Mindfulness & HEALTH CARE

LORI GERHART, BSN, RN, OCN Clinical Director, Lancaster Cancer Center

The demands on professionals and individuals in the health care world have always been recognized as a “given” by those very professionals and their leaders. That constant pressure inevitably leads to burnout. Burnout is a topic that has permeated the literature in medicine, general management, human resources management, and organizational development. It is considered a major cause of the deleterious impact on staff performance, productivity, and retention and even, to a degree, sub-optimal patient care.

The Role Of Mindfulness In Health Care

Mindfulness is not a new management fad or trend. Ancient Buddhist literature contains detailed guidance on mindfulness. More recent research exists in numerous articles on the subject specific to health care workers. “Evidence is accumulating that mindfulness training is useful in reducing stress for health care workers and may increase the quality of their interactions with patients.” [Mindfulness 6, 744-758 (2015), Original paper published :05 June 2014, Peter Morgan, Jane Simpson & Alistair Smith.]

Mindfulness is also commonly known to many as “Care for yourself so you can care for others… an age-old adage that is easily forgotten in our jampacked personal and professional lives.” [The Role of Mindfulness in Enhancing Self-Care for Nurses by Margo Halm, RN, PhD, NES-BC, Am J Crit Care (2017) 26 (4): 344-348.]

Working definitions of mindfulness from Oxford Languages include:

1. The quality or state of being conscious or aware of something. “Their mindfulness of the wider cinematic tradition”

2. A mental state achieved by focusing one’s awareness on the present moment,while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique

According to a 2020 blog article on mindful.org, “Mindfulness is the basic human ability to be fully present, aware of where we are and what we are doing, and not overly reactive or overwhelmed...”

WHAT IS MINDFULNESS IN SIMPLE TERMS?

Mindfulness means paying full attention to something. It means slowing down to really notice what you are doing. Being mindful is the opposite of rushing or multitasking. When you are mindful, you are taking your time. You are focusing in a relaxed, effortless way.

In general, we seek to develop three key characteristics of mindfulness:

• Intention to cultivate awareness (and return to it repeatedly)

• Attention to what is occurring in the present moment (simply observing thoughts, feelings, and sensations as they arise)

• Attitude that is non-judgmental, curious, and kind

Healthcare professionals and lay staff alike have many stressors in their daily working lives, even more so since the COVID-19 pandemic. Caring for oneself became an operational imperative, exacerbated by the trifecta of COVID and its many variants, the seasonal flu, and RSV. A focus on the Lancaster Cancer Center (LCC) workforce’s total well-being was recognized as the best approach to our personal and professional challenges.

Mindfulness In Practice

This article recognizes the powerful and current existence of pressures on healthcare workers and presents an approach to mental, emotional, and behavioral health in a medical practice setting. My experience with direct patient care, close collaboration with oncologists, and as a leader and manager of professional and lay staff members for over 32 years led me to explore methods to improve mindfulness. I recognized the need for an approach to the mental, emotional, and physical health of the physicians, nurses, and staff that would positively impact their caring for cancer patients and each other, reduce stress-related burnout symptoms, and enhance employee retention and engagement.

I began with a plan to research the subject of mindfulness and engage presenters on the subject. Taking account of the size of our practice, I tailored the plan to support our unique population of patients, physician, nurses, and staff at LCC. This program was designed as a long-term strategic investment that would serve to impact the key success factors at LCC to adhere to our stated mission of “Care Beyond Treatment” and thus improve and maintain individual and group performance.

I recognized early in my planning that operationalizing mindfulness training into the daily lives of employees would not be a once and done effort. I realized there had to be a pivot to a focus on total employee well-being. Below is the list of the processes I began to integrate to create a mindful environment at LCC.

• Holding daily team huddles and regular staff meetings during which plans and events are discussed to inform and share expectations about mindfulness as it relates to total well-being.

• Researching and organizing team-building activities for staff with the goal of increasing employees’ engagement, thus improving productivity and elevating retention rates.

• Reviewing patient satisfaction survey results regularly and sharing them.

• Offering an Employee Assistance Program and flexible PTO policies.

• Creating avenues for staff recognition of individuals’ manifestation of our mission, “Care Beyond Treatment.” Staff members have access to index cards (Cheers for Peers!) specifically for the purpose of sharing their witnessing of a co-worker doing something special for an employee or a patient or their loved one.

• Recognizing the need to support employees for clinical or other development opportunities, including attendance at relevant professional organizations, cross training, and furthering their education. This is based in the belief that LCC’s investment will lead to increased engagement. LCC has several employees who have progressed from their initial positions to more advanced positions over time.

• Acknowledging that financial wellness has a major impact on an employee’s overall well-being. Through our company-sponsored 401(k) plan, participants have access to financial advising for retirement, and participation is encouraged using a matching mechanism.

Our program at LCC is dynamic, evolving, and focused on developing a culture of awareness, caring, and engagement. We recognize we must remain committed to developing our culture of awareness — and encouraging mindfulness to enhance workforce and patient well-being is a part of that. A robust organization culture is not about benefits, size, or material advantages — it is about how people are treated.