Nursing

Sustain Attention, Vigilance, and Energy in Nurses with Mindfulness

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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/

 

Relieve Medical Professional Burnout with Mindfulness

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Relieve Medical Professional Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness programs in the workplace may help employees better deal with stress, and develop the ability to observe negative emotions and automatic thought patterns and behaviors, and remain calm, present, self-aware and alert, rather than succumbing to the slippery slope of negative emotions.” – Grace Bullock

 

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

 

Preventing burnout has to be a priority. But, 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 burnout, increasing resilience, and improving sleep.

 

In today’s Research News article “Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463663/, Thimmapuram and colleagues recruited hospital medical residents, staff physicians and nurses and allowed them to choose to participate in a no-treatment control condition or receive once a week for 12 weeks of meditation training consisting of one weekly 30-minute training session and morning and evening home practice. They were measured before and after training for burnout and emotional wellness. They also supplied salivary samples that were assayed for the molecular genetic aging marker of telomere length.

 

Following the 12-week intervention the meditation group had significant improvements in burnout including decreases in emotional exhaustion and depersonalization and a significant increase in feelings of personal accomplishment. The meditation group also had significant increases in measures of emotional wellness. In addition, the younger meditation participants (< 35 years of age) had a significant increase in telomere length.

 

The results are interesting but the study has a number of methodological shortcomings that prevent clear conclusions. These include self-selection for conditions and a no-treatment control producing potential confounding from participant bias, placebo effects, attention effects, experimenter bias, etc. There is evidence, however, from a number of better controlled prior studies that indicate that meditation practice can significantly relieve the symptoms of burnout and increase telomere length.

 

So, relieve medical professional burnout with mindfulness.

 

“Dealing with sick, scared, suffering and dying patients is draining all by itself. Throw in distraction by negative emotions like worry, anger, frustration, righteous indignation … and you can easily double the energy drain. Mindfulness is incredibly valuable, because it brings the energy drain of non-supportive thoughts and feelings to a screeching halt.” – Dike Drummond

 

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

 

Thimmapuram, J., Pargament, R., Sibliss, K., Grim, R., Risques, R., & Toorens, E. (2017). Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals. Journal of Community Hospital Internal Medicine Perspectives, 7(1), 21–27. http://doi.org/10.1080/20009666.2016.1270806

 

ABSTRACT

Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals.

Objective: We assessed the effects of a 12-week ‘Heartfulness Meditation’ program on burnout, emotional wellness, and telomere length in residents, faculty members, and nurses at a large community teaching hospital during the 2015–16 academic year.

Methods: All subjects completed a baseline Maslach Burnout Inventory (MBI) and Emotional Wellness Assessment (EWA) at the beginning of the study. Meditators received instructions in Heartfulness Meditation. At week 12, subjects completed a follow up MBI and EWA scores. Salivary telomere length was measured at baseline and week 12.

Results: Twenty-seven out of a total 155 residents (17.4%) along with eight faculty physicians and 12 nurses participated in the study. Thirty-five enrolled as meditators and 12 as controls. At 12 weeks, the meditators had statistically significant improvement in all measures of burnout and in nearly all attributes of EWA. Controls showed no statistically significant changes in either burnout or emotional wellness scores. Relative telomere length increased with statistical significance in a younger subset of meditators.

Conclusion: Our results indicate that meditation offers an accessible and efficient method by which physician and nurse burnout can be ameliorated and wellness can be enhanced. The increased telomere length is an interesting finding but needs to be confirmed with further research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463663/

Reduce Burnout in Palliative Care Teams with Mindfulness

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Reduce Burnout in Palliative Care Teams with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The fullness of life, tuned-in “being” and focused work that result from mindfulness have significant health and well-being consequences for hospice and palliative care professionals.” – Ellen Langer

 

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. It is estimated that over 45% of healthcare workers experience burnout. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion, sometimes called compassion-fatigue. This can be particularly problematic in a palliative care setting where empathy and compassion are critical.

 

Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning out has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Another factor that could affect healthcare workers’ responses to stress is self-compassion. By treating oneself with kindness and understanding the effects of stress can be mitigated. So, it makes sense to investigate the relationship of mindfulness and self-compassion to compassion-fatigue and burnout in palliative care workers.

