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Incorporating Mindfulness Into Practice

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Incorporating Mindfulness into Practice
Staci Dobson
WGU

Professional Presence
Healthcare requires many attributes to excel as a caregiver. Historically caring for the physical body has been our focus. Research has shown humans require care of the body, mind, and spirit to obtain optimal wellbeing. As a caregiver to be able to provide for the needs of the patient, we need to grow in our self-awareness and increase the mindfulness in our practice.
Models of Health and Healing. We have seen many advances in medicine over the last decade. Over the last century, technology has improved rapidly. With the technological advances made the importance of the awareness of the interconnectivity of the mind, body, and spirit for a person’s wellbeing. Dr. Larry Dossey describes three eras and how medicine has progressed. He referred to the first era as the “mechanical medicine” era, only ailments of the physical body were recognized and treated. The second era recognized how emotion and feelings can influence the body’s functions. The third and most progressive era includes our consciousness. Dr. Dossey states that consciousness is not confined to just the individual, but is boundless. (Dossey, n.d.)
The main difference between era two and three is the realization that caring for a patient’s spirituality is equally as important as caring for their physical body and their psychosocial well-being. The discovery in era two of psychosomatic illnesses and the inclusion of treating a patient’s mind along with their physical ailments was considered a” radical advancement”. Era three builds on era two, and includes caring for an individual’s spiritual needs along with the body and mind. (Dossey, n.d.)
Spirituality has many definitions, and is different from person to person, but research has proven it plays a crucial role in holistic care. Holistic care relates to the physical, psychological, spiritual, economic, and social dimensions of a person. (Rushton, 201) Praying, meditating, allowing quiet time, or even simply the gentle touch from a caregiver are examples of spiritual care. Dr. Dossey has studied the importance of prayer and its effect on healing, he states “there are no boundaries to consciousness” and concludes we are all interconnected. (Dossey, n.d.)
Personal style related to models of heath and healing. My personal style aligns with era three. Raised by my parents in a spiritual household we grew up praying daily. I have prayed with patients and for those whom I knew to be suffering. The small community hospital I work in does not have clergy on call; at the patients request I have called their religious leader and notified them of the patient’s needs.
I have worked labor and deliver for 25 years and in that time have introduced my patients who were interested to the benefits of holistic care. Working in a small community hospital affords me the opportunity to interact with my patients’ on many levels. I teach prenatal class proven methods of pain control that are non-pharmacological and that can be helpful during the labor process in my care. Aroma therapy, massage, rhythmic rocking and visualization are a few of the methods that I instruct patients who prefer a more natural approach to childbirth.
Personal professional presence. Nursing may have not been the best choice of careers for me; I am easily distracted and must consciously remind myself to focus on the task. With a multitude of demands and request, it is easy to get distracted. I have diligently worked on methods to keep myself on track and in the moment, my ability to manage distractions and stay focused has contributed to obtaining my role as supervisor. I am an extrovert and will always choose to sit with a patient and talk with them or their family members over charting. I find it very natural and easy to be in the moment when engaged in a conversation. I am passionate about exhibiting a caring attitude and providing patients and their loved ones with compassionate care. I have earned staffs trust and respect by placing their needs above daily task.
Personality Presence Many organizations are having their employees complete a personality test. They are discovering if we not only know our only personality traits but that of our coworkers it can lead to a more harmonious work environment. Understanding your own style will help you utilize your strengths and be aware of potential weaknesses. Knowing your coworkers type can enhance the culture and give you a better understanding of each individual. (The Myers Briggs Foundation, n.d.) My organization utilized the Myers Briggs Type Indicator (MBTI), which is similar to the Kiersey Temperament Sorter II. Both divide the personality into four areas.

