Australian Red Cross & Australian Psychological Society (2020). Psychological first aid: Supporting people affected by disaster in Australia. 3rd Edition. www.redcross.org.au
Hildegard Peplau quote was completely made-up, but (to my mind, at least) it sums-up the vibe of Interpersonal relations in nursing: A conceptual frame of reference for psychodynamic nursing (1952) :
“The relationship is the therapy.”
NB: as far as I know, this not a Peplau quote, but [thanks Google] I see that it has been attributed to M. Kahn (1997). Between therapist and client: The new relationship
Joseph Heller quote from Catch-22 (1961): “People knew a lot more about dying inside the hospital, and made a much neater, more orderly job of it. They couldn’t dominate Death inside the hospital, but they certainly made her behave. They had taught her manners. They couldn’t keep death out, but while she was in she had to act like a lady.”
Hurley, J. & Linsley, Paul. (2012). Emotional intelligence in health and social care: A guide for improving human relationships. Routledge.
Mental Health Coordinating Council (2013). Trauma-Informed Care and Practice: Towards a cultural shift in policy reform across mental health and human services in Australia, A National Strategic Direction, Position Paper and Recommendations of the
National Trauma-Informed Care and Practice Advisory Working Group, Authors: Bateman, J
& Henderson, C (MHCC) Kezelman, C (Adults Surviving Child Abuse, ASCA)
Tim Winton quote from Cloudstreet (1991):
““Life was something you didn’t argue with, because when it came down to it, whether you barracked for God or nothing at all, life was all there was. And death.”
Woody Allen quote from Without Feathers (1975) “I’m not afraid of death; I just don’t want to be there when it happens.”
One more thing
In doing this session previously it has popped-up that it can be distressing being unable to contact relatives from a blocked/private phone number. Here’s a tip:
From: Paul McNamara Sent: Wednesday, 9 December 2020 17:00 PM To:0412345678@smsmessages.health.qld.gov.au Subject: To send an SMS via QHealth email type your message in the subject space and send using the mobilephonenumber@smsmessages.health.qld.gov.auformat. Also, you can copy & paste the message into ieMR, as I’ve done here.
More info on this theme @ Thinking Health Communication? Think Mobile.meta4RN.com/mobile
End
That’s it. As always you’re welcome to leave feedback via the comments section below.
I’m not sharing this info as a macabre version of State of Origin or the Bledisloe Cup. It’s not a competition. It’s certainly not a game. Thousands of families across the world are in mourning.
Nevertheless, it is useful to have a benchmark of how we are faring. To give us perspective it’s useful to compare progress across areas/populations. As per the list below, Queensland’s population size compares better to New Zealand, Ireland, Norway and Singapore than other Australian states and territories.
Population Comparison (Australian states/territories + selected countries, small to large) Northern Territory 245,000 Australian Capital Territory 428,000 Tasmania 535,000 South Australia 1.75 million Western Australia 2.63 million New Zealand 4.82 million Ireland 4.94 million Queensland 5.11 million Norway 5.37 million Singapore 5.85 million Victoria 6.63 million New South Wales 8.12 million
So What?
Hopefully, the encouraging data in this chart serves as an anxiolytic for Queensland health workers and their patients. That’s the intent.
Compared to many countries Australia and New Zealand are doing very well with the whole #COVID19 thing.
Reminder: If you’re 20 points up before half time in the Bledisloe Cup don’t start celebrating victory. Stick with the game plan. #COVID19nz#COVID19auhttps://t.co/x2zctvY4qc
At this point in time (the beginning of April 2020) PPE is popping-up in news and social media feeds frequently. Understandably, with the outbreak of the #COVID19 pandemic, clinicians are much more conscious of Personal Protective Equipment (PPE) than usual. Even crusty old mental health nurses like me have revisited and refreshed our knowledge on PPE.
That’s sensible. It’s also sensible to acknowledge that there’s more than one type of PPE.