 

In today’s Research News article “Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501358/, Orellana-Rios and colleagues recruited staff members of a palliative care facility and provided for them a 10-week program of mindfulness training that was incorporated into their daily job duties. The training included discussions, loving kindness meditation, walking meditation and tong-len meditation. They were also encouraged and provided materials (CDs) for home practice. Participants were measured before and after treatment for burnout, anxiety, depression, somatization, emotion regulation, work satisfaction and enjoyment, and goal attainment. They also provided saliva samples for measurement of cortisol levels. After completion of the study, the participants were interviewed concerning the effectiveness of the program.

 

They found that following the training there was a significant decrease in burnout, perceived stress, and anxiety and a significant increase in emotional awareness, resilience, joy, goal attainment, and enjoyment of work. In the interviews, the participants generally reported improvements in feeling empowered to take care of themselves, including mindful pauses throughout their day, and lower levels of worry and rumination.

 

These are interesting and potentially significant preliminary results. This should be considered as a pilot study as there was no control or comparison condition included. The participants’ measurements before training were simply compared to those after training and there were no long-term follow-up measurements. But, the results are sufficiently interesting to justify the conduct of a large-scale randomized controlled clinical trial including an active control and long-term follow-up.

 

Taken together with previous research that has demonstrated that mindfulness training decreases burnout, anxiety, depression, and increases emotion regulation and resilience, the results suggest that mindfulness training is highly beneficial for the improvement of the emotional well-being of staff involved in palliative care. Although not measured, this suggests that staff turnover and importantly, the care for the patients was also improved.

 

So, reduce burnout in palliative care teams with mindfulness.

 

“in the end, talking to patients about palliative care can make a huge difference in their lives. It can restore their dignity and empower them to live the remainder of their lives on their own terms. And that’s why palliative care, which promotes quality of life through mindfulness, creativity, and compassion, is gaining widespread acceptance.” – Anne Bruce

 

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

 

Orellana-Rios, C. L., Radbruch, L., Kern, M., Regel, Y. U., Anton, A., Sinclair, S., & Schmidt, S. (2018). Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program. BMC Palliative Care, 17, 3. http://doi.org/10.1186/s12904-017-0219-7

 

Abstract

Background

Maintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine. We aimed to pilot an “on the job” mindfulness and compassion-oriented meditation training for interdisciplinary teams designed to reduce distress, foster resilience and strengthen a prosocial motivation in the clinical encounter.

Methods

Our objective was to explore the feasibility and effectiveness of this newly developed training. The study design was an observational, mixed-method pilot evaluation, with qualitative data, self-report data, as well as objective data (cortisol) measured before and after the program.

Twenty-eight staff members of an interdisciplinary palliative care team participated in the 10-week training conducted at their workplace.

Measures were the Perceived Stress Questionnaire, the Maslach Burnout Inventory, the somatic complaints subscale of the SCL-90-R, the Emotion Regulation Skills Questionnaire, the Hospital Anxiety and Depression Scale, and a Goal Attainment Scale that assessed two individual goals. Semi-structured interviews were employed to gain insight into the perceived outcomes and potential mechanisms of action of the training. T-tests for dependent samples were employed to test for differences between baseline and post-intervention.

Results

Significant improvements were found in two of three burnout components (emotional exhaustion and personal accomplishment), anxiety, stress, two emotional regulation competences and joy at work. Furthermore, 85% of the individual goals were attained. Compliance and acceptance rates were high and qualitative data revealed a perceived enhancement of self-care, the integration of mindful pauses in work routines, a reduction in rumination and distress generated in the patient contact as well as an enhancement of interpersonal connection skills. An improvement of team communication could also be identified.

Conclusions

Our findings suggest that the training may be a feasible, effective and practical way of reducing caregiver-distress and enhancing the resources of palliative care teams.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501358/

Improve Nursing Student Psychological Well-Being with Yoga

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Improve Nursing Student Psychological Well-Being with Yoga

 

By John M. de Castro, Ph.D.

