Experiences of pre-licensure and post-licensure nurses participating in mindfulness training: A qualitative study

Abstract

<p>Session presented on Sunday, July 26, 2015:</p> <p><strong>Purpose:</strong> The current healthcare environment burdens nurses with multiple demands on and of their attention. Nurses are faced with multiple requests from patients, families, and other health care providers that often leads to the need to resort to multi - tasking. Multi-tasking and interruption in the work place is associated with an increase in errors (Brooks, 2011). Further, ever- present technological devices are altering human attention spans, and how they relate to one another (Goldstein, 2013). Studies have found that healthcare providers who are unfocused, and less attentive are more likely to rush to judgment and demonstrate faulty thinking (Rakel, Fortney, Sierpina &amp; Kreitzer, 2011). Distracted health care providers have greater numbers of incorrect diagnoses and increased medical errors (Ludwig &amp; Kabat-Zinn, 2008; Sibinga &amp; Wu, 2010). In an effort to increase awareness, mindfulness practice has shown to be effective ( Weitz, Fisher, &amp; Lachman, 2012). Mindfulness training in healthcare providers is associated with improved empathy, increased attentive listening skills, decreases in provider burn out, and attitudes associated with patient centered care (Krasner, et al., 2009). Despite mindfulness practice being beneficial, many individuals struggle to successfully incorporate the practice into their lives on a long -term basis (Sitzman 2002). Practicing takes a strong commitment, and ongoing effort. Many people find that they struggle to find the time in their day to practice and become frustrated and deterred from continued practice when their minds continue to wander ( Kvillemo, &amp; Branstrom, 2011). Progress may be slow and contribute to feelings of wanting to give up (White, 2014). Mindfulness is a state of paying attention in a non-judgmental way with an increased awareness of the present experience. Mindfulness has the goals of developing clearer thinking, and sustaining awareness of a moment by moment experience, all while separating oneself from judgment of the situation and from strong emotions. Teaching and practicing mindfulness in medicine has been shown to decrease stress levels, improve coping skills, increase empathy as well as improve patient outcomes and safety, however the implementation of mindfulness programs and research in nursing lags behind (White, 2013).</p> <p><strong>Methods:</strong> This study aimed to explore the experiences of pre licensure nursing students and post licensure nurses who participated in mindfulness training. Following IRB approval potential participants were recruited from a School of Nursing in the South Eastern United States to participate in an 8- week mindfulness training program. Participants included pre licensure and post licensure nurses. A mindfulness training program was developed by the principal investigators and a mindfulness expert. The sessions were previously recorded live audience sessions, and were shown at each of the meetings during the study. Each session was facilitated by trained faculty and consisted of education on mindfulness, guided practice, and discussions around participants' feelings during practices. Sessions were held several times during the week and additional resources including self guided audio podcasts were provided. Sessions lasted less than 1 hour. Participants were provided with journals to record their thoughts, feelings, and emotions as they journaled through the multi week study. In addition, the journals were used to have the participants record their responses to prompting questions that were provided following each session. The journal entries served as the qualitative data source for this study. A qualitative descriptive approach was used to describe the experience of participants as they took part in the mindfulness training. After each training session, each participant was asked to reflect on their thoughts, feelings, and sensations during the mindfulness practice, as well as to reflect on additional prompting questions asked for that session.</p> <p><strong>Results:</strong> A total of 27 participants completed the qualitative portion of the study. Participants were asked to describe the thoughts, feelings and sensations that arose during practice sessions. One key theme that was identified was an increase in participant's self -awareness. Participants noted they were able to take a pause during stressful situations and avoid getting caught up in the turmoil. Another key theme was related to the process of mindfulness practice and the participant's ability to over the obstacles. Positive consequences of mindfulness training reported by participants include feelings of relaxation and calmness following and during practice. Longitudinally as the weeks progressed, a trend in the participants' awareness of their mind wandering and their improved ability to refocus was found. Participants were also asked to describe what they learn about themselves and others through the mindfulness training. The main findings included participants reporting living more in the moment, finding themselves less likely to overreact, and improvements noted in being able to stay calm in stressful situations.</p> <p><strong>Conclusion:</strong> Findings from this study indicate a need for mindfulness training and research in the nursing field. This study illuminated the benefits of a mindfulness practice. Participants articulated improvements in their ability to stay in the moment, react to stressful situations in a more thoughtful and calm way, and a decrease in tendencies to overreact. These realized improvements of attention to the moment, control of emotions, and stress coping may lead to better and more mindful provider - patient interactions, improvements in patient safety, and better patient outcomes. These findings provide evidence to support offering mindfulness training in academic and clinical settings. The key in offering this training will be to provide time, space, and support to bolster the chances that sustained efforts, and commitments to practice can be maximized.</p>