Positive Practice Environment (PPE)
Today some nurses who work on a ward receiving patients suspected/confirmed to have COVID-19 identified elements that are contributing to their ward working well. Although there’s still some anxiety, of course, generally it is a PPE (positive practice environment). Some of the things nursing staff identified were:
Team Nursing. The RNs highlighted this as a part of the PPE. In a team you never feel like it’s your burden to bear alone, there’s someone to check with donning and doffing personal protective equipment, and there’s always someone to help if you’re in the isolation room and need something extra.
Communication. Communciation within the nursing team, and between the nursing staff and senior medical staff is much better than usual. Regular meetings both formal and informal are really helpful.
Working Smarter. For example: before entering an isolation room, call the patient on their bedside/mobile phone to see if they need anything extra. Similarly, making an arrangement with the patient that they can buzz or phone if they need anything. Increased use of phone = decreased frequency of entering isolation room = decreased use of personal protective equipment.
Getting Smarter. Asking questions and brainstorming solutions. Everyone acknowledges that they aren’t experienced or experts in pandemics, and that collaborative care is the only way to problem-solve the way forward. Patients generate solutions too
Staying Focused. There is so much information swirling about regarding COVID-19, that it is important to limit the sources and exposure. We need to trust the health department that employs us to give us the correct information at the correct time. We can’t afford the time or mental/emotional energy to look at everything that’s out there.
Downtime is Sacred. When everything at work seems to have a COVID-19 twist to it, it’s important to shield against overload. Strategies include:
Don’t watch the news, watch a movie.
Be careful how much time we spend in the social media echo chamber.
Switch off social media and the TV and listen to music.
Ask friends and family not to use “the C word” around you.
Downtime is Sacred.
Three Final Thoughts
One
It’s not just about wearing PPE (as in personal protection equipment) it’s about creating a PPE (as in positive practice environment) too. Nobody pretends for a moment that there are not more and/or better ideas than those above, but being intentional about both lots of PPE is helping.
Two
What’s more contagious: COVID-19 or anxiety?
Three
I can’t believe that it’s been less than 2 months since the term “COVID-19” was first coined. It has infected nearly every news article and conversation since early February 2020.
“Clean Hands. Clear Head.” is an animation of a mindfulness script that distills the content of my 2016 blog post “Hand Hygiene and Mindful Moments” into a short (less than 2 minutes) video. The voice part was recorded on an iPhone at a hospital sink #authentic. The visuals were done on Prezi.
Addit 29/03/20: to my surprise, some people want a text version. I won’t write out the whole thing (too long, a bit dull), but below are some key phrases:
This is my mindful moment. The anxiety and tension will be washed away. I will rub in the resilience and kindness that sustains me. After 20 seconds or so I will pretend I’m TayTay, and shake it off. 🙂 I will smile, then will intentionally slow my breathing. Me and my hands will be safe.
Feels free to use/modify PRN. I would be grateful for source attribution as “meta4RN.com/head”
Just in case it’s handy here is a PDF: CleanHandsClearHead
And here is a MS Word version: CleanHandsClearHead
Part 2. Surviving Emotionally Taxing Work Environments. March 2020 version.
On a related topic, for the last few years I’ve facilitated many hour-long, interactive sessions called “Self Care: Surviving Emotionally Taxing Work Environments.” for my fellow nurses at the hospital where I work. As at March 2020, I’m not confident that we’ll have an opportunity to meet face-to-face as a group all that often, so I’ve tweaked the session, tried to cut-down on the rambling, and have switched from hour-long interactive, to 20 minutes of well-intentioned, a tad-amateurish, youtube video embedded below:
Self Care: Surviving Emotionally Taxing Work Environments. March 2020 version. (video, 20 mins)
Here’s a link to the Prezi version of “Self Care: Surviving Emotionally Taxing Work Environments. March 2020 version”: prezi.com/xcejt9pgd0b3
Part 3. References & Resources.
I’m recycling and combining a lot of old ideas for the March 2020 version of “Self Care: Surviving Emotionally Taxing Work Environments.” Self-plagiarism? Nah – it’s a groovy remix of some favourite old songs. Regular visitors to meta4RN.com may recognise the repetition, and be quite bored with me using the website as a place to store updated versions of old stuff. Sorry about that, but it’s just so damn convenient. 🙂
Here are the resources and references used in the presentation: (because I’m recycling old ideas this list is ridiculously self-referential).
