Black Midwives: A Labor of Love and Change

Black Midwives: A Labor of Love and Change

A midwife–especially a Black midwife–can tilt the balance between life and death for African American infants and their mothers. Regardless of income and education level, childbirth for Black women is more dangerous than it is for White women. Even Serena Williams had a dangerous close call during her pregnancy, after doctors failed to heed her request for a CT scan and blood thinner medicine. Despite her history of blot clots, it was posited that “Williams’ pain medication must be making her confused.”

The Centers for Disease Control reports that African American mothers die at three to four times the rate of White women, and the mortality rate of Black infants is higher than that of any other ethnic group in the US. Why? As AmericanProgress.org states in a 2019 policy blueprint, “Racism is part and parcel of being black in the United States, and it compromises the health of African American women and their infants… Put simply, structural racism compromises health.” According to Dr David Williams, a pioneer in measuring the effects of racism on health, “We now know that discrimination is linked to higher blood pressure, to high levels of inflammation, to low infant birth weight…”

Enter the Midwife

One action that promises to change these dire statistics is expansion of the midwifery movement, especially within the African American community. Angela Doyinsola Aina, interim director of the Black Mamas Matter Alliance (BMMA) recently told an American Public Health Association (APHA) conference, “We have to go beyond just talking about giving people, especially low-income people, access to care…. We also need to ask whether that care is high quality and culturally relevant.”

Where do Black midwives come into the picture? ProPublica notes in a report on how increasing the role of midwifery in the US could reduce maternal complications and mother/infant mortality rates, “Many… [US] states characterized by poor health outcomes and hostility to midwives also have large black populations, raising the possibility that greater use of midwives could reduce racial disparities in maternity care.” And Lamaze.org suggests, “When Black families are cared for by Black health professionals, like midwives, they are better heard, seen, respected, understood, and get their needs met, which relates directly to health outcomes.”

One of the women at the forefront of the Black Midwives movement is Jennie Joseph, founder of the Birth Place in Winter Garden, FL. Joseph’s work as a provider of perinatal services to underserved and uninsured women of color has already brought about positive change in the CDC numbers. Trained in the UK, where half of all babies are delivered by midwives, Jennie Joseph arrived in the US to find that in the most affluent country in the world, owing to concerted opposition from doctors and hospitals, midwives attend only 10% of all births. She also found that the US has a much higher incidence of maternal and infant mortality rates—particularly among minorities and the disenfranchised—than in countries such as Canada, Sweden, and the UK, where midwives attend the majority of births.

Joseph’s “open access” clinic at the Birth Place provides pre-natal and post-partum care for women regardless of their ability to pay and focuses on minority and underserved women in the area. As Miriam Zoila Perez marveled in the New York Times, the Birth Place manages to beat the dire maternity figures for women of color: “When you look into her statistics, you find something quite rare: Almost all of her patients give birth to healthy, full-term babies… maybe not surprising until you learn that the majority of them are low-income African-Americans, Haitians and Latinas….”

Expanding the Midwives’ Movement

Another pioneering Black midwife is Shafia Monroe, who has long been one of the major forces behind the Black midwives’ movement. Founder of the International Center for Traditional Childbearing (which was re-formed in 2018 as the National Association to Advance Black Birth) and winner of a Lifetime Achievement Award from the Human Rights in Childbirth Foundation, Monroe started working with mothers and infants as a nurse’s aide in the postpartum ward at Boston City Hospital at the age of 17. It was in 1991, when she encountered difficulties in finding a midwife of color for her own pregnancy, that Monroe founded her influential International Center for Traditional Childbearing. Under the auspices of the ICTC, she became a pioneering figure in the cause of Black midwifery. Monroe has worked tirelessly to reduce mortalities linked to pregnancy and to increase the number of Black midwives and doulas. To women who are interested in becoming midwives, Moore urges, “Join an organization! There’s MANA (Midwives Alliance of North America), ICTC, ACNM (American College of Nurse Midwives); there’s so many organizations. Look into organizations that are familiar with black reproductive issues, and our history.”

