Litter Picker

As I was driving up the road in Swanage today, I came across a huge pile of what looked like sugar lumps, but was actually polystyrene. I was in a bit of a hurry, as this weekend is a bit busy. I hesitated: should I stop to pick it up, or should I carry on?

I decided to stop to pick it up. The cubes of polystyrene were strewn across the road, being blown about by the sea-breeze, less than 200 metres away. I knew that collecting the rubbish was the right thing to do. After all, around 44 percent of sea-birds eat plastic, and polystyrene absorbs water so that it sinks to the bottom of the sea, meaning these and other plastic-derived pollutants are prevalent in our oceans. Well done, clever humanity, for polluting our oceans and aquatic life...

What does this mean to humans? Well, the fish eat the plastics, as well as swim around in plastic-polluted water. People eat fish, who are consuming plastic derivatives. Hmmm. I don't really eat much fish, partly for this reason.

What did surprise me (but perhaps shouldn't have), was that nobody offered to stop to help me pick up the hundreds of polystyrene cubes that someone had left in a nearby car park, presumably for the council to collect (if the wind hadn't dropped it all in the sea, that is). Unfortunately someone had partly driven over the box. forcing it to break up into tiny pieces.

One person did stop to watch me begin picking up the pieces, saying, "Oh dear, that is going to take you a long while, isn't it?!" before he continued his walk into town. It wasn't my rubbish! I was just doing  my bit to look after my lovely little spot in the world, which I would like to keep safe for wildlife and for the residents and visitors who enjoy the sights, the sea, the food...the fish...the plastic...?

So, if you want to consume non-plastic items, if you want your local and greater environment to stay beautiful (or even to begin to do so), please pick up your litter. What's to stop you picking up a piece of someone else's, too? We can also reduce the amount of plastic-wrapped items we buy; manufacturers need to reduce this too.

Practice being mindfully in the moment, as you consider how you are helping others, as well as yourself. Be the change you want to see in the world. Don't leave it up to someone else. We all have that responsibility. We all have the opportunity to help each other and the planet.
Thank you!

"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

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

"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.

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

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