 

“How can mindfulness help nurses? Greater awareness and less distraction in the clinical setting can improve your assessment skills and your performance of complex technical procedures that may reduce the risk of clinical errors. Mindfulness can enhance your communication with patients and other healthcare team members by bringing a greater awareness to how and what others are communicating. Listening and speaking with greater attention can lead to more effective communication and better clinical outcomes, particularly in crisis situations. Moreover, . . . mindfulness training can help nurses cope more effectively with stress and reduce the risk of professional burnout.” – Lois Howland

 

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

 

Preventing burnout has to be a priority. But, 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 burnout, increasing resilience, and improving sleep. It has also been shown that the combination of yoga, aerobic exercise and meditation is effective in improving the mental health of stressed employees.

 

Developing mindfulness early in healthcare careers could work to prevent later burnout. So, it makes sense to investigate the combination of mindfulness training and exercise that occurs in yoga training for nursing students to promote mental health and lower the likelihood of future burnout. In today’s Research News article “Effect of Yoga on Psychological Functioning of Nursing Students: A Randomized Wait List Control Trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483709/, Mathad and colleagues recruited 1st to 3rd year nursing students and randomly assigned them to be on a wait-list control or receive 8 weeks of yoga instruction and practice. The yoga practice was conducted daily and included breathing exercises, stretching, postures and meditation. The students were measured before and after training for mindfulness, resilience, self-compassion, satisfaction with life, empathy, and perceived stress.

 

They found that compared to baseline and the wait-list controls, the yoga training produced significant increases in mindfulness and self-compassion and a trend toward decreased perceived stress. Hence, yoga practice produced improvements in the psychological well-being of the nursing students. It remains to be determined if the students maintain the yoga practice and if the improvements persist into the future of their education and their practice as nurses. A longitudinal follow-up would be very helpful in this regard. In addition, future research should contain an active control condition, perhaps aerobic exercise, to determine if yoga practice per se was responsible for the observed benefits.

 

So, improve nursing student psychological well-being with yoga.

 

“The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character, and will . An education which should improve this faculty would be the education par excellence. But it is easier to define this ideal than to give practical directions for bringing it about.” — William James

 

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

 

Mathad, M. D., Pradhan, B., & Sasidharan, R. K. (2017). Effect of Yoga on Psychological Functioning of Nursing Students: A Randomized Wait List Control Trial. Journal of Clinical and Diagnostic Research : JCDR, 11(5), KC01–KC05. http://doi.org/10.7860/JCDR/2017/26517.9833

 

Abstract

Introduction

Nursing students experience considerable amount of stress to meet their professional demands. Yoga is an effective practice to reduce stress and improve psychological well being. However, improvement in psychological well being aids in stress management.

Aim

To evaluate the effectiveness of eight week yoga intervention on psychological functioning of nursing students.

Materials and Methods

This was a randomised Wait List Control (WLC) trial, we recruited total 100 students from Kempegowda Institute of Nursing, Bengaluru, Karnataka, India and randomized them into two groups (yoga=50 and WLC=50 students). The following instruments were used to collect the data, Freiburg Mindfulness Inventory (FMI), Self-Compassion Scale- Short Form (SCS-SF), Connor–Davidson Resilience Scale (CD-RISC), Satisfaction with Life Scale (SWLS), Jefferson Scale of Empathy HPS-Version (JSE-HPS), and Perceived Stress Scale (PSS). Data was analysed using Repeated Measures Analysis of Variance (RM-ANOVA) followed by post-hoc Bonferroni correction for all psychological variables.

Results

The results of our study report that eight week yoga intervention was significantly effective in improving self compassion and mindfulness among nursing students in experimental group than compared to WLC group. Even though there were improvements in resilience, satisfaction in life and perceived stress, results were not statistically significant.

Conclusion

Overall, results of the present study have demonstrated impact of eight week yoga intervention on the psychological functioning of nursing students. Yoga intervention can be inculcated in the nursing education to meet demands of the profession.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483709/

Reduce Stress Responses in a High Stress Occupation.

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By John M. de Castro, Ph.D.

 

“I am a registered nurse in an emergency department. Nowhere is Buddhism more helpful to me than at work. We see a large number of patients, often accompanied by their family members. Emotional turmoil is the norm. This, along with the unavoidable hustle and bustle of the department, makes for a frenzied atmosphere. My practice helps create a tiny refuge of peace in the midst of the turmoil.” – Daniel Defeo

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. In a recent survey 46% of all physicians responded that they had burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity. Since there is such a great need to retain healthcare providers, it is imperative that strategies be identified to decrease stress and burnout.

