Mindfulness: the terminology of stress

Mindfulness and the Emergency Healthcare Professional

Chapter 2: the terminology of stress

I agree that I am stressed, but I can’t change that

We all have default ways of reacting to stress and these “built in” patterns are regarded as fixed, or intrinsic, parts of our personality. 

He is just like that; he can’t help it.  It is just a pity he is the Director!

We react emotionally and physiologically to stressful situations and people around us at work or home, and may be triggered to be annoyed, angry, resentful or to lose our sense of equilibrium and balance.  These emotional reactions may be externalised (so called “outbursts”), or kept within while we maintain a calm exterior to the world (I suppose you could call the internalised reaction an “inburst”).  Either pattern of reaction can be destructive, and can adversely affect our health as well as our relationships, and the ED “culture” in our workspaces.

Why do we accept so much pain, caused by this emotional reactivity?

These reaction patterns to stress are commonly regarded as being “hard wired”, a part of our personalities, or an inevitable consequence of our life experiences.  We repeat these often painful, recurring patterns of reactions to external events, and this can be incredibly exhausting and can also contribute to feelings of “burn-out”.

Mindfulness research tells us that none of us are as “hard wired” as we may think, and that our default reaction patterns can be changed with even relatively brief practice of mindfulness techniques.  Setting aside a few minutes each day starts this process.

It could be just by catching ourselves at the start of a familiar irritable feeling, and reminding ourselves that there is another way to see the situation that seems to be triggering us. Taking a few slow breaths, and moving briefly away from other people if we can, creates a mental space for our mind to reset.

A bit like the methods we use in an ED resuscitation, when we recap, invite group inputs, and summarise how the patient is responding to our care. These strategies are healthy.

Starting your day with a few moments of mindfulness practice – keep it really simple, do the three slow consecutive breaths exercise, and envisaging your day going really well – will give you a new way of reacting to stress.  Or rather, a strategy for reacting less to stress than you otherwise might have previously. 

Keeping a discipline like this, even if only for a few conscious slow breaths, starts an internal process of change.  “Brain training” if you like.  It works for dogs, so why not brains?

But I still don’t see the point of all of this...

And I would completely agree with you that it is not for everyone.  But with really diverse and unlikely groups – including primary school kids (seemingly everywhere, these days!), prisoners, US Air Force pilots and ex-criminal shipyard workers in Alaska – incorporating mindfulness into their daily workplace routines, there has to be something to it that is worthy of our consideration.  Why would they do it otherwise?

So, does it actually help you?

I know that my own various roles in the ED and Hospital environment are dramatically enhanced by having the backdrop of daily mindfulness routines.  Hands down, no argument. Less stress, less conflict, less defensiveness, better health.  I could simply not do it all, without mindfulness.  Period. 

For me it is the beginning of the day, but particularly the end of the day when the world gets quiet.  Funny thing is, within the day, when we assume we will have no spaces for this stuff, there actually are many opportunities for brief mindful moments – waiting for coffee, walking to CT to get a verbal report, typing up notes – when we can recalibrate and do a mental “check in” on ourselves.  A quick “maintenance check” on the hard drive perhaps.

Next time let’s get into specifics and away from the general discussion about benefits. Here we provide a worked example of Airway, Breathing, Mindfulness… Because unless you actually try it, it is just theory…

Take care of yourself and thanks for reading.

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


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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