Australian College of Mental Health Nurses [www.acmhn.org], Australian College of Nursing [www.acn.edu.au], and Australian College of Midwives [www.midwives.org.au] (2019) Joint Position Statement: Clinical Supervision for Nurses + Midwives. Released online April 2019, PDF available via each organisation’s website, and here: ClinicalSupervisionJointPositionStatement
Eales, Sandra. (2018). A focus on psychological safety helps teams thrive. InScope, No. 08., Summer 2018 edition, published by Queensland Nurses and Midwives Union on 13/12/18, pages 58-59. Eales2018
Emotional Aftershocks (the story of Fire Extinguisher Guy & Nursing Ring Theory) meta4RN.com/aftershocks
Lalochezia (getting sweary doesn’t necessarily mean getting abusive) meta4RN.com/lalochezia
Nurse & Midwife Support nmsupport.org.au phone 1800 667 877
– we have specifically targeted 24/7 confidential support available
Nurses, Midwives, Medical Practitioners, Suicide and Stigma (re the alarming toll of those who undertake emotional labour) meta4RN.com/stigma
Nurturing the Nurturers (the Pit Head Baths and clinical supervision stories) meta4RN.com/nurturers
Queensland Health. (2009). Clinical Supervision Guidelines for Mental Health Services. PDF
Spector, P., Zhiqing, Z. & Che, X. (2014) Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies. Vol 50(1), pp 72-84. www.sciencedirect.com/science/article/pii/S0020748913000357
Chen, R., Sun, C., Chen, J.‐J., Jen, H.‐J., Kang, X.L., Kao, C.‐C. & Chou, K.‐R. (2020), A Large‐Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID‐19 Pandemic. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12796
End
Thanks for visiting. Let’s join the kindness pandemic to offset some of the crap that goes with the COVID19 pandemic.
As always, your feedback is welcome in the comments section below.
Stay safe.
Paul McNamara, 25 March 2020, with an update on 8 December 2020
The nature of nursing will mean that we are likely to be are exposed to a range of challenges. It’s not unusual for nurses to witness aggression, feel unsafe, have first-hand exposure to other people’s tragedies, and to deal with the physical and emotional outcomes of trauma. This emotionally taxing environment can be pretty stressful. It’s something we should talk about.
I’m often asked to talk about this sort of stuff at inservice education sessions. This page is a 2019 update to support those sessions.
Printed handouts are so last century.
“Self care: Surviving emotionally taxing work environments” is planned as an interactive session accompanied by visual cues to give the discussion a bit of structure. Consequently, the transcript/dialogue of the presentation can not be included here. The visual presentation itself doesn’t use powerpoint slides. It uses the prettier (and free!) platform Prezi instead: prezi.com/skmu0lbnmkm5/first-thyself/#
I’m recycling and combining a lot of old ideas for the 2019 sessions. Self-plagiarism? Nah – it’s a groovy remix of some favourite old songs. Regular visitors to meta4RN.com may recognise the repetition, and be quite bored with me using the website as a place to store updated versions of old stuff. Sorry about that. I’ll pop-up a new and original post in coming days.
Here are the resources and references used in the presentation: (because I’m recycling old ideas this list is ridiculously self-referential).
