Advanced Clinical Practice Fellowships

: How to Develop and Implement a Program Based on the Benefits of Mindfulness Stress Reduction for Frontline Healthcare Shift Workers for an Acute Care Setting

Summary

Healthcare workers are impacted by many different stresses. In general, stress can negatively affect the physical body and psychological well-being interfering with cognitive functions, overall learning and clinical performance.

 Previous completed work on Compassion Fatigue facilitated the understanding that stress whether it be physical, behavioral, or psychological, can have a detrimental effect on the nurse's health and well-being. The current pressures faced by all healthcare providers because of the Covid-19 pandemic, expands the importance and the urgent need for an evidence-based program aimed at mitigating stress and promoting wellness and optimal mental health. 

There is current evidence that interventions such as Mindfulness Based Stress Reduction (MBSR) programs have proven to decrease stress, anxiety, and depression, as well as improve one's attention span, mood, self-efficacy, and empathy. All these aspects are vital qualities that are essential for an effective, caring, and compassionate nurse to possess. I have garnered my knowledge through completing a literature search, connecting with experts in the fields of healthcare and mindfulness, and personal exploration of the various tools and practices of mindfulness and self-care to develop and implement a program based on the benefits of mindfulness-based stress reduction for frontline healthcare shift workers in an acute care setting.

Overall, this program plan is in keeping with many of KHSC's current and future strategic plans and will be a significant extension of the work already completed by our Occupational Health, Safety, and Wellness department. A MBSR program designed with nurses in mind, will increase awareness of the need to practice self-care, provide the supports and resources necessary, and encourage and influence health care workers to take ownership and control of their own health, well-being, and work-life balance. As a yoga instructor, and Ayurveda student, I am passionate about holistic health connecting the body, mind, and spirit utilizing preventive medicine to maintain optimal health. I feel a facilitated mindfulness program will have an elevating effect and positive impact on the health care workers by supporting them in their own self-care practices and in turn will have the capacity to provide high quality compassionate care to our patients and community. (350)

My overall learning goal is examining the benefits of mindfulness, meditation and stress reduction practices on the wellness and well-being of health care providers, specifically nurses who work shift work.  Increasing my knowledge and experience to develop an evidence-based educational program, based on mindfulness-based stress reduction practices that nurses can participant in, find valuable, manageable and sustainable within their lives. Knowledge was gained through completing a literature search and performing an external scan of developed MBSR programs, and through participation and exploration of the practices through facilitated programs and workshops. A literature search was completed using the key words, such as mindfulness, meditation, self-care, compassion fatigue, burnout, nursing, wellness, and stress generating systematic reviews of the effects of mindfulness practices for health care workers, qualitative research and quantitative… The research highlighted various stressors healthcare workers face within their working environments and their challenges and barriers for participating and incorporating mindfulness and stress reduction practices into their workday, as well as highlighted self-care practices that can help reduce compassion fatigue, stress and burnout and enhance resiliency for improved self-compassion, empathy, and job satisfaction. I have enhanced my knowledge and skills of incorporating these mindfulness tools and self-care strategies into my role as a clinical learning specialist and feel more able to facilitate mindfulness practice. Through speaking with experts in the various fields, I have been able to identify the necessary components for a sustainable mindfulness-based program. I have had the opportunity to gain a wealth of practical experience while completing this fellowship.  My role as CLS will enable me to implement such a program which will create sustainability. 

 

Outcomes

The short-term outcomes for the participating nurses are an enhanced skill set of compassionate communication, active listening, and therapeutic presence. These are skills that I have garnered which enable the strengthening of therapeutic relationships, mindfulness leadership and support healthy workplace environments. The learned evidence-based practices of mindfulness and self-care will be incorporated at daily safety huddles recognizing the need to support the healthcare workers psychological health.  Being able to show compassion, empathy and validation for the frontline nurses demonstrates that they are supported and not alone. The participants who are actively engaging in self-reflection and self-care practices will learn through example and learn to incorporate the tools and strategies into their own practice. The short-term goal is exploring the variety of practices with a long term outcome of setting a positive habit of self-reflection, self-care, and self-development.  The long-term outcomes for the staff will be seen through incorporating mindful and self-care practices at critical times within the nurse’s career, for example, medicine orientation for new hires, discussions with 4th year consolidating students for their change or leadership projects and the general hospital orientation for all healthcare workers. Education on caring for the caregivers will have positive effects on the delivery of patient care.

Kingston Health Sciences Centre (KHSC) and its leadership teams have been working tirelessly creating, offering, and implementing various resources to support its employees, during this increasingly strained time. The work that was completed, and experience obtained during this fellowship will enhance the work that is already in place at KHSC. It is the practical application of the tools and strategies of mindfulness and self-care being brought to an audience that has inherent challenges due to shift work. I have explored with Occupational Health, Safety and Wellness the supports already available, and the recommendations developed by the Mental Health Commission of Canada: National Standard of Canada: Psychological Health and Safety in the Workplace- Prevention, Promotion, and Guidance to staged Implementation.” Working with stakeholders, I will be able to put into action the available supportive policies as well as some of the applications mentioned in The RNAO Healthy Work Environments Best practice guidelines for Workplace Health, Safety and Well-being of the Nurse. During this fellowship I have been able to network with people in various departments throughout KGH, garnering support that will allow for a further expansion of the knowledge, and implementation to other programs throughout the organization. An uptake by the whole organization would foster further sustainability.  

Overall experience

Overall, this RNAO fellowship has opened up and provided opportunities within the nursing profession I could never have dreamed were possible. Health and well-being are integrative, personal, and shared among humanity. (Removed sentence here) The core values of nursing, self-reflection, self-care, and self-development have taken on a deeper meaning and value within my own practice. I have gained in knowledge, skills, tools, and experiences above and beyond what was imaginable. This time was a gift to explore the tools and strategies necessary to create clarity of thought and mental focus. Ultimately, I was able to construct those thoughts into a comprehensive form to be able to share with others. Through this personal exploration, I was able to reveal my core strengths and bring into realization positive, effective change influencing the workplace health and well-being of the nurse. I want to thank the RNAO for this amazing opportunity to explore, blossom, and grow in my nursing career as well as Kingston Health Sciences Centre and my mentoring team who were supportive right from the first word written on the application.  I cannot say it enough of how grateful I am for this extraordinary opportunity to be a part of all these experiences. I am grateful for the amazing connections I made along this journey and will forever cherish all of my garnered knowledge and skills. It feels like the best solo travel adventure I’ve ever taken.