Mindful Nurses are Better Nurses

Mindful Nurses are Better Nurses

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice helps nurses to be more fully present with their patients and themselves. The ability to pay attention to what is happening “right now,” in this room with this patient, and not be distracted by other demands and concerns, creates space to use your wisdom and knowledge effectively and with care for the dignity of each patient. Being more present to your own experience and habitual responses increases your ability to manage stress and enhances decision-making, well-being, and self-efficacy.” – Sandra Bernstein

 

In high stress occupations, like nursing, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

It is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur and thereby make them better in their roles as healthcare providers. Mindfulness has been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout and improve well-being, dedication, and compassion in nurses.

 

In today’s Research News article “The mediating role of cognitive and affective empathy in the relationship of mindfulness with engagement in nursing.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947930/), Pérez-Fuentes and colleagues recruited Spanish nurses and had them complete measures of mindfulness, empathy, including measures of cognitive and affective empathy, and work engagement including measures of vitality, dedication and absorption.

 

A correlational analysis revealed that the higher the level of mindfulness the higher the level of work engagement including vitality, dedication and absorption and cognitive empathy, and the lower the level of affective empathy. A mediation analysis of these data revealed that mindfulness had direct associations and also indirect associations via cognitive empathy with higher work engagement including vitality, dedication and absorption. That is that mindfulness was directly associated with work engagement and also indirectly associated as a result of mindfulness being associated with higher cognitive empathy that was, in turn, associated with higher work engagement.

 

These findings are correlational and as such causation cannot be established. Nevertheless, the findings suggest that mindful nurses have greater levels of energy (vigor), feel greater challenge and enthusiasm for their work (dedication), have greater attention to and concentration on their work (absorption), and have a better intellectual understanding of the feelings of others (cognitive empathy). In addition, mindful nurses, because they have higher levels of cognitive empathy, have additionally higher levels of work engagement.

 

These findings suggest that mindfulness is an important contributor to the work engagement, vigor, and absorption of nurses. This suggests that mindful nurses are better nurses. Future research should attempt to determine causation by training the nurses in mindfulness and observing whether work engagement increases and burnout decreases as a result of the training.

 

So, mindful nurses are better nurses.

 

Nursing is a high-stress profession that may be taking a toll on our nurses. Mindfulness-based programs can help nurses develop skills to manage clinical stress and improve their health; increase overall attention, empathy, and presence with patients and families; and experience work satisfaction, serenity, decreased incidental overtime, and reduced job burnout.” – Sue Penque

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Pérez-Fuentes, M., Gázquez Linares, J. J., Molero Jurado, M., Simón Márquez, M., & Martos Martínez, Á. (2020). The mediating role of cognitive and affective empathy in the relationship of mindfulness with engagement in nursing. BMC public health, 20(1), 16. https://doi.org/10.1186/s12889-019-8129-7

 

Abstract

Background

The work of health professionals is characterized by a high demand for psychological and emotional resources and high levels of stress. Therefore, the promotion of commitment and job well-being through strategies such as increased mindfulness, is important among nursing workers. Although mindfulness has shown positive effects in the health field, few studies have explored the mechanisms and processes underlying these results. We investigated the mediating role of empathy (cognitive/affective) in the effect of mindfulness on the dimensions of engagement in nursing professionals.

Methods

Sample was comprised of 1268 Spanish nurses between 22 and 62 years old, that completed the Utrecht Labor Engagement Scale and the adapted versions of Mindful Attention Awareness Scale and Basic Empathy Scale. The relationship between variables to be included in the regression analyses, bivariate correlations were carried out, and the descriptive statistics of these variables were also found. To estimate the mediation model was used, in this case for multiple mediation effects.

Results

Mindfulness is found to affect the Vigor and Dedication factors of engagement through cognitive empathy. While for the Absorption factor, the affective component of empathy also exerts a mediating role, although weaker than cognitive empathy. Cognitive empathy, as an individual factor, was shown to have a mediating effect between mindfulness and the factors of engagement in healthcare workers.

