Welcome to Mindfulness in Medicine, a monthly column by best-selling author Anne Bruce designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful leadership tool that enhances emotional intelligence in medicine. It is a tool that, when practiced, can help us develop and implement relational coaching skills and illuminate various ways to improve hospital operations and cross-departmental performance. Mindfulness also improves our capacity for decision-making and participatory medicine, all while enhancing our own health and well-being. Your comments and insights on these postings are greatly valued.
More than half of the doctors in America report experiencing at least one symptom of burnout, according to a nationwide survey of more than 7,000 physicians published in Archives of Internal Medicine, now called JAMA Internal Medicine.
Symptoms of burnout may include:
In addition to the toll it takes on providers' physical and emotional health, burnout can impact the practice of medicine. Strained empathy can lead us to see patients as mere medical problems rather than people first. In fact, research suggests a significant negative correlation between both physician and nurse burnout and patient satisfaction scores.
About a year-and-a-half ago at Chicago's prestigious Rush University Medical Center, more than 80 doctors and other healthcare professionals did the unheard of — something they rarely do during frantic days packed with patient encounters and meetings. They all sat together for 35 minutes straight, in silence.
Straight-backed with hands on knees and eyes open, they gazed ahead as the 'L' train rumbled past outside the building.
According to Mitchell M. Levy, MD, who led the exercise (known as mindfulness meditation), the purpose of this practice is remembering to come back to your breathing, stillness and posture over and over, no matter what the distractions.
Dr. Levy's well-attended, two-day course underscores the rising interest among physicians, medical schools and hospitals in using these practices to help alleviate doctors' stress and help reconnect them to their calling to heal.
Today, dozens of medical schools offer formal mindfulness programs and credit-eligible continuing education courses on mindfulness specifically designed for physicians and other healthcare professionals.
"What I've discovered now, to my amazement, is how ready people are to embrace this practice," says Dr. Levy, chief of pulmonary and critical care medicine at Brown University's Warren Alpert Medical School and medical director of the Rhode Island Hospital medical intensive care unit in Providence.
In the breakneck-paced world of acute care, healthcare professionals are being asked to do more with less. Applying timely mindfulness techniques helps take a distracted and stressed mind that is being pulled in many directions and provides an easy-to-use technique that allows it to rest and become clearer, almost instantly.
Today, a condensed four-hour version of Dr. Levy's course is offered to Brown medical students as well as practicing hospitalists, social workers and nursing staff.
Another veteran of physician-specific mindfulness training is Michael J. Blaime, MD. He directs the Penn Program for Mindfulness at the University of Pennsylvania Health System in Philadelphia and has offered mindfulness training since the early 1990s. His eight-week course is limited to medical and nursing students.
"It's always full, with a wait list," he says. "And that's a shift from 20-years ago. Today, it's downright fashionable."
Start on your way to work. Be aware of your body's tension when driving. Are your hands wrapped tightly around the steering wheel? Are your shoulders raised? Is your stomach tight? Consciously start working to relax.
Pay attention to your breathing throughout the day. Taking deep slow breaths can calm you. When we are frantic, we start to breath faster and erratically. Stop and inhale through your nose a slow, deep breath that you can feel all the way down to your gut (actually let your stomach expand). Hold it 3-4 seconds (close your eyes) and then exhale through your mouth. Do this several times. You will be infusing more oxygen into your brain, and you'll be recalibrating your inner compass of reason at the same time.
Change your environment at lunch. When you find yourself getting into a rut, switch things up. Often medical professionals eat in the same lounge in the same building almost every day. This often leads to an extension of the workday discussing difficult challenges and patient situations. Subconsciously we remain tense, even though mealtime is a time to nourish the soul.
At St. Jude Children's Research Hospital in Memphis, Tenn., doctors and nurses eat in the same cafeteria with patients and families, so the interaction changes daily. There are also lots of outdoor options for getting time alone to eat or just collecting thoughts, including a sanctuary area, manicured gardens and a multi-denominational chapel for inner reflection.
I have personally spent a good bit of time in this location, and the environment creates numerous opportunities for healthcare workers and families to be mindful, meditate and clear their thoughts several times a day.
Just "stop" two or three minutes during the day. Close your door, if you have one. Pay attention to your body's sensations. Give your mind time to settle down.
At the end of the workday, sit in your car for a moment and consciously start making the transition from work to home. Like most of us, you are now headed to your "other" full-time job.
Add two extra "pleasant activities" to your week. Activities may include things like:
I've had the privilege to study and work with some of the best mindfulness experts and authors on this subject over the past six years. I've also been privileged to meet many subject-matter experts who help professionals from all walks of life integrate mindfulness into their careers and workplaces. For resources and professional contacts in this area, please feel free to contact me.
Anne Bruce has provided training and performance coaching for Vituity. She also serves as MBSI's Employee Development Coach and Leadership Facilitator. Anne is a bestselling author with more than 20 books published by McGraw-Hill Publishing, New York. She considers her award-winning life-coaching book, Discover True North: A 4-Week Approach to Ignite Passion and Activate Potential (McGraw-Hill Publishing) to be one of her most "mindful" books to date. She also leads a popular Discover True North Expedition group on LinkedIn. Anne can be reached at 214-507-8242 or by writing to her at Anne@AnneBruce.com.