way to work. But when I think about it, it isn’t the person on the radio or the music that I love, it’s the act of driving and being quiet that I love. It’s the time spent alone with my thoughts, peppered with music and conversation that I love.

So, do I love listening to the radio? Maybe; but not as much as I love running. I LOVE running. I have to run to feel human, again. Running gives me headspace, time to meditate, time to listen to the radio (and sometimes reward myself with a little chocolate, afterwards). Running makes me feel happy and relaxed.

Yes, I love running. But I love nursing, too: I love coming to work. Seriously, I do. It helps me forget about any negative stuff going on in my life; I get to meet all sorts of different people from all walks of life; to me, nursing is an art where it is a constant project of learning to understand others, help alleviate symptoms or pain, help to make someone better, as well as have the privilege of sharing some of the most personal experiences of someone’s life, with joy, happiness or sadness and grief. There is little in life more rewarding than seeing someone come into hospital ill and in need of help, and leave with a smile on their face, fit and ready to carry on with their life. It is the same with my reiki and my mindfulness work. I feel such gratitude and love for the work I am lucky enough to do – and be paid to do it!

I love my children. They are the biggest, most love-inducing, intoxicating part of my life. I live and breathe for them. I will walk to the ends of the earth and back for them. Who wouldn’t do the same for their own children? My children are funny, silly, clever, annoying, talented, argumentative and unconditionally loving towards me. No matter what mood I’m in, they can snap me into a smile just by the things they say or do. Their hugs, our chats, the singing and dancing, their little notes telling me “I love you” or  their paintings and drawings show me that I am so lucky to have them in my life. They love life from moment to moment and at full speed. My family and friends carry the same significance to me.

And finally, I love myself. There is nothing wrong with saying this. In fact it is crucial for the rest to fall into place. If I didn’t, I couldn’t enjoy and treasure everything that is my life. My life is made up of these loves and joys. If it wasn’t, I couldn’t be happy. If I didn’t love myself, I couldn’t love my life the way I do. I have my off days, I have the days when I have to search a bit deeper to find that love and joy, but it is always there. I believe that without that love for myself, other aspects in my life carry less meaning. I nurture myself and  others. It’s what I do. Nurturing the love within means that everything else can grow, too.