Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

Mindfulness in Medicine: Creating Compassionate Engagement with Every Patient

3/3/2014 8:11:54 PM | 0 comments

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.

Mindfulness is becoming more and more a critical part of practicing high-quality medicine and engaging with compassion and without judgment with every patient. The original roots of mindfulness in Buddhism are steeped in healing, alleviating suffering and cultivating compassion through nonjudgmental behaviors. These practices have spread to secular use throughout the United States and Canada for more than 50 years. Health professionals at prestigious hospitals and medical centers, such as the University of Massachusetts Medical School, the Faculty of Medicine at McGill University in Montreal and many other institutions, actively participate in this practice with patients and colleagues.

So how do you define mindfulness? One definition is that mindfulness refers to the practice of meditation that cultivates present moment awareness. Meditation is proven to foster clearer thinking and open-heartedness. Therapeutic uses of mindfulness in medicine are growing. Note the obvious connection between the words "medicine" and "meditation" from the Latin word mederi — meaning to heal.

Seemingly Simple, but Sometimes Daunting to Practice

In even simpler terms, mindfulness is a process that expands the world around us and broadens awareness of our bodies. It focuses on breathing techniques and helps us absorb all that is going on around us. The goal: to be able to intentionally pay attention and to be in the moment, to feel the sensations of our bodies and therefore connect more fully with others, achieve better health, less stress and peace of mind. However, these simple goals can feel daunting and difficult to achieve in a complex world where it seems that everything is happening at breakneck speed and measured in fractions of seconds of Internet time.

The Doing Mind or the Being Mind?

According to Sarah Silverton, an occupational therapist and counselor at the Centre for Mindfulness Research and Practice at Bangor University in Northern Wales, there is a significant difference between what she calls a being mind and a doing mind. This is an excellent point for any healthcare professional to study.

A medical practitioner, for example, using his or her doing mind, analyzes a patient's condition, orders tests and prepares a diagnosis or recommendation for moving forward, all while keeping an eye on the clock and measuring a variety of operational items for the practice or hospital. While caring for the patient with a doing mind, the practitioner may also be making to-do lists in their head or worrying about getting a lot more done during the frantic pace of the day. This state of mind may prevent the practitioner from fully absorbing the details of the environment or completely connecting with the patient, because he or she is distracted and not fully present or in the moment. Perhaps the practitioner has not taken time to focus on his or her breathing techniques first before seeing the next patient.

But a medical practitioner who is using his or her being mind learns over time how to choose where to direct their focus and attention, creating a richer experience with patients and colleagues. The hurdle is learning how to disengage the doing mind which is causing ongoing stress, discomfort or communication problems.

In medicine (or any other business), it can be difficult to switch gears, causing us to feel busy and frantic even when the situation isn't called for. Our brains keep sending a signal that says, "This job is not yet completed!" Mindfulness practices help us evaluate which mode of mind we are in and how to switch to the mode best suited for the situation at hand. This is how compassionate engagement between doctor (or any medical practitioner) and patient is achieved. (Note: specifics on how to do this effectively will be featured in upcoming columns and are detailed in previous postings to this blog by Dawa Tarchin Phillips: How Mindfulness Can Improve Doctor-Patient Relationships: Part 1 and Part 2.)

A Mindful Harvard Professor

Harvard professor Bill George, former executive at Medtronic (a world leader in medical device technology and therapies) knows firsthand what the power of mindfulness can mean in healthcare. According to George, mindfulness tools and practices help employees to measure and manage life as they are living it. In a Harvard Business Review Blog, George commented that mindfulness teaches us to pay attention to the present moment, recognize feelings and emotions, and practice keeping them under control — especially in high-stress work environments like healthcare.

Mindfulness is a valuable life tool because oftentimes the difficulty for many of us simply is achieving the practice of disengaging our thoughts and distractions. To be silent and clear our minds, or to hear the voice within, is sometimes not so easily accomplished as it is talked about. The inability to get quiet creates stress, because we can find ourselves being busy and feeling the need to do things when it really isn't necessary. It's hard to switch our minds into a calming mode, which makes for a potent recipe called "Stress Soup."

Dishing Up the Stress Soup

The National Institute for Occupational Safety and Health estimates that ailments directly induced by stress cost organizations about $200 billion a year in things like tardiness, loss of top-talent workers, lower productivity and increased absenteeism. It's estimated that perhaps as many as 90 percent of employee medical visits are linked in some way to stress and tension, and that includes visits by medical professionals themselves.

While stress is almost unavoidable, our resilience to it can be improved by cultivating mindfulness and positive psychological states.

Harvard is challenging students to redefine their definition of success and to consider the impact of truly making a positive difference in the lives of their colleagues, their companies and their friends and families. It's a proactive measure to help doctors and lawyers and business leaders before they actually get into the workplace.

George says, "When you are mindful, you are aware of your presence and the ways you impact people. You observe and participate in every moment." Certainly these are requisites in the practice of medicine today.

Get a "Mindful" of Information

For more information on mindfulness, check out:

Institute for Mindful Leadership
www.InstituteForMindfulLeadership.org

Mindfulnet
Mindfulnet.org

Search Inside Yourself Leadership Institute (SIYLI)
www.siyli.org (pronounced "silly")

Anne Bruce has provided training and performance coaching for MedAmerica and CEP America. 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.



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