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Mindfulness: A Cure for Auto-Pilot

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This article encourages the use of mindfulness practice during the work day to prevent burnout and reduce stress. The concepts of mindfulness are defined and explained. The perspective and concepts discussed are informed by research conducted by experts on mindfulness practice.

Mindfulness: A Cure for Auto-Pilot

Have you ever felt that your automatic pilot just switched on the moment you walked in the door? No matter what setting you are working in, nursing demands a complex skill set. To keep up on any given day, one must have their critical thinking, multi-tasking, speed, and accuracy skills polished and at the ready. It is clear why at the end of a 12-hour shift it seems as if every ounce of physical, emotional and cognitive energy has been consumed, leaving you empty. It makes sense that you would want to protect your energy level, not to mention side-step any metaphorical land mines quietly waiting to explode. Switching on Auto-pilot may seem like a quick fix, a desperate attempt to conserve your valuable energy to get through the day, but this experiential avoidance may be having a paradoxical effect.

Humans have an inherent natural survival instinct that determines our reaction to unpleasant or uncomfortable events in our environment (e.g., combative or resistant patients, family members or difficult staff). This primitive instinct tries to steer us away from unpleasant things because of their potential for harm. This same instinct affects our internal processes as well, disconnecting us from unpleasant thoughts (e.g., worry or judgement), emotions (e.g., frustration, grief, stress, helplessness), or sensations (e.g., physical fatigue or tension). We protect ourselves by using experiential avoidance and, for some, it looks like switching on the auto-pilot. The irony is that experiential avoidance has been found to actually maintain psychological distress (Hayes et al., 1996).

No matter how hard you try to escape yourself and all of your internal thoughts, feelings, and experiences, you are stuck with you. Interestingly, struggling with discomfort is what actually maintains this cycle and changing the relationship with the present experience is what helps long-term. It can seem a bit nebulous, but in order to relieve yourself from the struggling, you must open yourself up to experiencing the very thoughts, feelings and sensations that you are trying to avoid. It takes a lot of practice. However, it will serve you well if you can develop a willingness to contact whatever comes up during the work day - even if what comes up creates stress, irritation or sadness.

Mindfulness-based research purports that although experiential avoidance (i.e., automatic pilot) can alleviate distress in the moment, over time it teaches us to become intolerant of our own internal experience. Jon Kabat-Zinn, a world authority on the use of mindfulness, defines it as: "Paying attention in a particular way: on purpose, in the present moment, and non-judgmentally." Mindfulness is about waking up, connecting with ourselves, and appreciating the fullness of each moment of life. Kabat-Zinn calls it, "The art of conscious living." It is a profound way to enhance psychological and emotional resilience, and increase job satisfaction.

Accepting your authentic experience in the moment is the complete opposite of avoidance. When we learn to practice mindfulness in our daily lives and apply an open and accepting attitude to all internal and external experiences (including the painful ones), then we free ourselves from suffering. Notice that I did not mention that you would be free from pain? Pain is part of life. Suffering does not have to be. When we sit with unpleasant thoughts, feelings, and sensations (even if only briefly), they lose their power over us. They become just thoughts - just feelings - and just sensations.

Research shows mindfulness training can help nurses cope more effectively with stress and reduce the risk of professional burnout. A study based on Jon Kabat-Zinn's 1979 study was conducted on a trial of nurses and found that those who participated in an 8-week Mindfulness-Based Stress Reduction training program (MBSR) had significantly fewer self-reported burnout symptoms, along with increases in relaxation, mindfulness, attention and improved family relations, compared to nurses in a control group.

The next time that you experience some aversive, unpleasant, or unwanted experience, use it as an opportunity to choose to respond to the event differently than you normally would. Try to engage with curiosity and openness. Try to notice the unpleasant event, welcome it into your experience, examine it for what it is, accept it completely (which does not mean approve of it), and then allow yourself to let it go.

Example of a Mindfulness Exercise (practice 10 minutes a day):

Focus on your breathing. Notice the sensations of the breath as it travels in and out of your body. Don't try to make the breath happen in any particular way; just notice your breathing as it is happening. Of course, your mind will get caught up in other mental events, such as planning or daydreaming. But mindfulness simply invites your attention back to the breath without criticizing or judging the mind's wandering. This "awareness of breath" meditation helps slow your mental activity and builds the capacity to stay focused. Taking a few slow, mindful breaths before entering a patient's room can activate the parasympathetic nervous system, causing the "relaxation response," which helps you feel more centered and more fully present with the patient.

Pain is inevitable, suffering is optional ~ Anonymous.

I am a doctoral candidate who has worked in many areas of mental health, including the emergency department. I could not have done my job without the expertise and support of my fellow RNs, LNAs, PAs and MDs. I have been eternally grateful for my experiences assessing mental health/substance abuse patients in the ED and will bring this experience into my next endeavor.

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2 Comment(s)

I took the 8-week MBSR course last year and it was a game changer in helping me deal with long-standing issues related to anxiety and depression. By the time I took the class my work-related/nurse role-related anxiety (coupled with some significant personal losses and setbacks) had reached an untenable pitch. Mindfulness practice has not made me impervious to stress or discouragement, but it has made me more resilient - able to move back to an okay place far quicker and easier.

For me, it's about bringing moments of mindfulness into my every-day experience. It's wonderfully simple and really doesn't require you to change anything external in your life. You increase the aggregate of "being okay" moments and over time you find that your set-point has subtlely shifted to a happier place.

Some hospitals actually offer the course to employees. If it's not offered directly by your hospital/employer, you might be able to use your health plan's Wellness initiative benefit to offset the cost of taking a course from a local college or therapist.

Davey Do

Has 41 years experience.

Well written article, cwentworth. A great concept!

Reminds me of the concepts of "living in your body" or "living in the moment".