Audrey Tolouian1* and Melissa Wholeben2
1 Clinica Assistant Professor, School of Nursing, The University of Texas at El Paso, El Paso, Texas, United States of America
2Assistant Professor, School of Nursing, The University of Texas at El Paso, El Paso, Texas, United States of America
*Corresponding author: Dr. Audrey Tolouian, EdD, RN, CNE, Clinical Assistant Professor, School of Nursing, The Uni- versity of Texas at El Paso, El Paso, Texas HSSN Building, 500 West University Avenue, The El Paso, Texas 79968, United States of America, E-mail: actolouian@utep.edu
Tolouian and Wholeben. CasesMed Res J 2020, Volume 2 Issue 1
Citation: Tolouian A, Wholeben M (2020) The Pandemic Need for Mindfulness. CasesMed Res J 2(1): 17-18.
Copyright: © 2020 Tolouian A, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: July 29, 2020 | Accepted: August 13, 2020 | Published: August 15, 2020
Abstract
In a trauma facility, it is important that there be training for the healthcare providers that gives them tools to manage their internal reactions to the day to day events, as well as create a safe space and encourage a sense of community. For healthcare workers in high trauma areas- such as the new COVID-19 units, post- traumatic stress syndrome (PTSD) has been on the rise, in 2011, 14% of nurses were diagnosed, in 2019 an estimated 40% of nurses suffer from the disorder. With the small amount of 18% of nurses feeling they are prepared with proficient self-care skills to manage the effects caused from day to day events of the work environment prior to the COVID-19 pandemic that number is expected to rise exponentially. In a perfect world, healthcare providers would be given mindfulness training as they enter their specified career coursework. Once the students graduate, the orientation at the facility could take these trainings and reinforce them throughout the orientation period to emphasize the importance of self-care.
Keywords: COVID-19, Mindfulness, Trauma
Introduction
In a trauma facility, it is important that there be training for the healthcare providers that gives them tools to manage their internal reactions to the day to day events, as well as create a safe space and encourage a sense of community. Historically, nurses are taught how to holistically care for patients and their families, however there is not a lot of focus placed on their own self-care. With the current COVID-19 pandemic, this self- care becomes essential as it allows nurses to defuse after taking care of critical patients and their families. It is important that we teach our nurses how to take care of themselves as well as the patients, in order to maintain best patient care outcomes. Nursing students and graduate nurses are notoriously stressed, with high impact exams and the need to learn mass amounts of information plus clinical skills, creates an area ripe for tension [1]. Add in a pandemic halfway through the semester, and anxiety levels increase even more. Once they graduate, however, this stress does not go away, it often intensifies for the first couple of years post-graduation [2,3].
Background
For healthcare workers in high trauma areas, such as the new COVID-19 units, post-traumatic stress syndrome (PTSD) has been on the rise, in 2011, 14% of nurses were diagnosed, in 2019 an estimated 40% of nurses suffer from the disorder [4,5]. Diagnosed cases are predicted to escalate in the upcoming post-pandemic days, prompting the VA system to send out a call of awareness to healthcare providers [6]. In trauma centers, after a traumatic event, a professional counselor might perform either an informal defusing session within 12-24 hours, or a formal structured debriefing within 3 days [7]. With our new sustained pandemic situation, the acute event has turned into a chronic elevated crisis level that is impossible to continually debrief. Healthcare workers need mindfulness training in order to be able to provide some relief to themselves [5].
Identified Gap
With the small amount of 18% of nurses feeling they
are prepared with proficient self-care skills to manage
the effects caused from day to day events of the work
environment prior to the COVID-19 pandemic, that
number is expected to rise exponentially [5]. Currently,
nursing school curriculums do not prepare students
to deal with the increased situational stressors of their
jobs. Only 6% of nursing schools provide any type of
mindfulness skills in the curriculum. [4,8]. In addition, with many hospital training programs being moved to
on-the job training, there is a deficit of trainings tied to
self-care and wellness.
John Kabat-Zinnis the creator of the University of
Massachusetts' Medical Clinic's Stress Reduction and
Relaxation Program, currently called the mindfulness-
based stress reduction (MBSR) which seems to be the
gold standard for mindfulness teachings at this time.
His definition of mindfulness is "the awareness that
arises from paying attention, on purpose, in the present
moment and non-judgmentally" [9]. The everyday person
can create a particular habit of being, that will allow them
to forget what it is like to be unhappy, as being unhappy
will be forgotten. This thought that choosing to be happy
and remembering the feeling, is based on the Buddhist
sati and encourages us to remember [10].
Mindfulness trainings have been associated with
quizzical minds, an increased inter-relation between self
and patient, heightened engagement, improved awareness
of mistakes, and better clinical insight [11]. If they were
intertwined in hospital orientation programs, it could
improve the community of the hospital. The programs
have been known to produce an increased a sense of
satisfaction at work, less overtime needed to complete
daily tasks and decreased rates of burnout, which then
relates to decreased attrition, overall improved quality,
and increased patient safety outcomes [8]. Which then
relates to hospitals saving money, in addition to having
happier employees.
Discussion-Implications for Nursing
Self-care and wellness activities are part of the nursing
tool kit and are mandated by the ANA Code of Ethics fifth
provision [12]. By performing self-care actions, the nurse
can internally build up their empathy and compassion
during stressful events promoting safety and higher-
quality patient care. In addition, specific programs, such
as the MBSR interventions, have had positive results with
new nurses, and it is recommended that administrators
institute mindfulness into academic curriculum and work
facilities [2].
Nursing facilities can assist in creating a mindfulness
environment by creating facility-based support groups
that will screen the workplace for stressors and provide
anticipatory guidance if there are any noted concerns. In
addition, these support groups can have forums where
self-care/wellness mindfulness strategies are discussed.
On an administration level, protocols can be put in place
to assess high-impact nursing floors for stressors and
staff coping levels. Strategies can be implemented to
help mitigate stressors and decrease stress when trauma
events occur.
Conclusion
In a perfect world, healthcare providers would be given
mindfulness training as they enter their specified career
coursework. Once the students graduate, the orientation
at the facility could take these trainings and reinforce
them throughout the orientation period to emphasize the
importance of self-care. This would provide the needed
skills to help prevent the self-internalizing of traumatic
events that are chronically witnessed. In turn, these skills
would result in the following outcomes:
(1) Decrease in effects of job-related PTSD,
(2) Increase in healthcare provider self-care activities,
and
(3) Decrease in nursing attrition rates/increase in job
satisfaction.
Authors' Conflict of Interest
The authors declare no conflict of interest.
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