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Mindfulness: A Nursing Perspective Mary Jo Kreitzer PhD, RN, FAAN

Mindfulness: A Nursing Perspective Mary Jo Kreitzer PhD, RN, FAAN. Florence Nightingale. “ Never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard seed germinates and roots itself. ”. Overview.

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Mindfulness: A Nursing Perspective Mary Jo Kreitzer PhD, RN, FAAN

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  1. Mindfulness: A Nursing Perspective Mary Jo Kreitzer PhD, RN, FAAN

  2. Florence Nightingale “Never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard seed germinates and roots itself.”

  3. Overview • Mindfulness and Nursing • Why is it relevant? • Why might it be difficult? • Clinical Applications of Mindfulness Interventions • Applying Mindfulness in Our Lives • Self-Care • Wellbeing

  4. Why relevant? • As nurses are in a privileged profession. On a daily basis, we witness and encourage human growth and courage; human liberation and transformation. We touch the most vulnerable and value-laden aspects of life.

  5. In many ways, nursing is the most intimate profession.

  6. Presence • Fully conscious and aware. • Deeply listening. • Relating in a way that reflects a quality of “being with” vs. “doing for”.

  7. Presence • Physical • Psychological • Therapeutic

  8. Mindfulness is a way to cultivate our capacity to be fully present.Mindfulness is not a technique, it is a way of being

  9. Pause:Think about your most recent encounter at work, with a patient or colleague. Were you truly present?

  10. Why might this be hard for nurses?

  11. We live and work in a world of multitasking and expectations of high productivity.

  12. We have been conditioned from an early age to live in the future.

  13. Paying attention on purpose, in the present moment, non-judgmentally …

  14. Hardest Work in the World

  15. To grow into the fullness of who we actually are is the challenge of a lifetime for each of us as human beings. Jon Kabat-Zinn

  16. Clinical Applications Mindfulness can be used as a useful adjunct to almost any therapy. Not meant to replace other psychotherapy theories, techniques and skills. An approach or attitude, not an artificial, manipulative technique.

  17. To be effective, it is also an approach that needs to be lived and practiced, not just read and talked about.

  18. “A therapist has to practice being fully present and has to cultivate the energy of compassion in order to be helpful.” Thic Nhat Hanh

  19. Mindfulness The emphasis is on staying in the present moment, with a non-judging, non-striving attitude of acceptance.

  20. Meditation • Meditation is a self-directed practice for relaxing the body and calming the mind. • In many traditions, is used to achieve insight and expanded awareness. • People can meditate while sitting quietly, chanting, or moving mindfully.

  21. Mindfulness-Based Stress Reduction • 8-weekly 2.5-hr classes, daylong retreat • Practices: body-scan, sitting meditation, walking meditation, mindful eating, gentle yoga • Didactic information on stress and health

  22. Research on Mindfulness Meditation

  23. Mindfulness Meditation Improve Mood Improve Sleep Improve Immune System Change Your Brain

  24. Measures Self-Report Immune Changes Telomeres Brain Scans

  25. Clinical Research Pain Anxiety Depression Hypertension Psoriasis

  26. Clinical Research Solid organ transplant recipients Insomnia Cancer recovery Caregivers of people with AD Dual diagnosis of CD and TBI

  27. Changes in the Brain • Meditation is correlated with significant changes in brain function. • Increase in gamma waves. • Activity in left pre-frontal cortex (positive emotions) greatly exceeded activity in right pre-frontal cortex (anxiety and other negative emotions).

  28. Mindfulness Meditation and Brain Structure 8 week MBSR course associated with measureable changes in the brain regions associated with memory, sense of self, empathy, and stress. People are not just feeling better because they are relaxing! Psychiatric Research: Neuroimaging Jan 30, 2011

  29. Positive Emotions Affect our brain function and change our behavior. Flood our brains with dopamine and serotonin – chemicals that not only make us feel good, but also increase our capacity to learn, organize information, and make and sustain neural connections. Meditators are capable of growing the left prefrontal cortex, the part of the brain most responsible for feeling happy.

  30. “Mindset” doesn’t just change how we feel about an experience – it actually changes the objective results of that experience.

  31. Pause:Notice the quality of your awareness now without judging it; simply notice.

  32. Mindfulness-Based Cognitive Therapy Designed to prevent depressive relapse for people who have had 3 or more depressive episodes. Traditional CT targets change in the content of a person’s thoughts. (notice a thought and question the evidence for or against the thought)

  33. Mindfulness-Based Cognitive Therapy Thoughts are seen as impermanent, passing moments that are not necessarily true. Participants practice activities that generate feelings of pleasure and mastery.

  34. Dialectical Behavior Therapy Marsha Linehan Used with people with borderline personality disorders. Involves teaching mindfulness to help with emotional regulation. Focuses on the concept of “radical acceptance” – letting go of struggling against reality.

  35. Dialectical Behavior Therapy Marsha Linehan Concept of dialectics is used in helping clients balance acceptance and change. Examination of opposing perspectives and arriving at some synthesis or integration. DBT emphasizes finding a balance between reasonable mind and emotional mind – called wise mind.

  36. ACT – Acceptance and Commitment Therapy Based on mindfulness model of human psychological wellbeing. Invites clients to bring mindfulness into their day to day experiences.

  37. Mindfulness-Based Relapse Programs Chemical dependency Smoking

  38. Mindfulness-Based Programs Mindfulness-Based Cancer Recovery MB-EAT – eating awareness program EMPOWER – enhancing mindfulness prevention of weight gain Mindful Parenting Mindfulness-Based Relationship Enhancement

  39. Mindful Practice Intention Attitude Attention

  40. Intention sets the stage for what is possible. It is a direction, not a destination.

  41. Attention – a deep and penetrating focus, not simply grazing the surface. Attention that is discerning, non-reactive and sustained.

  42. Focus An unstable mind is like an unstable camera.

  43. Attitude: open hearted compassion- curiosity- openness- acceptance- love

  44. Pause:Do you notice when your mind wanders and when it is concentrated, when your interest peaks and when it wanes, when you feel urgent and when you are relaxed?

  45. Mindful Nurse Mindfulness is a way of being in the world. Cultivating the qualities of kindness, compassion, joy and equanimity.

  46. Mindful Nurse We need to extend that perspective and those qualities beyond those we care for. Self-care – we cannot give what we do not have.

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