Kiersey Temperament Sorter
Idealists (NF), as a temperament, are passionately concerned with personal growth and development. Idealists strive to discover who they are and how they can become their best possible self -- always this quest for self-knowledge and self-improvement drives their imagination. And they want to help others make the journey. Idealists are naturally drawn to working with people, and whether in education or counseling, in social services or personnel work, in journalism or the ministry, they are gifted at helping others find their way in life, often inspiring them to grow as individuals and to fulfill their potentials.
Idealists are sure that friendly cooperation is the best way for people to achieve their goals. Conflict and confrontation upset them because they seem to put up angry barriers between people. Idealists dream of creating harmonious, even caring personal relations, and they have a unique talent for helping people get along with each other and work together for the good of all. Such interpersonal harmony might be a romantic ideal, but then Idealists are incurable romantics who prefer to focus on what might be, rather than what is. The real, practical world is only a starting place for Idealists; they believe that life is filled with possibilities waiting to be realized, rich with meanings calling out to be understood. This idea of a mystical or spiritual dimension to life, the "not visible" or the "not yet" that can only be known through intuition or by a leap of faith, is far more important to Idealists than the world of material things.
Highly ethical in their actions, Idealists hold themselves to a strict standard of personal integrity. They must be true to themselves and to others, and they can be quite hard on themselves when they are dishonest, or when they are false or insincere. More often, however, Idealists are the very soul of kindness. Particularly in their personal relationships, Idealists are without question filled with love and good will. They believe in giving of themselves to help others; they cherish a few warm, sensitive friendships; they strive for a special rapport with their children; and in marriage, they wish to find a "soul mate," someone with whom they can bond emotionally and spiritually, sharing their deepest feelings and their complex inner worlds.
Idealists are relatively rare, making up no more than 15 to 20 percent of the population. However, their ability to inspire people with their enthusiasm and their idealism has given them influence far beyond their numbers. (Kiersy, n.d.)
Personal Results. I agree with the Keirsey Temperament Sorter II results; I can identify with a large part of the description. Not only am I drawn to being around people, but also am energized by the interactions. I find joy in assisting others, from something as simple as opening a door to walking beside them as they go through a major life event. A career in nursing has always aligned with my need to help others.
I strive for harmonious relationships at work and in my personal life. I tend to be the peacemaker; tension in relationships causes me to be uneasy. Having the traits of an Idealist, I struggle with the notion I cannot always maintain harmony in my life.
Personal Preferences. Many of my life choices align very closely to my results. I have chosen nursing as my career so I can be in a position to nurture and help those I work with. The choice of labor and delivery for my specialty was an easy one, I believe that every delivery I assist with I am witnessing a miracle. I have moved into a leadership role, some of the traits mentioned in the Keirsey Temperament Sorter II benefit me as a leader, but others make my position more challenging. When dealing with many personalities making decisions that will please all can be at times impossible. My desire for harmonious relationships can make decisions hard when I know the outcome could potentially cause discord with staff.
Spending time with family and friends is my favorite activity. Isolation and too much alone time drains me. I attend exercise classes on a weekly basis; the participants in my class hold each other accountable for attendance. Participating in a women’s life group through church and volunteering in the nursery also bring me joy.
I have many acquaintances, but only a handful of close friends. We have maintained our relationships since grade school; the bond we share is truly special. My husband is my best friend, I enjoy spending time him and prefer actives that we can do together. I have a very special and unique relationship with each one of my kids, and only truly feel like my heart is whole when they are all home.
Challenges. Knowing my own personality type has increased my awareness of my interactions with others. When interacting with my coworkers I have learned that I tend to gravitate toward extroverts like myself. Knowing others personality traits has helped me tailor my approach to different situations. When working with Rationales I now know to give them time when processing a question. Idealist can be quick to respond and even though we like to keep peace, we may tend to overlook our quieter contemplative coworker. Another challenge I face, as an Idealist is my friendly, outgoing, exuberant style of dealing with people does not work for everyone. I have learned to modify my approach when dealing with Guardians and Rationales to help enhance their perception of me and the ideas I present to them.
Working with Rationales remains challenging for me. I have a tendency to make decisions very quickly and lose patience with the methodical methods often time employed by this type of personality. I also find my approach to people emotional and build relationships quickly, and may undervalue or overlook the quieter more serious Rational. I continue to work on my perception of others, and with the knowledge I am gaining using the personality types; I continue to grow in my skills as a leader and coworker. Mindfulness Practice Nursing is a selfless job, caring for others and always putting the needs of others before your own can lead to burnout. A common symptom noted with burnout is emotional exhaustion. Research has shown practicing mindfulness can decrease the rate of nursing job dissatisfaction and the incidence of burnout. (Lichtenberg Heard, Hartman, & Bushardt, 2013) Learning the symptoms of burnout and being mindful of one’s self can lead to a healthier happier lifestyle. Goals. The four aspects that make up the whole person are physical, emotional, spiritual, and vital/rhythmic. If we attend to all four areas of our self and develop a mindfulness practice to incorporate all areas, we have the potential to defeat burnout. Our physical person is probably the one area most people find easiest to focus on. The goals in this area are easy to set, have the fastest results, but tend to be pushed aside and often neglected. My first goal for my physical self is to set aside time 3 days a week for exercise. I receive instant gratification from exercise and love the energy boost I receive. I plan to utilize my YMCA membership at least once a week for a group class, and the other 2 days working out at home prior to going to work. I am going to start a food diary to help my awareness of my intake. I need to lose weight and tracking my intake will help me control my caloric intake and help me be mindful of my food choices. Emotional health is also vitally important for each of us. Once again as an extrovert, to maintain balance in my life I need to make time to be with others in a non-work environment. I am going to make the effort to plan an outing with friends at least once a month. Having time with friends brings me great joy and I find I historically have not prioritized this as I should. The next change I am going to make is nightly when I am talking to my husband, I will stop other activities and really be in the moment. I find as we communicate I do not always give him my full attention. I believe this will help strengthen my marriage. The vital/rhythmic aspect of my life is potentially the most ignored. The first change I will make is to my sleep cycle. I have found to feel my best I would benefit from a sleep schedule. I plan on going to bed and waking each morning close to the same time daily. On the days I do not need to be at work I can use the extra time in the morning for reflection or meditation. I also want to include rhythmic breathing on a daily basis. Taking on the supervisory role has led to increased stress on a daily basis, to help decrease my stress level I am going to learn rhythmic breathing and practice as needed. Spirituality is also commonly an ignored area in our lives. We have recently started attending a new church and one of my goals is to attend one of the three services weekly. My week starts out on a more even keel when I feed my spiritual side. I also want to read the bible on a daily basis. I will set aside 20 minutes each day to read and meditate on the scripture. Strategy Goal | Plan | I will exercise 3 times a week. | Use the App DailyBurn and exercise at home I will go to the YMCA and participate in a weight class every Monday. I also will plan every Wednesday and Saturday to. | I am going to count my daily calories. | I will use an App on my phone and log my calories after each meal. I want to stay at 1200 calories and logging will help my awareness of my intake. | I will make monthly plans to spend time with friends. | I am going to reach out to my friends and make plans in advance to socialize on a regular basis. I will also plan this into my budget. | Focus attention on my husband during conversations. | I will mindfully stop any activities I am engaged in and make eye contact while we are conversing. I will give him my full attention. | I will regulate my sleep schedule. | I will go to bed at night by 10pm and set my alarm clock daily for 5:30. On the days I am not working I will use the quiet time in the morning for meditation. | I will practice rhythmic breathing daily. | I will learn a rhythmic breathing technique and practice daily. I will incorporate the breathing activity into my daily schedule | Attend church regularly. | I will attend 1 of the 3 services offered weekly. | Read the bible daily. | I am going to obtain a guide for reading the bible in one year. I will set aside 20 minutes a day for the reading. |