Australian College of Mental Health Nurses [www.acmhn.org], Australian College of Nursing [www.acn.edu.au], and Australian College of Midwives [www.midwives.org.au] (2019) Joint Position Statement: Clinical Supervision for Nurses + Midwives. Released online April 2019, PDF available via each organisation’s website, and here: ClinicalSupervisionJointPositionStatement
Eales, Sandra. (2018). A focus on psychological safety helps teams thrive. InScope, No. 08., Summer 2018 edition, published by Queensland Nurses and Midwives Union on 13/12/18, pages 58-59. Eales2018
Emotional Aftershocks (the story of Fire Extinguisher Guy & Nursing Ring Theory) meta4RN.com/aftershocks
Football, Nursing and Clinical Supervision (re validating protected time for reflection and skill rehearsal) meta4RN.com/footy
Hand Hygiene and Mindful Moments (re insitu self-care strategies) meta4RN.com/hygiene
Lalochezia (getting sweary doesn’t necessarily mean getting abusive) meta4RN.com/lalochezia
Nurse & Midwife Support nmsupport.org.au phone 1800 667 877
– we have specifically targeted 24/7 confidential support available
Nurses, Midwives, Medical Practitioners, Suicide and Stigma (re the alarming toll of those who undertake emotional labour) meta4RN.com/stigma
Nurturing the Nurturers (the Pit Head Baths and clinical supervision stories) meta4RN.com/nurturers
Queensland Health. (2009). Clinical Supervision Guidelines for Mental Health Services. PDF
Spector, P., Zhiqing, Z. & Che, X. (2014) Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies. Vol 50(1), pp 72-84. www.sciencedirect.com/science/article/pii/S0020748913000357
Zero Tolerance for Zero Tolerance (a reframing of reducing aggression) meta4RN.com/zero
It’s OK if you forget everything about today’s talk, just don’t forget that there is 24 hour support available via 1800 667 877 or https://nmsupport.org.au
On Tuesday 4th December 2018 Naomi Halpern’s workshop “Working with Complex Trauma: The Snow White Model” was delivered at the Royal Brisbane and Women’s Hospital. I was amongst the small group of mental health nurses and social workers who joined the workshop via videoconference from Cairns Hospital. Here are my notes/tweets:
Childhood onset of complex trauma often occurs when the people who were meant to be protective turn out to be harmful to the child = insecure, disorganised attachment @halpernnaomi1#ComplexTrauma
“What we know about mental health professionals is that we’re not immune to childhood trauma… we need to be aware of our own attachment style and how that influences our work” @halpernnaomi1#ComplexTrauma
“A diagram like this is really helpful for our clients so they can understand why they respond they way they do. Psycheducation is an important part of our work.” @halpernnaomi1#ComplexTraumapic.twitter.com/oebNMTU2Ol
“Our responses are hardwired: fight, flight, freeze and submit (tend and befriend).” Aims of psychoeducation are understanding and to address/overcome shame. @halpernnaomi1#ComplexTrauma
Here’s a pearl from @halpernnaomi1: co-write the notes at the end of the session, eg: “What do you think the most important part of today’s session?” Copy it down verbatim, address any misunderstandings on the spot. #ComplexTrauma
What’s Snow White got to do with #ComplexTrauma? For starters:
– mother dies at birth
– father grieving, is emotionally absent
– remarries: the step-mother has a few problems
– narcissist step-mother mistreats + attempts to kill Snow White
– father isn’t protective@halpernnaomi1pic.twitter.com/1WMM3f5FiX
New (to me): maladaptive daydreaming = prolonged, induced daydreaming which interrupts/prevents IRL relationships. Often (not always) includes disassociation @halpernnaomi1#ComplexTrauma
Another @halpernnaomi1#ComplexTrauma pearl: We all have parts of self, and working with parts can be very helpful. eg: “That’s what the scared part of you feels Are there other parts of you that aren’t so scared? Parts of you that can think about things differently?”
This section of the @halpernnaomi1#ComplexTrauma workshop explores the different parts of Snow White: Doc, Grumpy, Happy, Sneezy, Bashful, Dopey, Sleepy, Dead Snow White, Prince Charming, Step-Mother, Huntsman, Father.
Terrific, interesting concept/frame. Too detailed to Tweet.
Impulse control is more difficult for people a history of #ComplexTrauma. Behaviours like drinking too much, starving yourself and self-harm serve to soothe and distract. @halpernnaomi1
New (to me): the concept of “fire season” where the client/therapist/service moves from crisis to crisis to crisis.
When there’s ALWAYS an emergency response, there’s no time for cleaning-up, back-burning, learning lessons and future planning. @halpernnaomi1#ComplexTrauma
If we focus on the solution to the problem (eg: substance abuse, eating disorder or self-harm) we might be missing the point. Those behaviours are being used for distress reduction.