As the co-director of Black Mamas Matter Alliance (BMMA), Elizabeth Dawes Gay, says, “If even one more person just says they want to take up the cause, they want to become a doula, they want to become a midwife, they want to start an organization—to me that’s a success.”

Expanding Rural Healthcare Access: Nursing Holds the Key

Expanding Rural Healthcare Access: Nursing Holds the Key

Urbanization and declining farm incomes are causing many rural communities to struggle, and the healthcare providers who serve those communities are facing major challenges attracting talent and sustainably treating a dwindling, aging population. This shortage of providers directly impacts access to care in rural communities. A recent NPR poll of rural Americans found that, despite 87 percent reporting having some form of health insurance, more than one quarter of respondents had not been able to access healthcare when they needed it at some point in the last few years.1 These troubling statistics are a call to action for healthcare leaders, and a call to reimagine and reinvent how we deliver care in rural areas. Undoubtedly, nursing will play a critical role.

The Growing Role of Telemedicine

The gap between rural healthcare needs and provider capacity is growing—literally, by miles. From 2013 to 2017, 67 rural hospitals closed, 23 of which were 20 or more miles away from the next closest hospital.2 As the distance between providers and patients increases in rural areas, telemedicine will play an important role in care delivery. For decades, nurses have counseled patients over the phone regarding health questions, but technological advancements are creating exciting new possibilities like enhanced remote patient monitoring and advanced telehealth apps. By improving the suite of telehealth resources available to rural area patients, they’ll have easier access to preventive and primary care in their own communities—often, from the comfort of their own homes.

However, there are many primary care services that must be delivered on site by a provider, and rural communities are suffering from an acute shortage of healthcare providers. According to the National Conference of State Legislators, 77 percent of rural counties are designated as health professional shortage areas.3 Compounding the existing shortage is the fact that rural primary care physicians are, on average, older than their urban counterparts, which will only worsen this troubling trend over time.

Filling the Care Gap with NPs and PAs

Addressing the supply shortage, the number of nurse practitioners (NPs)4 and physician assistants (PAs)5 who graduate each year is outpacing the number of medical doctors (MDs)6. In 2017, there were approximately 68 percent more new NPs and PAs than MDs. The numbers of NPs is projected to continue growing,7 and they must be empowered to meet primary care needs with a widened scope of practice, enabling them to treat patients more independently. Nurse practitioners can provide essential in-person care without a physician. Twenty-two states and the District of Columbia have pursued some expansion of scope of practice for NPs,8 including rural states like Nebraska, where 13 of 93 counties lack even one primary care physician.9 Additionally, other Advanced Practice Registered Nurses (APRNs), like certified nurse-midwives and clinical nurse specialists, can also address rural health needs when physicians cannot.

Nursing talent will play an essential role in expanding access to rural healthcare, but it will require a concerted effort to recruit, educate, train, and retain nurses in rural areas. First, healthcare leaders and nursing educators need to elevate this opportunity in our dialogue with students. Rural nursing is a high-need role for professionals excited to make a difference and pioneer innovative approaches to care. Healthcare providers have continuity in small towns, getting to know patients personally and addressing their needs.

Providing Healthcare to All Communities

As called for in the National Academies of Sciences, Engineering, and Medicine’s 2011 The Future of Nursing report, we must continue to encourage nurses to pursue advanced education, enabling them to take on advanced practice responsibilities.10 This can be done through innovative programs designed to increase access to education and prepare them without having to leave their communities. Educating nurses where they live may mean they’ll stay there longer, which is especially helpful in addressing the need.

In rural healthcare, the nursing profession has the opportunity to showcase the full range of its abilities and embrace the future of expanded nursing practice. Close collaboration between nursing educators, policymakers, regulators, and health systems will enable us to embrace these opportunities, making care more efficient, affordable and accessible for rural America. Working together, let’s reaffirm our commitment that all citizens, wherever they live, deserve a system equipped to meet them where they are and provide superior care. The nursing profession stands ready and eager to do our part.

Karen Cox, Ph.D., R.N., FACHE, FAAN, is President of Chamberlain University, which has the largest nursing school in the country, and Immediate Past President of the American Academy of Nursing.

