For Healthcare Workers
T.E.A.M – Together Everyone Achieves More
An open letter to all the amazing Australian Healthcare Workers
I wrote the following blog when we first met COVID-19 in the early parts of 2020. The information is the same however there is something else that I want to address and share as a matter of urgency. It is crucial that we understand that when we are in fight flight freeze, or survival mode, our immune system is lowered, making us more susceptible to illness and disease. So, in this current climate and life in general, we need to make stress relief, stress reduction a part of our toolbox. How do we do that? We breathe in a way that we trigger our vagus nerve and cut in our parasympathetic nervous system, we self-regulate our nervous system consciously. We abdominal breathe. We all can do this. We all can teach our children and families to do this and we can teach our clients and patients how to do this.
I am with you, I care about you and I care about this world we live in deeply. I have been quite silent of late doing a lot reflection and listening. Our healthcare TEAMs, our Aged Care TEAMS have a big job in front of us again. Our healthcare colleagues across the globe are asking us to listen and learn so we can do this better. We need to be in a state of calm to be able to hear them.
I came across an article that touched my heart – “That discomfort you’re feeling is grief” I bet we all remember Elisabeth Kubler-Ross and her five stages of grief, denial, anger, bargaining, sadness and finally there is acceptance. The stages can happen in all different orders however when we get to acceptance, that is where the power to adapt, grow and thrive becomes available. Resilience can be born. This article will help you to see clearly what is happening in our world at this time. https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief
The next knowledge we need to understand is what does stress actually do to us on a physical, mental and emotional level. And why is it necessary to reduce our stress to protect us and the people we care for. We as nurses and healthcare workers, matter and we need to value and prioritise our self-care and wellbeing. We have to stay calm to keep the knowledge, leadership, decision making part of our brain, the prefrontal cortex , on line. Our lives and the lives of others depend on this, now more than ever.
Here is a link to a short video as to “Why” we need to calm down. https://youtu.be/rKdkW2416FE When we are in fight, flight, freeze response, the prefrontal cortex shuts down and we can’t access it. Obviously when this is shut down people are reacting from ways they don’t even understand such as the toilet paper? People are turning on each other. It is important to understand that minds are in survival mode and they are not thinking straight, we can help them come back on line firstly by leading this and inspiring this. All our healing and our conscious best version of ourselves happens in the calm state or the parasympathetic nervous system response. Our healthy immune system needs us to stay in parasympathetic nervous system response. When we are calm, we can consciously choose our decisions rather than react unconsciously. It might be the difference between you putting on your appropriate PPE or going into a situation unprepared. You are calm and think with clarity.
Our body is so clever and it has the ability to re calibrate and reset. We have the ability to activate our parasympathetic nervous system by simply breathing in a specific way. I call this the RESET breath. It’s commonly known as abdominal breathing. Here is the link for A Moment of Mindfulness poster https://www.themindfulnurseaustralia.com.au/wp-content/uploads/2020/02/Moment-of-Mindfulness-1.2-MNA.pdf which demonstrates how to activate your parasympathetic nervous system simply through breathing. This RESET breath or abdominal breathing, triggers your vagus nerve and cuts in your parasympathetic nervous system response, slows everything down and brings your prefrontal cortex back on line. If we practice this breathing we have the ability to calm ourselves in a moment, and regain conscious control of ourselves. We are breathing anyway, we may as well make it count. When you get the three stages of the abdominal breath going well you can introduce a box breath where you inhale for three (one side of the box) hold for three (second side of the box) exhale for three (third side of the box) and pause for three (fourth side of the box). Then repeat. Remember to practice, practice, practice. You will be able to feel your heart rate slow. The better we get at breathing this way the more control we have of resetting our survival or fight flight freeze response. We can firstly find our peace, then help bring others into this peace.
I want to talk about mindfulness and “why” mindfulness, that leads to insight or awareness, is so important in keeping you and everyone else safe. Here’s a short video explaining what happens in the brain and why finding mindful awareness can make such a positive impact in your life. https://www.youtube.com/watch?V=vta0j8ffcvs You don’t have to do formal mindfulness for 20 minutes or meditation practice. As you calm down and start loving the silence you might definitely want to. I love my quiet time. There are so many ways you can get to your calm and your peace. You want to find something that gets your mind to that space where you are engaging all your senses. To get to your calm. That could be walking, running, swimming, surfing, yoga, whatever is right for you while maintaining social distancing. It is this time that resets, re balances our foundations. In these hard, trying times, it is so important for you to find some time for yourself, your resilience will depend on it. We are not in a sprint race, we are in a marathon and we need to pace ourselves and build our resilience.
Here is a link to an article Insights into insight: analysis of case files of nurse and midwife registrant performance complaints. https://www.sciencedirect.com/science/article/abs/pii/S132276961830091X This article leads us to the “why” mindful nursing practice is so important simply as the practice of mindfulness leads to greater awareness or insight. Mindfulness is a tool that gets your brain to that quiet calm space that engages your prefrontal cortex of your brain. This is where all your key learning tools, leadership, knowledge is accessed. Mindful awareness is the ultimate insurance policy. It keeps you and everyone else safe as you consciously respond rather than react. It has never been so important that we consciously chose our decisions with the best part of our brain open and active.