It can be difficult to see and understand where you and your client are on Karpman’s drama triangle. It’s helpful when managing transference, countertransference and outside relationships. @halpernnaomi1#ComplexTraumapic.twitter.com/210PZWnf9P
A small cheer goes up in the Cairns Hospital videoconference site when @halpernnaomi1 emphasises the importance of clinical supervision when we work with people who have experienced #ComplexTrauma (there are some @CSorgau peeps here 🙂)
Another good @halpernnaomi1#ComplexTrauma tip: Don’t be afraid to use props (cushion, ball, drawings, movement) in therapy, especially if the client is numbed/shut-down. Just practice what you’ll use/do with a colleague first.
Re therapeutic use of self: it’s a relationship that can assist rewiring the brain through co-regulation, attunement, present moments @halpernnaomi1#ComplexTrauma
Both the therapeutic relationship and the client’s informed consent will need to be renegotiated. The client needs to feel in control. @halpernnaomi1#ComplexTrauma
Another @halpernnaomi1#ComplexTrauma tip: Use writing to articulate internal communication/dialogue.
Ask the question by writing with your dominant hand.
Answer it by writing with you non-dominant hand.
Start with something benign. Take time before tackling distressing stuff.
The psychoeducation, insight and reflection, mindfulness and mentalization aspects of therapy are the work of the prefrontal cortex. @halpernnaomi1#ComplexTrauma
“Working with Complex Trauma: The Snow White Model” ends with a reminder that the wicked Queen dies, Prince Charming arrives, and Snow White becomes fully integrated and lives happily ever after.
A terrific #ComplexTrauma workshop. Thanks @halpernnaomi1! 🙂
Some people take notes in workshops using ye olde method of pen and paper. I’m not criticising – pen and paper are cute and quaint. But how on earth do they find their notes quickly and easily after the workshop has ended?.
I tweet my notes. They’re quickly and easily retrieved via phone, tablet or computer at anytime. Sometimes, if the presenter is OK with it, I collate workshop/conference tweets and plonk them all on my webpage for even quicker and easier future reference. That’s what this is all about.
Also, sometimes I have trouble explaining to other health professionals why I’m enthusiastic about Twitter for work-related stuff. It’s easier to show examples of how I use it, rather than just chin-wagging and flapping-about like a chook in a cyclone.
End
Sincere thanks to Naomi Halpern (aka @halpernnaomi1) for an engaging, informative workshop. For a single person to hold the attention and interest of those of us who were joining via videoconference for a whole day is very impressive. Also, I’m grateful to Naomi for agreeing to my request to collate these tweets here.
That’s it. As always, your feedback is welcome via the comments section below.
On Monday 17th September 2018 I’ll be presenting to the Cairns & Hinterland HHS palliative care team regarding clinical care and clinical supervision. It is planned as an interactive session accompanied by visual cues to give the discussion a bit of structure. Consequently, the transcript/dialogue of the presentation can not be included here. The visual presentation itself doesn’t use powerpoint slides. It uses the prettier (and free!) platform Prezi instead: http://prezi.com/gtsqjgs9zdby
This page serves as a one-stop directory to the online resources used to support the discussion, and as an easy way for me to find the presentation. 🙂
I’m recycling and combining a lot of old ideas for the session (there’s that self-plagiarist vs groovy remix of favourite old songs thing again), so this list below is ridiculously self-referential:
Football, Nursing and Clinical Supervision (re validating protected time for reflection and skill rehearsal) meta4RN.com/footy
Hand Hygiene and Mindful Moments (re insitu self-care strategies) meta4RN.com/hygiene
Joseph Heller quote from Catch-22 (1961): “People knew a lot more about dying inside the hospital, and made a much neater, more orderly job of it. They couldn’t dominate Death inside the hospital, but they certainly made her behave. They had taught her manners. They couldn’t keep death out, but while she was in she had to act like a lady.”
On 21st December 2012 (Cairns time) nurses from the United Kingdom and Australia came together on Twitter using the #WeNurses hashtag. The planned Twitter chat was used to discuss issues raised by the much-publicised death of a nursing colleague – Jacintha Saldanha.