Notes on sources:

  1. https://www.npr.org/sections/health-shots/2019/05/21/725059882/poll-many-rural-americans-struggle-with-financial-insecurity-access-to-health-ca
  2. http://medpac.gov/docs/default-source/reports/jun18_medpacreporttocongress_sec.pdf#page=69
  3. http://www.ncsl.org/research/health/closing-the-gaps-in-the-rural-primary-care-workfor.aspx
  4. American Academy of Certified Nurses Enrollments and Graduations 2017-2018
  5. Physician Assistants Education Association Program Report 33, 2017
  6. https://www.aamc.org/download/321532/data/factstableb2-2.pdf
  7. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm (visited June 2019 ). Data reflects a projected percentage change in employment from 2016-2026 and may not reflect local economic conditions
  8. https://www.healthleadersmedia.com/clinical-care/more-states-pushing-autonomy-scope-practice-battle
  9. https://www.omaha.com/livewellnebraska/nebraska-counties-have-no-primary-care-doctor-here-s-what/article_f0911c82-70c8-5929-b983-045a0fc151d1.html

10. http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-      Change-Advancing-Health/Report-Brief-Education.aspx

Empowering Yourself

Empowering Yourself

You’re good at your job. Perhaps you’re even great at it. No matter what, if you want to get ahead in your career, you need to trust yourself. On a daily basis, you may have confidence in the physicians, social workers, and techs whom you work with. But you also need to have that same faith in yourself.

We asked Tina Marie Baxter, MSN, APRN, GNP-BC of Baxter Professional Services, LLC in Anderson, Indiana for tips on how nurses can empower themselves. She gave us a lot of fantastic information as well as some things to think about.

Some nurses are so focused on caring for patients that they don’t think about themselves. What are some of the basics that they should know about empowerment and what it can do for them?

Nurses forget that we are the biggest population of health care workers. According to The Truth About Nursing there are 10 nurses to every three physicians in the United States. The American Association of Colleges of Nursing reports that nursing is the “nation’s largest health care profession, with more than 3.8 million registered nurses nationwide” (Nursing Fact Sheet). We hold tremendous power. We need to remember that when we are confronted with a problem in our jobs and are looking for creative solutions.

As nurses, we are advocates for our patients. We should be sitting at the board room table and not be afraid to participate in the discussions that affect not only our practice but also patient outcomes. I have seen nurses downplay their skills and knowledge saying, “I’m just a nurse.” We are not just nurses. We are heroes. We need to embrace it. We are the experts in our field. This is not to say that we can’t learn anything new, but if we invest in ourselves and our personal development, we will be the better for it. We can empower each other by standing up to bullying that we see in the workplace and letting others know that it is not okay. We can empower each other by using our natural skills as problem solvers to improve the conditions on the unit.

As an individual, you can contact your local legislator about a problem in your community. You are a person of influence there, and you should never forget that people look up to nurses. You often hear, “I could never do what you do” from the public. You are a nurse and are in a uniquely privileged position. This is one of the reasons I have contacted my state representative about drafting legislation to stop violence against nurses in my state because I saw a nurse assaulted by a patient, and nothing was done. This is empowerment at its best, speaking out for the good of all.

What action steps can nurses take to empower themselves? Can you give some tips?

Nurses can become advocates for themselves. We need to do the homework and back up our findings with facts. Nurses are very creative. We need to hone that creativity and encourage it in the workplace.

I encourage nurses to engage in lifelong learning. By lifelong learning I do not necessarily mean going back to school to get another degree — although that is a viable option if one is so inclined. I mean engaging in learning a new skill that is not necessarily nursing related. For instance, I am learning about SEO, affiliate marketing, and podcasting as a way to reach a new audience with what I have to offer to the market place. You may learn a new skill or sharpen a talent that you already possess to make impact.

For example, in our local community, we had a nurse who had a beautiful singing voice. She would be requested to sing for the patients when they were coming out of surgery if they were scared or when they needed some comfort.

There is a lot to learn out there that does not cost a lot of money. There are wonderful podcasts, TED talks, webinars, and YouTube tutorials that are free on the internet. You have to take advantage of it.