 

Emergency and intensive care medicine is at the top of the list of stressful medical professions. It also leads in the incidence of burnout with over half experiencing it. Burnout is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning out has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. There have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout with successful outcomes.

 

In today’s Research News article “A Small Randomized Pilot Study of a Workplace Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel: Effects on Salivary α-Amylase Levels.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1252171248140132/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624325/

Duchemin and colleagues examine the effectiveness of a mindfulness based stress reduction program, including meditation, gentle yoga, and relaxing music, on mindfulness, psychological and biological (salivary α-amylase) markers of stress, burnout, and professional quality of life. They recruited hospital intensive care health professionals who were not current mindfulness practitioners. The participants were then randomly assigned to the mindfulness training group or to a wait-list control group. After completing the battery of tests they were then either provided an 8-wk mindfulness intervention or carried on their normal routines for 8 weeks. This was followed one week later by a repeat assessment battery.

 

They found that the participants’ perceived stress of the work environment did not change over the course of the study, but the psychological and emotional responses to the stress did, with the mindfulness group showing a significant, 25% reduction, compared to 13% reduction for the controls. In addition, the mindfulness group had a significant, 40%, decline in salivary α-amylase compared to 4% for the controls, indicating a significant reduction in the biological response to the stress. Hence, the mindfulness training produced a significant reduction in the ICU workers biological, psychological, and emotional responses to stress.

 

This is an important outcome. Obviously, training does not change how stressful the work is. But, it did change the workers’ responses to the stress, making them more resistant to the effects of the stress. This is in keeping with a large number of studies demonstrating that mindfulness training decreases the physiological and psychological responses to stress. The deleterious effects of stress on the individual occur due to the individual’s response to the stress, not the stress itself. So, the mindfulness training tends to assist with the core of the problem. The study was not long-term enough to tell if this would reduce burnout. But, given the short-term effects of the intervention, it would be expected that it would.

 

So, reduce stress responses in a high stress occupation.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“Letting go is a huge quality and practice of mindfulness. Everything changes and everything ends. You have to be able to let that go so that you can take care of other people, sleep at night, and not burn out. It’s easy to be mindful, it’s just hard to remember to be mindful. The trick is practice until you do it.” – Diane Sieg

 

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

 

Study Summary

Duchemin, A.-M., Steinberg, B. A., Marks, D. R., Vanover, K., & Klatt, M. (2015). A Small Randomized Pilot Study of a Workplace Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel: Effects on Salivary α-Amylase Levels. Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine, 57(4), 393–399. http://doi.org/10.1097/JOM.0000000000000371

 

Abstract

Objective: To determine if a workplace stress-reduction intervention decreases reactivity to stress among personnel exposed to a highly stressful occupational environment.

Methods: Personnel from a surgical intensive care unit (SICU) were randomized to a stress reduction intervention or a wait-list control group. The 8-week group mindfulness-based intervention (MBI) included mindfulness, gentle yoga and music. Psychological and biological markers of stress were measured one week before and one week after the intervention.

Results: Levels of salivary α-amylase, an index of sympathetic activation, were significantly decreased between the 1st and 2nd assessments in the intervention group with no changes in the control group. There was a positive correlation between salivary α-amylase levels and burnout scores.

Conclusions: These data suggest that this type of intervention could not only decrease reactivity to stress, but also decrease the risk of burnout.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624325/

 

Keep Health Care Professionals from Burning Out with Mindfulness

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By John M. de Castro, Ph.D.

 

“Through practicing mindfulness we become more aware of subtle changes in our mood and physical health, and can start to notice more quickly when we are struggling. Rather than waiting for a full meltdown before we take action, we can read the signals of our minds and bodies and start to take better care of ourselves.” – The Mindfulness Project

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

Burnout is not a unitary phenomenon. In fact, there appear to be a number of subtypes of burnout. The overload subtype is characterized by the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion. The lack of development subtype is characterized by the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities. The neglect subtype is characterized by an inattentive and careless response to responsibilities, and is closely associated with inefficacy. All of these types result from an emotional exhaustion. This exhaustion not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion.

 

Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning has to be a priority. Mindfulness has been demonstrated to be helpful in treating and preventing burnout. One of the premiere techniques for developing mindfulness and dealing effectively with stress is Mindfulness Based Stress Reduction (MBSR) pioneered by Jon Kabat-Zinn. It is a diverse mindfulness training containing practice in meditation, body scan, and yoga. As a result, there have been a number of trials investigating the application of MBSR to the treatment and prevention of health care worker burnout.