This curated version of the Twitter chat demonstrates nurses using social media in a constructive manner, and responding to the issues surrounding Jacintha’s passing with thoughtfulness and grace. This was in sharp contrast to the shrill, insensitive and ill-informed way the matter was discussed elsewhere on social media and in mainstream media in the UK and Australia.
I’ve used sub-headings in red to structure the chat as per the themes that emerged.
WordCloud created from the full transcript of the #WeNurses Twitter chat
Preliminary Information.
1.
1 hr until tonights joint UK / AUS #WeNurses chat – a sensitive subject tonight that we are hoping to learn from > http://t.co/3GRJMsuW
Unfortunately, Storify is shutting-down on 16 May 2018 and all content will be deleted.
I’m using my blog as a place to mimic/save the Storify pages I created and value.
End Notes
This archive of Tweets relate directly to two blog posts I wrote at the time. If you’re interested in elaboration re the context at the time, please visit these pages:
Questions of Compassion meta4RN.com/questions-of-compassion
WeNurses: Communication and Compassion meta4RN.com/WeNurses
As always, please use the comments section below for any feedback/questions.
The nature of nursing will mean that we are likely to be are exposed to a range of challenges.
Feeling unsafe, witnessing violence, tragedy and dealing with trauma are some examples.
This emotionally taxing environment can result in tension with colleagues, family and friends.
This session will begin day two of the conference by creating an opportunity to discuss the following:
What are the professional implications of working in challenging areas of nursing and healthcare?
How can we maintain unconditional positive regard?
Why self-care matters and how to practice what we preach!
What’s all this then?
“First Thyself” is planned as an interactive session accompanied by visual cues to give the discussion a bit of structure. Consequently, the transcript/dialogue of the presentation can not be included here. The visual presentation itself doesn’t use powerpoint slides. It uses the prettier (and free!) platform Prezi instead: prezi.com/skmu0lbnmkm5/first-thyself/#
This page serves as a one-stop directory to the online resources used to support the discussion.
I’m recycling and combining a lot of old ideas for the session (there’s that self-plagiarist vs groovy remix of favourite old songs thing again).
Here are the resources and references used in the presentation:
Emotional Aftershocks (the story of Fire Extinguisher Guy & Nursing Ring Theory) meta4RN.com/aftershocks
Football, Nursing and Clinical Supervision (re validating protected time for reflection and skill rehearsal) meta4RN.com/footy
Hand Hygiene and Mindful Moments (re insitu self-care strategies) meta4RN.com/hygiene
Lalochezia (getting sweary doesn’t necessarily mean getting abusive) meta4RN.com/lalochezia
Nurse & Midwife Support nmsupport.org.au phone 1800 667 877
– we have specifically targeted 24/7 confidential support available
Nurses, Midwives, Medical Practitioners, Suicide and Stigma (re the alarming toll of those who undertake emotional labour) meta4RN.com/stigma
Nurturing the Nurturers (the Pit Head Baths and clinical supervision stories) meta4RN.com/nurturers
Spector, P., Zhiqing, Z. & Che, X. (2014) Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies. Vol 50(1), pp 72-84. www.sciencedirect.com/science/article/pii/S0020748913000357
Zero Tolerance for Zero Tolerance (a reframing of reducing aggression) meta4RN.com/zero
It’s OK if you forget everything about today’s talk, just don’t forget that there is 24 hour support available via 1800 667 877 or https://nmsupport.org.au
Nurses and other health professionals are expected to attend to hand hygiene about eleventy seven times a day. The WHO and HHA recommend 5 moments for hand hygiene: before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient, and after touching patient surroundings. 57.4% of Australia’s nurses/midwives are hospital/ward-based [source], they’re doing A LOT of hand hygiene.
On top of that, while they’re going about their business and busyness, ward-based nurses are interrupted10 times an hour [source]. Yep, every 6 minutes there’s something or somebody distracting us from our tasks and thoughts. Dangerously disorderly much? Hopefully that doesn’t happen to neurosurgeons, commercial airline pilots, tattoo artists or Batman.
Especially Batman.
Pro-Tip: most of us can not do this at work. Only respond to distractions with face-slapping if you are Batman.