How will empowering themselves help them career-wise?

Each nurse’s journey will be individual and different. I can say for myself that I would not want to do anything else. I have maintained an open mind and a natural curiosity. I want to know how things work. Whether it is a system, a process, or patient problem, I want to know the answer. If you approach your career as an investment in yourself, you can go far as you want to go. I look at each new challenge as an opportunity to better myself.

Is there anything I haven’t asked you about how nurses can empower themselves that is important for them to know?

Find a mentor. Find someone that you admire, introduce yourself and invite them out for coffee or lunch. You will be surprised at how many people would genuinely like to help you. Listen to the advice you are given and put it into action.

Many nurses, and people in general, make promises to themselves, but fail to put a plan of action together. You have to make a plan, commit to it, and work it out. This is something I encourage my clients that I mentor and coach to do. We sit down and map out a plan of action with measurable outcomes or milestones along the way.

One final note, as you are working your plan, celebrate the small successes along the way. Did you meet one new contact that will help you further your business? Did you finally complete your certification? Celebrate. Publish your success, and invite your friends to celebrate with you.

Strategies for Long-Distance Caregivers

Strategies for Long-Distance Caregivers

Being a primary caregiver for a family member who lives in a different city or state can feel like a full-time job, complete with its own set of stressors and related emotions.

“I think caregivers can be disappointed at times,” said Vicki Williford, a chronic care nurse in Greensboro, North Carolina. “The home health nurse comes and goes, and [the caregiver] still has another 23 hours to go.”

That’s 23 more hours to make sure the care recipient has taken medication, avoided falls, eaten healthy meals, and made it to the bathroom in time — all of which have to be supervised remotely by long-distance caregivers.

The need for non-clinical family members to provide care to aging loved ones will likely continue to rise, due to a growing population of seniors and the shortage of health care providers in America. The burden of caregiving may be further complicated by distance; a 2015 study from the National Alliance for Caregiving found roughly 25% of caregivers live 20 minutes or more from the recipient’s home (PDF, 1.8 MB).

What unique challenges do long-distance caregivers face, and how can a relationship with a health care team help overcome these challenges?

The Challenges of Caring from Afar

Nearly 44 million Americans provide unpaid care for a family member. Of these Americans, between 5 million and 7 million are doing so from a distance of one hour or more, according to a report from the Journal of Gerontological Social Work.

All caregivers, regardless of geographic proximity, are met with tasks that challenge emotions and resilience, as they work to provide the best possible quality of life for a loved one in need of support. They may have difficulty accessing clinical training, balancing caregiving with a full-time job and personal life, and managing the length and scope of caregiving.

Those supporting a family member from a distance may experience added stress from coordinating logistics remotely, without the affirmations of face-to-face interactions from a health care team and their loved one.

Challenges unique to long-distance caregivers include:

  • Traveling to and from the care recipient’s home
  • Using technology to stay in touch
  • Limited in-person communication with the care recipient
  • Building provider relationships from afar
  • Coordinating legal and financial concerns remotely
  • Planning visits for other family members
  • Keeping all parties up-to-date
  • Wavering confidence about choices made for the care recipient

Digital Tools for Long-Distance Caregivers

Some caregivers may find help through digital tools that make it easier to check in on a care recipient, which can include:

Mobile Apps – For face-to-face communication

Smart Devices — to adjust home temperature or door locks

Wearable Devices — to transmit vitals or call 911 in case of an emergency

Home Cameras — to monitor activity and visitors; for keeping track of medication schedules and deliveries; providing alerts of home break-ins

Keep in mind, not all technology seems user-friendly at first, so it’s important to check in with all parties — including a health care provider — about the level of comfort using new tools.

Being Part of the Health Care Team

Many care recipients have a team of providers, such as nurses, managing multiple aspects of their treatment. Caregivers can certainly be a part of that team, even from a distance. That team can also offer support for the caregiver.

“All the research suggests that we do better with adversity by having people who are in our corner,” said Dr. Barry J. Jacobs, clinical psychologist, family therapist, and author of The Emotional Survival Guide for Caregivers.

