By Ann Williamson, PhD, RN, NEA-BC
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Creating a nursing workforce that is resilient to occupational stress and burnout is critical for engagement, job satisfaction and retention, as well as the overall success of any healthcare organization.
While nurses are perhaps the greatest stewards of patient care, because they work on the front lines of care delivery – they are also one of the most likely caregiver groups to experience the negative effects of occupational stress. According to statistics noted in publications such as Clinical Psychology: Science and Practice and the International Journal of Osteopathic Medicine, approximately 40 percent of nurses experience occupational burnout.
To help nurses, as well as other caregivers, alleviate occupational stress and avoid burnout, Cleveland Clinic Abu Dhabi is in the process of implementing a commonly preferred stress management and self-care technique – mindfulness.
Throughout the years, an abundance of research has been devoted to the study of self-care techniques in healthcare professionals. Several studies, such as The Art and Science of Mindfulness: Integrating Mindfulness into Psychology and the Helping Professions, by Shauna L. Shapiro, PhD, and Linda E. Carlson, PhD, have shown that mindfulness initiatives can lead to decreased perceived stress and significantly increased self-compassion.
The overall goal with mindfulness interventions is to provide caregivers with practical, easy-to-use tools and resources to build their resilience. There are a number of reasons why mindfulness interventions are preferred over other self-care approaches for healthcare professionals. One of the most prominent is that mindfulness skills can be used all the time – not just when people are in high states of stress, like with other stress management interventions.
The new mindfulness program at Cleveland Clinic Abu Dhabi, known as the ‘Compassionate Intension Program,’ is designed to help caregivers build resilience so they can better cope with the rapid changes and uncertainty that are staples of the healthcare industry. Additionally, the program caters to the unique needs of Cleveland Clinic Abu Dhabi’s healthcare team.
Cleveland Clinic Abu Dhabi first started seeing patients in January 2015. To prepare for the arrival of patients, the organization recruited thousands of healthcare professionals from 70 countries.
Not only did these caregivers start new jobs, most also moved into a new home in a new country – experiencing three of life’s major stressors, all at the same time. Additionally, being a new hospital, the systems and routines of care at Cleveland Clinic Abu Dhabi have been in a process of development, which has incurred added changes and adjustments as processes are refined.
Since the hospital has become fully functioning, the leadership team has been closely monitoring engagement scores, focus group reports, culture of safety data, and exit interviews to examine levels of caregiver stress and emotional exhaustion. The feedback and results have shown higher levels of stress than desired.
Thus, the Cleveland Clinic Abu Dhabi Leadership Council and Recruitment and Retention Council determined that a mindfulness program could help lower caregiver stress. The program is being led by Suzi Robertson-Malt, PhD, APRN, FRCN, FOM, Director, Clinical Education, Evidence-Based Practice and Magnet®, and Sahar Andesha, Program Manager, Magnet. Currently, a full-scale research study is being conducted by a selection of physicians and other Cleveland Clinic Abu Dhabi caregivers. However, to date, a selection of mindfulness sessions have been implemented into caregiver training and professional development initiatives and have garnered extremely positive, unsolicited feedback.
The sessions are designed to introduce caregivers to mindfulness as a wellness tool they can utilize in both their workplace and personal lives. Currently, there are three sessions in place:
- In Tune Tuesdays: Held biweekly, ‘In Tune Tuesdays’ are 20-minute classes designed to further educate attendees on mindfulness and how to improve mindfulness in their work environment. The classes are held at three different times to accommodate caregiver schedules.
- Mindfulness Rounding: Also a biweekly activity, ‘Mindfulness Rounding’ features a team of mindfulness experts who visit clinical units. The experts conduct learning huddles and one-on-one conversations with caregivers, sharing quick tips. Their pocket cards or guides offer information on easy-to-implement mindfulness techniques.
- Introduction to Mindfulness Workshop: This 8-week workshop, featuring 1-hour weekly sessions, was developed around the evidence-based standards of mindfulness experts, including, Jon Kabit-Zinn, PhD, of the University of Massachusetts Medical School, Center for Mindfulness, and Richard Davidson, PhD, of the University of Wisconsin’s Center for Healthy Minds and Oxford University’s Mindfulness Center. It offers a deeper dive into various mindfulness techniques.
Part I of II
This article is the first in a two-part series. Upon completion of Cleveland Clinic Abu Dhabi’s research study on caregiver mindfulness, a second article will reveal the study’s findings, notable highlights, successes of program implementation, and more.
Dr. Ann Williamson is the Chief Nursing Officer of Cleveland Clinic Abu Dhabi.