Mindfulness: Teacher Training

Mindfulness and the Emergency Healthcare Professional

Chapter 12: Front-line ‘transformers’

To recap:

  • Mindfulness for busy people is a discipline and an attitude, supported by regular practice
  • It is like a lens, through which we can view each event in the unfolding day
  • We can use mindfulness to transform our unhelpful reaction patterns

There’s no time for toilet breaks, let alone mindful breaths…and as for that mindful workplace stuff – give me a break!’

That kind of comment may sound familiar to most of us.  And there is no doubt that through our working days in the ED, we are ‘on the go’ from shift start until much later, with breaks truncated, and going from patient to patient it may seem as though we are just in a kind of survival mode

So, what’s the relevance of mindfulness to this…

Let’s maybe rearrange the end of that sentence to ‘a survival of kind mode’

A very few people working on a shift with an attitude of kindness can transform the enjoyment of the shift for everyone, and most importantly, for the patients’ experience.  Those people may be medical staff, nurses, administration or reception staff, or environmental services and catering staff.  The influence of our attitude and energy that we radiate throughout our day goes way further than we imagine.  In distant areas of the hospital, staff who you may have never met will be influenced by you, and so in turn will their care for patients or their role in the hospital be affected, either positively or negatively.  I know this, from my own clinical life as an emergency physician.

If that number of ‘transformers’ is only one person, the power to positively impact the energy and resilience of other staff members is still significant, but if two or more are working actively to support everyone around them, to help steer conversations away from negativity, and to demonstrate consistent compassionate care, the cumulative positive effects can be enormous. 

“Show me the data…”

Many people working in the front line of emergency medicine already know this, and are taking action to become the transformers within their workspaces.

I recommend the resources of our FACEM colleagues at WRAP EM, who are developing ED wide mindfulness, wellness and resilience innovations, and other Australian EDs have introduced ‘appreciation notice boards’ and related initiatives, to help acknowledge and strengthen the culture and morale of their teams, for example the Learning from Excellence (LEX) programme in the Royal Hobart Hospital ED

These examples of ‘team mindfulness’ do of course overlap with individual mindfulness, but what is exciting is that these programmes create positive change across the wider ED and hospital workforce, thereby developing increased whole-staff wellness, stress resilience and a healthy team culture, using principles derived from mindfulness.

“That stuff is the Director’s role…”

It is easy and appealing perhaps to think that we are not really responsible for nurturing every other person in our ED or workspace, and that some conversations matter more than others, or some interpersonal interactions are more important than others.  Mindfulness and meditation show us that we cannot hide behind our titles, labels and other artificial classifications, particularly in the way we relate to others.  Delving into ourselves usually brings up an uncomfortable awareness of any inconsistencies and half-truths that we need to transmute into more authentic patterns of relating to others.

Change in culture within an ED (or anywhere) requires a small dedicated nucleus of people, and while it is certainly important for Directors and Managers to be aware of emotional intelligence and mindfulness, there is no reason why any person or people within a workspace cannot become transformers and initiators of mindful culture change.  You can be the change you want, as the saying goes.  The quality of your light affects everything around you, in ways you may have never believed possible. 

Mindfulness practice session

In one of your scheduled morning mindfulness sessions, try doing the following exercise to demonstrate what we have covered so far…. Even better, perhaps discuss this concept at a ward meeting or planning session. 

Preparation time: 10 minutes

Level of difficulty: Easy

  • Settle into a chair for the session
  • Use a breath awareness or another transition technique*
  • With each out-breath, imagine you are sliding further down into complete stillness
  • Notice any distractions that ‘pull you back’
  • When you notice that you have been distracted, simply resume the transition technique
  • When you realise that you have reached that ‘bottom of the ocean’ stillness, do nothing else
  • Just sit at this level and enjoy that slow, spacious thinking
  • Now see yourself as being deeply responsible for distributing this stillness, and a powerful level of genuine care, to all the people who you will see today after this session of mindfulness
  • See yourself as a transformer, taking the inner qualities that you are exploring for your own growth, and giving them away freely to others you will meet
  • As you breathe at this stillness level, see yourself opening up progressively to operate in this new role
  • Be open-minded about this exercise having a real and positive effect on those around you as you undertake your work today
  • When you are ready, slowly come out of the session, using your breath and beginning to move your muscles and limbs
  • Open your eyes and when fully awake, resume your day
  • Thankyou

*For information on transition techniques see Article 006 – tools for transitions and 007: it’s all in your imagination

“I can’t teach this stuff”

We teach in every moment, as we walk down a corridor, or show respect to other drivers on the road.  We teach our students and colleagues when they see the way we handle delays or other staff at work.  In the ED, we are always on open display, and are observed by others continuously.

If we allow ourselves to attack a colleague verbally, or deliberately embarrass someone, we are teaching.

If we use offensive or sexist language, we are teaching.

So, with such public exposure and educational authority, we have a choice to make.

Do we pretend that we don’t need to be consistent at all times, or do we jump into the idea that we are always teaching, always influencing culture, always being visible role-models, and always demonstrating what kind of transformer we want to be in our workspace?  And do we apply mindfulness concepts not just occasionally, but all the time once we realise how widely these concepts are being introduced across work spaces?

Of course we are teachers, and you and I also, whether we like it or not. 

Seeing yourself as a custodian

Seeing yourself as a custodian of the whole work space (or the whole ED) creates a sense of responsibility for all the people who come into your ED.  What you do matters, and it sure is noticed.  With mindfulness strategies, and some regularity of practice, you will enhance your own stress resilience and wellbeing to such an extent that you will feel you do have enough to give back to others.

If you are burnt out, you will be a lousy custodian and ED role-model.  Do what you need to change that, back towards balance.  Maintaining inner balance is homework we all must do.

And then, you will become the change you want, the role-model who lifts the spirits of all the people you meet at work.  Others will certainly notice that you radiate something special, but they can’t quite put their finger on what it is…

This is all possible, amidst the noise and haste of our ED working lives.

Thankyou for reading this, and take care of yourself

Further reading

Waiver: These articles represent my own views and approach to mindfulness, and do not purport to be the official view of ACEM.  They are not intended to replace appropriate medical or mental health care, provided by professionals in these domains


Prof Andrew Dean LITFL Author
A/Prof Andrew Dean, MBBS FACEM Grad Cert Clinical Simulation. Emergency Physician and DEMT at St John of God Hospital, Ballarat, Victoria, Australia. Head of Ballarat Rural Clinical School, School of Medicine Sydney, University of Notre Dame Australia.
Still searching for new and innovative teaching methods for emergency medicine education.  Also a committed advocate for mindfulness meditation, and the nurturing of emotionally intelligent clinical teams in health care.

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