“We don’t take over people’s lives,” he said of caregivers. “We work with them to provide support to enhance their lives to be more functional and help them live more the way they want to live.” Both the caregiver and provider need to understand the strains that each party is experiencing, which comes from clear and consistent communication. There are several ways family members can demonstrate to providers they want to be an active participant in a loved one’s care.

Building a Relationship with a Provider Remotely
  • Identify a member of the family who has the capacity and availability to be granted power of attorney for medical decision-making and communication with the primary provider.
  • Establish the need for regular check-ins and preferred modes of communication.
  • Attend appointments when possible. If it’s not possible to be there in-person, try dialing in, or follow up with a phone call to the provider and care recipient.
  • Conduct background checks of aides who are providing in-person care.
  • Keep notes of changes in health or questions about the care recipient’s needs.
  • Make a list of medications and other treatments in order to support medication adherence and monitor changes in therapies.
  • Understand that a treatment plan will evolve as the care recipient’s condition changes, and be open to that change.

Williford said it’s common for families to lack consensus on a treatment plan for a patient with an unexpected hospitalization, which can make a provider’s job much more difficult.

“Families come in from all these different states, out of town, and then they’re now faced with: ‘What do we do with Mom?’” she said. “They’re trying to decide, and yet the mom’s saying to me, ‘No one asked me what I wanted.’”

Having these conversations as a group can help the care recipient feel that they have agency over their treatment plan and keep everyone on the same page — regardless of what time zone they’re in.

A Taste of One’s Own Medicine

Supporting a loved one from afar involves complicated responsibilities and constant communication that can prove taxing. It’s common for long-distance caregivers — especially those with less support — to feel emotionally burned out or exhausted. Being far away from the care recipient can increase anxiety about a loved one’s wellbeing, and may be compounded by stress of periodic traveling or lack of sleep for providing care across different time zones.

Without proper self-care, caregivers may experience caregiver strain, or a feeling of burnout that leaves individuals unable to perform daily tasks or cope with feelings of anxiety.

“You know you’re experiencing burnout as a caregiver if you’re waking up in the morning with a sense of dread,” said Jacobs.

How to Manage Burnout as a Long-Distance Caregiver
  • Set a cadence for phone calls.
  • Make time to self-reflect each day.
  • Take an inventory of your emotions.
  • Accept help when it’s offered; ask for help when it’s not.
  • Utilize a care team on the ground to perform in-person tasks.
  • Take notes during visits so there’s less to memorize.

Drawing boundaries is one thing; adhering to them is another. Caregivers have to carve out time to care for themselves and get the help they need as well. Jacobs said he uses a marathon as a metaphor for caregiving.

People “need to see this as a long, arduous course for which they need to really take care of themselves along the way,” he said.

“They run past a water station at mile five and people are waving water bottles at them,” Jacobs said. “That kind of self-replenishment on a regular basis develops some sort of emotional wellness program.”

Even when distance is not a factor, caregivers are still at high risk of being overwhelmed. In fact, boundaries can be extremely difficult for spousal caregivers in particular, who feel a heightened sense of obligation for their loved one’s well-being. Spousal caregivers are at increased risk for burnout. Many of them — almost one in five — are outlived by their husband or wife, according to a 2018 study published in the journal Alzheimer’s & Dementia. Accepting an offer of assistance, even when it doesn’t seem crucial at the time, can help caretakers sustain the energy and will needed to provide the best quality care, while still finding time to rest and enjoy life with their loved ones.

Resources for Long-Distance Caregivers

Refer to the organizations below for further reading and resources on how to provide high-quality care for a loved one, from afar.

Citation for this content: [email protected], the online DNP program from the Simmons School of Nursing 

Nine Dimensions of Wellness: Optimize Your Personal Health and Well-Being

Nine Dimensions of Wellness: Optimize Your Personal Health and Well-Being

This is a condensed excerpt of the chapter on health and well-being from the new book Evidence-Based Leadership, Innovation and Entrepreneurship in Nursing and Healthcare: A Practical Guide to Success. Click here for free access to the full chapter through 02/15/2020.

Although nurses, other clinicians, and healthcare leaders take great care of others, they often do not prioritize their own self-care.