So, here’s the idea: if you’re going to do hand hygiene dozens of times a day anyway, don’t just do it for your patients: do it for yourself too. We’re not cold callous reptilian clinicians, we’re educated warm-blooded mammals who do emotional labour. We need to nurture ourselves if we are to safely continue to nurture others.
5 moments for hand hygiene & head hygiene!
Turn the 5 moments of hand hygiene into mindful moments. Make the 5 moments for hand hygiene 5 moments for head hygiene too. Yes, clean hands save lives – let’s not forget that clear heads save lives too!
Come up with a process/script that works for you, maybe something a bit like this:
Mindful Moment (The 30-Second Handrub Version)
Step towards the pump bottle with intent. This is my mindful moment. I’m taking a brief break.
Squirt enough to squish.
The rub is slippery at first. Frictionless fingers feel fine.
Feel the product texture and temperature. The rub is cooler than the air. The rub is cooler than my fingers. It feels nice.
Start with cleaning. The first half of my hand hygiene routine is about rubbing stuff off. Let the stuff I want to get rid of float away.
Move on to restoration, healing. The second half of my hand hygiene routine is about rubbing in resilience and health. Let the stuff that sustains me seep into my skin.
Check in on the breathing. The slower and deeper the better. If the breathing or the brain are running too fast, slow down and repeat steps 5 and 6.
There’s no rush. Slowly scan the surroundings. With any luck someone from infection control is watching.
Smile.
Breathing slowly, its time let the air rinse off the residue.
One more slow breath. Its time to get back to work.
Mindful Minute (The 60-Second Handwash Version)
Step towards the sink with intent. This is my mindful minute. I’m taking a brief break.
Let the water flow.
Feel the water flowing over both hands. The water’s warmer than the air. The water’s warmer than my fingers. It feels nice.
Start with cleaning. The first half of your hand hygiene routine is about washing stuff away. Let the stuff you need to get rid of flow down the drain. Let it flow away.
Move on to restoration, healing. The second half of my hand hygiene routine is about rubbing in resilience and health. Let the stuff that sustains me seep into my skin.
Check in on the breathing. The slower and deeper the better. If the breathing or the brain are running too fast, slow down and repeat steps 5 and 6.
There’s no rush. Slowly scan the surroundings. With any luck someone from infection control is watching.
Smile.
Breathing slowly, its time rinse both hands.
Breathing slowly, its time to thoroughly dry both hands together.
Throw the towel in the bin.
One more slow breath. Its time to get back to work.
Clean hands save lives. Clear heads save lives too!
Acknowledgements & Context
This is not my original idea. I first stumbled across the idea of combining hand hygiene with head hygiene via Ian Miller‘s November 2013 blog post “mindfulness during handwashing”: http://thenursepath.com/2013/11/18/mindfulnurse-day-8/. I’ve been using the idea myself and suggesting it to colleagues and students ever since. When I left the clinical environment for a few months, I found myself really missing intentionally punctuating my day with mindful moments. Since returning to clinical practice I’ve come to appreciate the strategy even more than I did when I first started using it 3 years ago.
So why am I blogging about it too? Why now? Well, on Monday I attended the Australasian College for Infection Prevention and Control 2016 conference to chat about Twitter [link to that presentation here. Also, check-out the #ACIPC16 hashtag here and here]. Luckily I was there for the opening plenary sessions, and was pleasantly surprised at the emotional/psychological literacy that was being displayed and advocated for. The opening presentations by Peter Collignon, Mary Dixon Woods and Didier Pittet all went to some lengths to emphasise the importance of emotional intelligence, constructive communication and building relationships. It was really impressive stuff; giving the hand hygiene and mindful moments idea a remix is my way to give recognition/thanks to the #ACIPC16 conference delegates and organisers.
Just so you know, a quick google search reveals that others have also thought of using hand hygiene as a mindful moment, eg this paper:
Gilmartin, Heather. (2016) Use hand cleaning to prompt mindfulness in clinic: A regular prompt for reflection could reduce distraction. BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i13 (Published 04 January 2016)
and this video:
There are others too. Do you think using hand hygiene as a mindful moment could become mainstream?
End
That’s it. As always your comments are welcome via the space below.
meta4RN 