Meeting the goals I have outlined above will take some time and effort on my part. I know there will be days and possibly even several in a row I will fail to keep them. However, as I continue to work towards my goals my health and wellbeing will improve. As they become routine in my daily life I truly believe my increased sense of wellbeing will also affect those around me in a positive way. Being mindful of my own needs will increase my awareness of the needs of those around me.
Healing Environments An Optimal Healing Environment (OHE) as defined by the Samueli Institute incorporates all aspects of human care. The care is divided into four categories, external, internal, interpersonal, and behavioral. Focusing on all four areas will guarantee a holistic approach in healing and fulfill a person’s mind, body, and spiritual needs. (Sakallaris, MacAllister, Voss, Smith, & Jones, 2015) St. Charles Medical Center (SCMC) in Bend, Oregon and North Hawaii Community Hospital (NHCH) in Waimea on the Big Island of Hawaii are examples of hospitals the embrace an OHE. The external environment of both facilities provides an abundance of windows to allow the natural lighting in. SCMC walls and floors are in muted tones with complimentary art in many areas. Televisions in the patient rooms default to channels with nature scenes. NHCH enabled the windows in the patient’s rooms to open to afford them the opportunity to enjoy fresh air. NHCH also has several gardens designed to promote wellbeing and facilitate the wellbeing of not only the patients but the staff as well. (Christianson, 2007) NHCH and SCMC have committed to caring for the whole person and have integrated numerous methods to care for the patients and staffs internal environment. NHCH has a registered nurse on staff that is certified in healing touch and sees approximately 40% of the patients. Both hospitals provide acupuncture, massage therapy and aromatherapy as nurses feel may be helpful, or by patient request. (Christianson, 2007) The interpersonal environment is addressed at NHCH by educating staff to care with intent. Dietary staff is instructed not to prepare meals if they are angry because of the contraindication to the healing intention. The hospital also announces patient lavender overhead when prayer or positive healing intent is needed for a specific patient. SCMC promotes relationship-centered care to promote healing. A health coach helps patients plan a personalized health plan. They also provide patients and the community with a Health Resource Center, the center assist with finding resources and information about their health and supporting them in their decision making to promote optimal health. The center also provides massage therapy, yoga and relaxation methods free of charge. (Christianson, 2007) Self-awareness. Being mindful and in the moment will allow for a more personal relationship with my staff and increase my awareness of their needs. During my interactions with my patients I will be aware the affect I have on their perception of their stay at the hospital. I can influence the external environment by offering my patients aromatherapy and dimming the lights for an increased bonding experience with their newborn baby. During labor, assisting a patient with breathing techniques and massage can help decrease the pain of contractions and help the labor progress quickly. Caring for me and being mindful of my needs is the first step to becoming a better caretaker. I am going to continue my journey of self-awareness; this will in turn benefit my family, staff, and patients.