Conclusions

The level of mindfulness influences engagement of nursing professionals positively, and this result is mediated mainly by cognitive empathy. Both mindfulness and empathy are modifiable individual factors, so their intervention by designing and implementing specific programs, can increase the commitment and wellbeing of professionals generating benefits to workers and to their patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947930/

 

Improve Well-Being in Nurses with Mindfulness

Improve Well-Being in Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For nurses, many of them went into the field because of their ability to connect with people and make a difference in their lives. Mindfulness is a path to help us reconnect with what brings meaning to the profession. It brings humanity back to healthcare.” – Susan Bauer-Wu

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout and improve well-being in nurses.

 

In today’s Research News article “Mindfulness to promote nurses’ well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716566/), Penque recruited Registered Nurses (RNs). They participated in a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consists of 8 weekly 1-hour group sessions involving meditation, yoga, body scan, and discussion. The participants were also encouraged to perform daily practice at home. They were measured before and after training and 3 months later for mindfulness, self-compassion, serenity, interpersonal reactivity, work satisfaction, and burnout.

 

She found that following the Mindfulness-Based Stress Reduction (MBSR) program there were significant increases in mindfulness, self-compassion including  self-kindness, common humanity, mindfulness, serenity, and interpersonal reactivity including perspective taking, and empathetic concern. There were also significant decreases in burnout, isolation, overidentification, self-judgment, and personal distress. She also found that the higher the levels of mindfulness, the higher the levels of self-compassion and serenity.

 

The results must be interpreted with caution as there wasn’t a control, comparison, group. So, potential confounds such as placebo effects, experimenter bias, Hawthorne effects, etc. were present. Other, better controlled studies, however, have demonstrated that mindfulness training increases self-compassion and reduces burnout. So, it is likely that these same benefits of mindfulness training occurred here irrespective of confounding conditions.

 

The Mindfulness-Based Stress Reduction (MBSR) program is a complex of meditation, yoga, and body scan practices. It is not possible to determine which components or combination of components were responsible for the benefits. Regardless, the results suggest that MBSR training is a safe and effective program to improve the well-being of nurses and reduce burnout. This can not only improve the psychological health of the nurses but also improve the retention of these valuable and important healthcare workers.

 

So, improve well-being in nurses with mindfulness.

 

Mindfulness can positively affect how nurses feel and cope with the pressures of their work, thereby resulting in better self-care and improved patient outcomes.” – Nursing Times

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Penque S. (2019). Mindfulness to promote nurses’ well-being. Nursing management, 50(5), 38–44. doi:10.1097/01.NUMA.0000557621.42684.c4

 

This article examines the effects of MBSR on job-relevant factors, including mindfulness, self-compassion, empathy, serenity, work satisfaction, incidental overtime, and job burnout. Nursing is a high-stress profession that may be taking a toll on our nurses. Mindfulness-based programs can help nurses develop skills to manage clinical stress and improve their health; increase overall attention, empathy, and presence with patients and families; and experience work satisfaction, serenity, decreased incidental overtime, and reduced job burnout.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716566/

 

Improve the Mental Health on Intensive Care Nurses with Mindfulness

Improve the Mental Health on Intensive Care Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Nurses are particularly vulnerable to stress and burnout, with little time in their schedule to commit to self-care or intensive stress reduction programs” . . . on-the-job mindfulness-based intervention is viable for this nursing population. In addition to reductions in stress and burnout, participants also reported improved job satisfaction and self-compassion.” Mindful USC

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. This is particularly acute in intensive care. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout in medical professionals in high stress areas.

 

In today’s Research News article “Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482227/), Lu and colleagues recruited intensive care nurses and had them complete measures of burnout, mindfulness, anxiety, depression, perceived stress, and subjective well-being. The measure of subjective well-being is a composite that includes a high level of satisfaction with life, more positive emotions, and fewer negative emotions.