Burnout and depression now affect over 50% of clinicians in the United States and compromise the quality and safety of healthcare, as nurses and physicians who are experiencing poor mental and physical health are at greater risk of making medical errors. A recent national study of over 2,300 nurses from 19 healthcare systems throughout the country found that depression was the leading cause of medical errors. In this study, nurses who reported poor mental or physical health had a 26% to 71% higher likelihood of making medical errors. It is critical that healthcare leaders and clinicians prioritize their own self-care so that they can achieve optimal health and well-being for themselves, support a high level of wellness in their staff, and deliver the highest quality of safe care to others.

The Nine Dimensions of Wellness

Taking time each day to monitor and attend to your own well-being can have multiple rewards for you, from physical to emotional and financial health and well-being.

Presented here is an overview of the nine dimensions of wellness, designed to start you on your journey toward optimal well-being. Each dimension of wellness is vital and interconnected. Just as you are told by a flight attendant to place an oxygen mask on yourself first before you put one on your child, you cannot take good care of your family, your staff, or your patients unless you first prioritize your own health and well-being and engage in good self-care.

Physical Wellness

Physical wellness is not just limited to exercise; it includes healthy eating, engaging in regular preventive care and health screening, proactively taking care of health issues that arise, and sustaining healthy lifestyle practices on a daily basis. Focusing on self-care now will have lasting positive effects on your long-term health and well-being.

Emotional Wellness

Emotional wellness includes the ability to identify, express, and manage the full range of your feelings. It also includes practicing techniques to deal with stress, depression and anxiety, and seeking help when your feelings become overwhelming or interfere with everyday functioning.

Financial Wellness

Financial well-being includes being fully aware of your financial state and budget, and managing your money to achieve realistic goals. When you analyze, plan well, and take control of your spending, you can make significant changes in how you save, spend, and feel. Almost three in four Americans surveyed in a recent American Psychological Association (APA) study (2015) said they experience financial stress. Financial stress can affect your physical and emotional well-being. According to the APA, high levels of financial stress are associated with an increased risk for ulcers, migraines, heart attacks, depression, anxiety, and sleep disturbance, and may lead to unhealthy coping mechanisms, such as binge drinking, smoking, and overeating.

Intellectual Wellness

Just as a flexible body indicates physical health, a flexible mind indicates intellectual health. When a person is intellectually healthy, he or she has a value for lifelong learning; fosters critical thinking; develops moral reasoning; expands worldviews; and engages in education for the pursuit of knowledge. Any time you learn a new skill or concept, attempt to understand a different viewpoint or exercise your mind with puzzles and games, you are building intellectual well-being. Studies show that intellectual exercise may improve the physical structure of your brain to help prevent cognitive decline.

Career Wellness

Engaging in work that provides personal satisfaction and enrichment and is consistent with your values, goals, and lifestyle will keep you professionally healthy. After sleep, we spend most of our time at work, so ask yourself if your work motivates you and lets you use your strengths or abilities to their full potential. Burnout, stress, and dissatisfaction at work should prompt an evaluation of your career wellness. Even if you cannot change where you work right now, you can change your approach to the stressors and challenges you face at work.

Social Wellness

Social wellness can be defined as our ability to effectively interact with people around us and to create a support system that includes family and friends. Evidence shows that social connections not only help us deal with stress but also keep us healthy.

Creative Wellness

A review of more than 100 studies of the benefits of the arts (music, visual arts, dance, and writing) found that creative expression has a powerful impact on health and well-being among various patient populations (Jacobs, 2015). Most studies agree that engagement in the arts decreases depressive symptoms, increases positive emotions, reduces stress, and, in some cases, improves immune system functioning.

Creative wellness means valuing and participating in a diverse range of arts and cultural experiences to understand and appreciate your surrounding world. Expressing your emotions and views through the arts can be a great way to relieve stress. Do not let self-judgment or perfectionism get in the way. Allow yourself creative freedom without worrying about whether you are doing it well, and take time to appreciate the creative efforts of others.

