Thursday, 25 February 2016

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

Tuesday, 2 February 2016

"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.


Nikki Harman