 

They found that the higher the nurses’ levels of mindfulness the better the nurses’ mental health including lower levels of anxiety, depression, perceived stress, negative emotions and burnout and higher levels of subjective well-being, life satisfaction and positive emotions. They also found that the greater the levels of perceived stress the worse the nurses’ mental health including greater levels of burnout, negative emotions, anxiety, and depression, and lower levels of mindfulness, satisfaction with life, positive emotions, and life satisfaction. In addition, they found that mindfulness moderated the negative effects of perceived stress such that when mindfulness was high, perceived stress had a smaller relationship with emotional exhaustion, depression, anxiety, and negative affect and a larger relationship with positive affect.

 

In interpreting these results, it needs to be recognized that the study was correlational and as such causation cannot be determined. But previous research has already established that mindfulness produces reductions in burnout, anxiety, depression, perceived stress, and negative emotions and produces increases in life satisfaction, positive emotions, and subjective well-being. So, it is reasonable to conclude that the present findings were due to the causal effects of mindfulness. But the present findings add to this knowledge by showing that mindfulness not only directly improves the psychological state of the nurses but also acts to reduce the negative impact of stress.

 

These effects of mindfulness are important as burnout in high stress occupations like nursing is all too common. The results suggest that mindfulness training should be routinely administered to intensive care nurses to improve their well-being and mental health and reduce the likelihood that they will experience burnout.

 

So, improve the mental health on intensive care nurses with mindfulness.

 

Learning mindfulness also helped the ICU personnel to “become aware of what their individual stress response is” and to “practice flexibility in cultivating alternative ways” of dealing with chronic stress.” – Marianna Klatt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lu, F., Xu, Y., Yu, Y., Peng, L., Wu, T., Wang, T., … Li, M. (2019). Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses. Frontiers in psychiatry, 10, 260. doi:10.3389/fpsyt.2019.00260

 

Abstract

This study aimed to explore the potential moderating effect of mindfulness and its facets on the relationships among perceived stress and mental health outcomes (burnout, depression, anxiety, and subjective well-being) among Chinese intensive care nurses. A total of 500 Chinese intensive care nurses completed self-report measures of mindfulness, burnout syndromes, perceived stress, depression, anxiety, and subjective well-being. Correlation and hierarchical multiple regressions were applied for data analysis. Mindfulness moderated the effects of perceived stress on emotional exhaustion (the core component of burnout syndrome), depression, anxiety, positive affect, and negative affect but not on the other two dimensions of burnout and life satisfaction. Further analyses indicated that the ability to act with awareness was particularly crucial in improving the effects of perceived stress on depression. These results further broaden our understanding of the relationships between perceived stress and burnout, depression, anxiety, and subjective well-being by demonstrating that mindfulness may serve as a protective factor that alleviates or eliminates the negative effects of perceived stress on depression, anxiety, burnout syndrome, and subjective well-being and may instigate further research into targeted mindfulness interventions for Chinese intensive care nurses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482227/

 

Sustain Attention, Vigilance, and Energy in Nurses with Mindfulness

Sustain Attention, Vigilance, and Energy in Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As attention is rooted more firmly in the present and less on the past and/or future, depression, rumination, and anxiety decrease,” the article explains. “The resulting effect is energy that was once spent clinging to the past or worrying about the future can now be spent in the present.” Mindful nurse leaders are likewise aware of the employees and organizations behind their day-to-day work. They’re authentic. They connect with others. They stay in touch with their values.”

 

Medical professionals have to pay close and sustained attention to their jobs. The consequences of lapses and error can be catastrophic. Yet often their jobs are repetitive which can tax attention and reduce needed vigilance. Contemplative practices have been shown to improve attention and vigilance and to maintain high levels of performance on the job. In today’s Research News article “Positive Effects of Mindfulness-Based Training on Energy Maintenance and the EEG Correlates of Sustained Attention in a Cohort of Nurses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838011/ ), Wong and colleagues investigate the effectiveness of mindfulness training to improve attention and vigilance in nurses tested in a laboratory environment.