References

References
Christianson, J. B. (2007). St Charles medical center-bend: adjusting to change, North Hawaii Community hospital: a blended medicine perspective. In reinventing the patient experience: Strategies for leaders (pp. 79-106). Retrieved from eds.a.ebscohost.com.wgu.idm.oclc.org
Dossey, L. (n.d.). A conversation about the future of medicine. Retrieved from http://www.dosseydossey.com/larry/QnA.html
Kiersy. (n.d.). kiersey.com
Koerner, J. G. (2011). Healing Presence: The Essence of Nursing (2nd Edition) (2nd ed.). []. http://dx.doi.org/
Lichtenberg Heard, P., Hartman, S., & Bushardt, S. (2013, November2013). Rekindling the flame: Using mindfulness to end nursing burnout [Article]. Ovid, 44(11), 24-29. http://dx.doi.org/10.1097/01.NUMA.0000436366.99397.10
Rushton, L. (2014, 04/17/2014). What are the barriers to spiritual care in a hospital setting? British Journal of Nursing, 23, 370-374.
Sakallaris, B. R., MacAllister, L., Voss, M., Smith, K., & Jones, W. B. (2015, May 1, 2015). Optimal Healing Environments [Article]. Global Advances in Health and Medicine, 4, 40-45. http://dx.doi.org/10.7453/ggahmi.2015.043
The Myers Briggs Foundation. (n.d.). myersbriggs.org…...

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