Environmental Wellness

Increasing awareness of your surroundings can improve overall well-being. Being environmentally well means recognizing the responsibility to preserve, protect, and improve the environment, and to appreciate your connection to nature. Environmental wellness intersects with social wellness when you work to conserve the environment for future generations and improve conditions for others around the world. Research has demonstrated that green space, such as parks, forests, and river corridors, is good for our physical and mental health. Your environment is not limited to the great outdoors though; it also includes everything that surrounds you—your home, your car, your workplace, the food you eat, and the people with whom you interact.

Spiritual Wellness

Spiritual wellness is largely about your purpose, not religion. You can seek spiritual wellness in many ways, including quiet self-reflection, reading, and open dialogue with others. A spiritually well person might explore the depth of human purpose, ponder human connectedness, and seek answers to questions like, “Why are we here?” Spiritual wellness includes being open to exploring your own beliefs and respecting the beliefs of others.

Protect and Cultivate Your Health and Well-Being

Changing your wellness habits is not easy; it typically takes 30 to 60 days to make or break a new habit. Setting goals for your well-being can make a significant positive difference in your life and in the lives of others. When trying to make changes, set SMART goals: goals that are Specific, Measurable, Achievable, Realistic, and Time-bound. Most people are not successful with their health and wellness objectives because they set goals that are unrealistic. For example, if you only exercise for 15 minutes, twice a week, do not set a goal to exercise for 30 minutes 5 days a week. A more realistic goal is 15 minutes three times a week or 20 minutes twice a week.

Click here for free access to the full chapter through 02/15/2020.

How to Stay Mindful as a Nurse

How to Stay Mindful as a Nurse

At any given moment working nurses are pulled in numerous directions, as multitasking is the currency of the occupation. In many instances, nurses are caring for high acuity patients on units with inadequate nurse staffing. Nurses are trained in principles of documentation, the six to eight “Rights” of medication administration, and round regularly on their patients to maintain safety. 

Distraction can still wreak havoc on a shift if a nurse is not focused carefully on the immediate task at hand. A 2013 study revealed that “42% of healthcare-related life-threatening events and 28% of medication adverse reactions are preventable.” So how can nurses bring their full attention to what they are immediately concerned with?

Mindfulness Can Help

By embracing the practice of mindfulness. It’s a term that’s mentioned often in relation to relaxation and meditation these days, but it can be helpful during working hours as well as after hours. To be mindful, according to Merriam-Webster, one is “bearing in mind,” “aware,” or “inclined to be aware.” PsychologyToday.com states that mindfulness “is a state of active, open attention to the present.” Essentially, being mindful is being fully present and attentive to what is happening in the present.

Mindful over Multitasking

Nurses can incorporate mindfulness into their everyday practice by making the effort to bring their focus to the present whenever they are interacting with patients, which will improve work performance. Save any multitasking for times not spent working directly with patients. Before entering a patient’s room, pause briefly and take a breath. Bring the focus to the specific details of the patient’s case and keep it there as long as the interaction lasts. Actively listen when they speak.

Try this applied exercise in mindfulness:

  • Before entering a patient’s room, scan your body for tension – look for tension in common places such as the jaw or shoulders and relax those areas.
  • Be aware of feeling rushed or anxious, and acknowledge these feelings without trying to eliminate them.
  • Take a couple of mindful breaths, dissolving your tension and busyness on the exhale.
  • As you prepare to meet your patient, adjust your mindset to be fully present.
  • Knock on the door and make eye contact as you enter the room.
  • Introduce yourself and make a personal connection.
  • Chat with your patient for a few moments before moving on to your assessment or reaching for your computer.
  • Whenever you notice your focus has wandered, gently redirect back to your patient and the task at hand.

Reduce Stress

Incorporating mindfulness into everyday practice can reduce reactivity to stress. By being more mindfully deliberate, nurses can implement their daily plans with less distraction. Adopting the mindful approach is considered much healthier than multitasking. And paying full attention to patients can only improve assessment skills.

Adopting the practice of being mindful and returning the mind to the present whenever the focus strays can help keep nurses on task with less stress and more efficiency. A mindful nurse is far less likely to make mistakes. And that’s something from which everyone benefits.

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