 

They recruited nurses and trained them in mindfulness with an 8-week, once a week for 90 minutes, program based upon the Mindfulness-Based Stress Reduction (MBSR) program, containing meditation, body scan, and yoga practices. Training attendance was monitored and recorded. They were measured before and after training with a 20-minute psychomotor task requiring sustained attention and vigilance. In addition, the nurses were measured for sleep duration for two nights. They also completed scales of energy and mood and had their brain activity monitored during rest and during meditation, and with an electroencephalogram (EEG). They also recorded the event related potentials (ERP) in the EEG evoked by stimulus presentation during the attention and vigilance task.

 

They found that following mindfulness training the nurses had significantly smaller reduction in energy during performance of the attention and vigilance task and the greater the attendance at the mindfulness training sessions, the greater the energy sustainment. This was also true for their attention and vigilance, with nurses with high training attendance having significantly smaller reductions in response speed and significantly smaller increases in attentional lapses over the 20-minute task duration. Hence, those nurses with high mindfulness training attendance sustained their energy and attention better over the task period.

 

With the electroencephalogram (EEG), they found that after mindfulness training there were significantly smaller reductions in alpha rhythm power during meditation, suggesting improved attention. These improvements were higher in nurses who attended training more regularly. Similar findings were present with the EEG event related potentials (ERP), such that P3 amplitude reductions were lower over the attention and vigilance task, indicating greater sustainment of arousal and attention. Hence, brain electrical activity also suggested greater sustainment of attention following mindfulness training.

 

The results are interesting and potentially important. They suggest that mindfulness training can improve nurses’ abilities to sustain attention and vigilance over a prolonged period. This was evidenced by both behavioral and EEG indicators of sustained attention and vigilance. This is potentially important as it may suggest that mindfulness training may improve performance on the job, reducing lapses and errors. Future research is needed to verify if, indeed, mindfulness training has similar effects on the job that it has in the laboratory.

 

So, sustain attention, vigilance, and energy in nurses with mindfulness.

 

“Burnout continues to be a significant occupational hazard in the nursing profession. Mindfulness may be the necessary approach to help combat nursing burnout, affording considerable promise for the future of the nursing profession.” – Pamela Heard

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wong, K. F., Teng, J., Chee, M. W. L., Doshi, K., & Lim, J. (2018). Positive Effects of Mindfulness-Based Training on Energy Maintenance and the EEG Correlates of Sustained Attention in a Cohort of Nurses. Frontiers in Human Neuroscience, 12, 80. http://doi.org/10.3389/fnhum.2018.00080

 

Abstract

Mindfulness based training (MBT) is becoming increasingly popular as a means to improve general wellbeing through developing enhanced control over metacognitive processes. In this preliminary study, we tested a cohort of 36 nurses (mean age = 30.3, SD = 8.52; 2 male) who participated in an 8-week MBT intervention to examine the improvements in sustained attention and its energetic costs that may result from MBT. Changes in sustained attention were measured using the psychomotor vigilance task (PVT) and electroencephalography (EEG) was collected both during PVT performance, and during a brief period of meditation. As there was substantial variability in training attendance, this variable was used a covariate in all analyses. Following the MBT program, we observed changes in alpha power across all scalp regions during meditation that were correlated with attendance. Similarly, PVT performance worsened over the 8-week period, but that this decline was mitigated by good attendance on the MBT program. The subjective energy depletion due to PVT performance (measured using self-report on Likert-type scales) was also less in regular attendees. Finally, changes in known EEG markers of attention during PVT performance (P300 and alpha-band event-related desynchronization) paralleled these behavioral shifts. Taken together, our data suggest that sustained attention and its associated costs may be negatively affected over time in the nursing profession, but that regular attendance of MBT may help to attenuate these effects. However, as this study contained no control condition, we cannot rule out that other factors (e.g., motivation, placebo effects) may also account for our findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838011/