 

In today’s Research News article “Outcomes of MBSR or MBSR-based interventions in health care providers: A systematic review with a focus on empathy and emotional competencies”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1197241983633059/?type=3&theater

http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30014-5/fulltext

Lamothe and colleagues summarize the published literature on the effectiveness of Mindfulness Based Stress Reduction (MBSR) for healthcare worker burnout. They found that the preponderance of evidence from a variety of different trials indicated that MBSR treatment is effective for burnout. In particular, the research generally reports that MBSR treatment significantly improves mindfulness, empathy, and the mental health of healthcare workers. It was found to significantly relieve burnout, and reduce anxiety, depression, and perceived stress.

 

Hence, the published literature is highly supportive of the application of MBSR for the prevention and treatment of healthcare worker burnout. It appears to not only help the worker, but the improvement in the empathy of the worker projects positive consequences for the patients. In addition, the reduction in burnout suggests that MBSR treatment may help to reduce healthcare workers leaving the field, helping to relieve the systemic lack of providers. These are remarkable and potentially very important results.

 

Mindfulness training makes the individual more aware of their own immediate physical and emotional state. Since this occurs in real time, it provides the individual the opportunity to recognize what is happening and respond to it effectively before it contributes to an overall state of burnout. Indeed, mindfulness training has been shown to significantly improve emotion regulation. This produces clear experiencing of the emotion in combination with the ability to respond to the emotion adaptively and effectively. So, the healthcare worker can recognize their state, realize its origins, not let it affect their performance, and respond to it appropriately, perhaps by the recognition that rest is needed.

 

So, keep health care professionals from burning out with mindfulness.

 

“It helps people to undo some of the sense of the time pressure and urgency that makes it so hard to feel present for your patient, and it helps your patients feel like you’re really there, really listening and that you really care. What you learn is to undo the distractedness that comes with worrying about what happens next, and the concern with what’s already over and done with. It doesn’t take more time; it takes an intention and practice to do it successfully.” –  Dr. Michael Baime

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Burnout Burnout with Mindfulness

psyjdc 2 Comments

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Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. This is the fatigue, cynicism, and professional inefficacy that comes with work-related stress.

Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout with emergency medicine at the top of the list, over half experiencing burnout. With there being a shortage of doctors and nurses preventing existing healthcare workers from burning out is a priority.

How can burnout be prevented or mitigated? One potential treatment is mindfulness training. A study investigating mindfulness’ association with burnout in emergency room nurses is reported in today’s Research News article “Protective benefits of mindfulness in emergency room personnel. Journal of affective disorders”

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Westphal and colleagues report that indeed stress is prevalent in the ER. It is most frequently associated with interpersonal conflicts and large numbers of consecutive days working. But mindfulness appeared to help as high mindfulness was associated with lower levels of anxiety, depression, and burnout in the ER nurses.

Mindfulness may help in this high stress context by helping with the interpersonal conflicts that are reported to be at the root of their stress and burnout. Mindfulness has been shown to improve interpersonal relationships and social connectedness. This may be very helpful in dealing effectively with co-workers and thereby reducing stress and improving social resources for dealing with the stress.

Mindfulness has also been shown to reduce distress contagion. This occurs when one person observes another suffering a disease or injury and experiences in one’s physical body a similar or related distress. This is common in nurse–patient relationship particularly with empathetic nurses. In fact, this distress contagion is the physical equivalent to empathy. By reducing this distress contagion mindfulness may be reducing stress and burnout.

Mindfulness has also been shown to improve emotion regulation. Mindful people are better at recognizing their emotions and responding to them effectively. Mindful people experience emotions fully, but recognize them and don’t let them dictate what they do. This allows them to work effectively in an emotionally charged environment like the ER.

Finally, mindfulness is known to reduce the psychological and physical responses to stress. Being mindful doesn’t inoculate the individual from stress. Rather it blunts stress’ effects on them. This occurs on a physical level with lower stress hormone responses and lower sympathetic activation in response to stress. It also occurs on the psychological level with less anxiety and depression produced by the stress.

So, burnout burnout with mindfulness!

CMCS