We have a professional responsibility to keep ourselves safe. We want to keep ourselves safe first, for our families and loved ones. We are human and we matter too. Our code of conduct asks us to know where our stress levels are at and to address them as required. This doesn’t stop in a pandemic it actually is more crucial now than ever. You matter!! You always have. This is our professional self-care and we owe it to ourselves, our families and each other to support each other always. We need to keep our prefrontal cortex on line and our stress levels down! We need to nourish our bodies.
Self-care in healthcare is all about coming back to ourselves with kindness and self-compassion first. You simply can’t give something that you don’t have. It is imperative that we take care of ourselves first. We can establish that we need support, then the next step is to care and be vulnerable enough to ask for help, then we need to accept it. For nurses, Nurse and Midwife Support is a 24 hour, free, confidential phone line set up to support nurses by nurses. I’ve picked up the phone and it was awkward at first. Its like anything, the more you do it, the more comfortable you get with it. This support line is for anything, family work, simply anything. Nurses are always helping their clients through crisis, this is a line to help us. We need to help ourselves and pick up the phone. They are waiting to support us through this pandemic. You can ring them if you cant sleep. You can debrief with them. You can ring them about anything. In the current climate we need to utilise these services more than ever and be proactive and take preventative measures. Here is a link to find out what Nurse and Midwife Support does https://www.nmsupport.org.au/news/what-does-nurse-midwife-support-do
There is Employee Assistance Program, Lifeline 131 114, Beyond Blue 1300 224 636. I have included a link to my Crisis Avoidance Poster for guidance if it resonates. https://www.themindfulnurseaustralia.com.au/wp-content/uploads/2020/02/Crisis-Avoidance-1.1-123046-this-One-.pdf When you are aware you need help you can then take the action your comfortable with and access it as start the journey to recovery and wellbeing and learn the ultimate skills of resilience.
The most valuable investment you can ever make is investing in yourself. Your homes , your possessions don’t really mean anything without you. I have put together a list of some of my favorite resources for you. Here is the link, Braving Inventory – known as the anatomy of trust. https://daretolead.brenebrown.com/wp-content/uploads/2020/02/BRAVING.pdf What do you need to develop this trust, this partnership of trust with your employer? What are your boundaries? Do you know your responsibilities? Here is a link to The Cycle of Calm poster, where you gain clarity, community and connection. Awareness, Acceptance, Action ! https://www.themindfulnurseaustralia.com.au/wp-content/uploads/2019/06/Cycle-of-Calm-1.0-PDF.pdf. I hope these resources help you grow and thrive as much as they helped me.
The Art and Science of Mindfulness Integrating Mindfulness into Psychology and the Helping Professions – Shauna L. Shapiro and Linda E. Carlson
Mindfulness for Beginners – Jon Kabat-Zinn
The Proven Power of Being Kind to Yourself Self-Compassion – Kristin Neff
The Mindful Self-Compassion Workbook – Kristin Neff, Christopher Germer
Full Catastrophe Living How to cope with stress, pain and illness using mindfulness meditation – Jon Kabat – Zinn
Dare to Lead – Brene Brown
The Upside of Stress – Why stress is good for you and how to get good at it – Kelly McGonigal, PhD
This is a great link for a six week free mindfulness based stress reduction course with lots of great information.
Another fantastic website you could try where you could do the self compassion scale survey is at https://self-compassion.org
Some great APPS are
- Treat – Alfred Health (Specifically for healthcare professionals)
- Calm – https://blog.calm.com/health
- Smiling Minds
You have to have an open mind and then you “DO” have to do the work. For me the “WHY” is a gamechanger. This will change your life and the lives of the people around you. You just have to give it enough time to see if things change. You need to be patient with yourself. When you live mindfully your life will flow regardless of the external circumstances. The only thing you can ever control is your self and that is enough and everything. Lets lead by example.
“Empathy. If you have done your work and set boundaries you can tread that water forever!” Brene Brown.
Thank you for everything you do and I am so proud to be walking this road with all the amazing healthcare professionals in this beautiful country of ours, the lucky Country, Australia. I am going to lastly come back to the first article – That Discomfort You’re feeling is Grief. David Kessler adds another stage, the sixth stage of grief. I am going to ask you to join me in fulfilling and embodying this sixth stage being “meaning”. I am going to ask you that we not forget our colleagues from other countries that have been so devastated by this pandemic and that we bring meaning to their suffering and experience by showing grattitude by valuing and utilising the information that they have shared. Lets learn from them and set our intention to be the best version of ourselves and do the best job we can whilst looking after everyone as a collective. Stay Safe. “BE WELL”.
Lucinda Jones van Buuren
Mindful Life Coach, Mindfulness Meditation Coach, Passionate RN