Most hospital environments are fertile breeding grounds for caregiver stress: exposure to occupational hazards, discrimination, physical and psychological violence, insufficient remuneration, unfavorable work-life balances, unreasonable work loads, and limited career development opportunities. (See "Positive practice environments for health care professionals.")
Despite and in the midst of these ever-present stressors, caregivers strive to effectively and regularly connect with patients and their families using evidence-based practices, such as:
- Using nonverbal communication behaviors, especially eye contact and social touch (e.g., handshake, hug or pat on the back)
- Communicating friendliness, warmth and respect (See "Best relationship practices for patient-centered care")
- Sitting down to speak with the patient
- Engaging in active listening, asking open-ended and/or"pointed" questions
- Establishing rapport
Hospitals employ multiple strategies to enhance the caregiver experience:
- Improving organizational climate, culture and cohesion
- Implementing wellness programs and policies
- Addressing workplace violence, discrimination, harassment and occupational healthcare
- Eliminating wasted time and maximizing staff ability to work at the top of their licenses
- Enhancing shared governance and decision-making
- Reducing conflict and strengthening relations, especially between physicians and nurses
- Improving compensation and benefits
- Evaluating and ensuring safe staff-to-patient ratios and workloads
- Providing greater opportunities for professional development and career advancement
- Bettering access to and quality of equipment, supplies, etc. (See "Interventions aimed at improving the nursing work environment: a systematic review" and "Improving Patient Care by Improving Nurses' Work Environment")
One strategy, because it is universally accessible, affordable and effective at improving addressing stress and its causes, deserves greater attention and use.
"Mindfulness is the process of learning how to be with all experiences while being less judgmental and reactive. Aspects of mindfulness practice include self-reflection, acceptance, self-care, developing resources to care for others, and opening to difficulties without avoidance. This practice leads to an open heart," according to "Does Mindfulness Decrease Stress and Foster Empathy among Nursing Students?"
In the first study of its kind linking the effects of mindfulness-based stress reduction on nurse stress and burnout, the authors concluded that mindfulness-based interventions "might offer nurses tremendous help in dealing with stress."
Researchers showed in a randomized controlled pilot that an eight-week mindfulness-based program "may be effective for reducing stress and increasing quality of life and self-compassion in health care professionals."
Another study evidences "the potential of mindfulness training to be used with nurses and nurse aides to treat and prevent stress-related problems and to promote coping and health. It also suggests that training does not necessarily need to be implemented in the time-intensive format in which it is usually provided to benefit individuals with high levels of job stress."
Most of the other strategies listed above to improve the hospital environment involve significant investments in time, financial resources and planning. Mindfulness-based interventions are low- to no-cost in nature, accessible at all times and in every circumstance, and show promising evidence-based results. Healthcare organizations, therefore, have a powerful strategy at their disposal to improve the caregiver experience and ability to effectively connect with patients and their families.
Even if and when the physical environment remains the same, mindfulness-based interventions enable the inner environment within each of us to notice the causes of stress associated with our life experience without getting caught up in them. Such an accepting, nonjudgmental presence is the foundation for consistently practicing the evidence-based practices that help us make effective, quality connections with patients and their families and improve their experience and outcomes.
Doug Della Pietra is the director of Customer Services and Volunteers for Rochester General Hospital in New York, where he directs an intentionally-designed patient- and family-centered volunteer program, oversees the front-line valet and guest services teams, and leads the service excellence element of the Patient Experience Initiative while co-chairing the hospital's Patient Experience Team. Follow Doug@DougDellaPietra on Twitter.