Today is the ninth week of our ten week mindfulness series by Dr Patricia (Trish) Lück, a palliative care physician and facilitator of mindfulness-based stress reduction (MBSR) programmes, exploring self-care for the healthcare professional in everyday palliative care moments.
It is telling that this is an issue even for me, despite the fact that I have widely lectured and given workshops on precisely this topic. I was struck recently in conversation with my daughter that after so many years of doing the traditional required amount of children’s ‘bee’ projects, I never really considered that the bee was not just playing a role in collecting nectar for the hive and in making the honey, but that the bee needed to feed itself along the way first to sustain its own energy capacities. It felt like a light bulb moment: so very simple, but one I had consistently missed for many years.
Self-care can be as simple as taking a few more purposeful moments in the day to eat, drink, walk, sit, hold conversation, listen deeply, exercise, wash and sleep with greater awareness. Taking time to be with the tasks that need doing each day in the small things we already do that take care of our bodies, minds, work spaces and families. The capacity to allow mindful awareness to arise within the moments of our day enables our capacity to connect with what is needed now and not to be stuck in an automatic mode of ‘just carrying on’ no matter the need. The capacity to stop, take a few breaths, a few moments, to reflect and observe what is happening and then proceed can be a valuable pause inserted into the unfolding of each day.
Michael Kearney, in his excellent article on self-care of physicians at the end of life, identifies some simple measures that could be protective against burnout. These include mindful meditation, reflective writing, supervision and mentoring, sustainable workload, promoting feelings of choice and control (as discussed in last week’s article), a supportive work community, fostering communication and self-awareness skills, practicing self-care and mindfulness based stress reduction for team.
For me it begins with becoming aware of how we care for ourselves already each day and pay a little more attention to that – and especially how we communicate with ourselves and others, how much kindness we bring into each day. Peirro Ferrucci in his book: The power of kindness states that: “Attention is the medium through which kindness can flow. No attention, no kindness. And also no warmth, no intimacy, no relationship.” Attending to ourselves with kindness, love and care can be the greatest gift we offer those we attend to in our daily lives. Mindfulness can be a radical act of love and kindness in and of itself. Being with whatever arises in this moment, without judging how it should be – or how we should be –with heart and with warmth and with kindness, is a moment of self-care purely through the simple act of showing up for our lives with kindness and care.
Finally, I wish to remind ourselves that we can find self-care and meaning and vision in the very presence of our daily work. Often we neglect that this can be a source of self-care in and of itself, that it is what we have chosen to pursue each day and to continue to engage with every day. As Rachel Remen, doctor, healer and author, states: “No question that the medical system (in the USA) is seriously broken, but Medicine itself is not. Even on the most stressful and pressured of days there are moments in which we can experience something else, moments in which we connect to people on a very intimate level and make a difference to them and they to us. Times when, despite everything, we experience compassion, give and receive love, ease suffering and fear and are profoundly trusted. Instances when the greatness and courage of an ordinary person is suddenly revealed and we know ourselves to be in the presence of a hero. Or we recognize that we ourselves are heroes. No question that these experiences are brief, but they happen daily. And often they are life-giving – like taking single breathes of pure oxygen in the middle of a deep-water dive. There is a deep river of meaning that runs through the work of every health professional. It can sustain us in difficult times.”
So as you continue into the next week, take some time to sit, breathe, walk, be, and allow – in those moments of connection and reflection and mindfulness – to be fully present to the magnificence of your life. Take some time to STOP, engage in mindful meditation and reflective writing and engage with kindness and care with yourself, your patients and your own families.
S – Stop
T – Take a breath
O – Observe, pause, take a few moments to consider what is happening now. What are you feeling, thinking, what sensations are present. What is needed now.
P – Proceed with full awareness and no longer with the automaticity of the habitual mind but with the capacity to respond with awareness of knowing this moment fully.
Kearney, M.K., Weininger, R.B, Vachon, M.L.S. et al. Self-care of Physicians Caring for Patients at the End of Life: “Being Connected … A Key to My Survival” JAMA. 2009; 301(11). pp:1155-1164