Overdue Reckoning on Racism in Nursing

Join me in attending this free series of timely web discussions: Overdue Reckoning on Racism in Nursing.

NurseManifest

We are excited to announce a series of web discussions “Overdue Reckoning on Racism in Nursing” starting on September 12th, and every week through October 10th! This initiative is in part an outgrowth of our 2018 Nursing Activism Think Tank and inspired by recent spotlights on the killing of Black Americans by police, and the inequitable devastation for people of color caused by the COVID-19 pandemic.

Racism in nursing has persisted far too long, sustained in large part by our collective failure to acknowledge the contributions and experiences of nurses of color. The intention of each session is to bring the voices of BILNOC (Black, Indigenous, Latinx and other Nurses Of Color) to the center, to explore from that center the persistence of racism in nursing, and to inspire/form actions to finally reckon with racism in nursing.

Lucinda Canty, Christina Nyirati and I (Peggy Chinn) have teamed up…

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Olden Days of Nursing: Dialysis

I still remember the teenager but not his name or how long he had been getting peritoneal dialysis (PD). I recall him walking between his parents down the long hospital corridor. He was going home to die. A father with small children had preempted the teenager’s spot on the dialysis unit. Restricting patients was necessary because supplies and personnel were in short supply at the time. Dr. Norman Lasker, head of the Renal Division made that decision unilaterally. 

I  had taken care of the teen when he came in for twice weekly treatments. His mother and father came with him bringing magazines with pictures of sweaty wrestlers, which I found repulsive. Not having any brothers, what did I know about teenage boys? However, we did have something in common: the new TV show, Batman. I would watch the show each week (no binge watching then) so when the teen came on the unit, we would have something to talk about. 

What happened to him after he was sent home? Hospice or palliative care hadn’t evolved, as yet. How did his parents manage? Did he wind up in a hospital at the end of his life? 

I called Carol Passarotti-Novembre. She and I worked on the same research floor: a 15-bed unit at Pollak Hospital in Jersey City. Carol was the first renal nurse in New Jersey, working alongside of Dr. Lasker in one of the first Dialysis Centers in the US in 1961. Only three other major Dialysis Centers existed then: Boston, Seattle and New York City. Dialysis nurses received on-the-job-training. 

Carol didn’t remember the teenager.

 

Of course, she wouldn’t since she had so many other patients. Some were on chronic PD, like the teenager. Patients came twice or three times a week, interspersed with emergency dialysis for acute problems like drug overdose, end stage renal failure, and post-surgical renal shutdown. For eight years, Carol was on call 24/7. Only once did she miss an on-call emergency. Another staff nurse from the research unit stepped in. The patient survived. 

Later on, Dr. Lasker was no longer the lone decider. Carol told me that a “board consisting of physicians, administrators, clergy and others reviewed potential patients to receive dialysis treatments.” She sat on this board. 

Carol ran the show at the Dialysis Center. The “Dialysis Center” was in reality four beds devoted to renal patients on the 15-bed unit. 

The procedure for PD was as follows:

After warming two-liter glass bottles of dialysis solution in the sink, Carol hung them from an IV pole. The fluid flowed into the peritoneal cavity and remained in the patient for 30 to 40 minutes. The bottles were taken down from the IV pole, inverted and placed on the floor so the fluid would drain back into the bottles, which took another 10 minutes. Repeat. The patients stayed overnight since each treatment lasted 36 hours. 

Carol managed up to four patients on Monday, Wednesday and Friday or Tuesday and Thursday. The day shift helped when we could. Evening and night nursing staff managed the PD during their shift. Carol discontinued the PD the following morning only to see the same patients come back the next day. 

Not surprisingly, Carol got to know her patients and their families well, as did all us nurses, since each patient came to the unit so frequently. 

One patient, Ellen, a slight Italian women with a large family, stopped breathing and became pulseless when I was in her room. I did what we were taught to do at that time. I slipped her on to the floor, struck her sternum with the side of my hand, breathed into her mouth and started chest compressions. The doctors on the unit came to assist me. We revived her. When she awoke, she told us she didn’t want to be resuscitated. We didn’t ask these questions in 1965. Happily, for me, when Ellen stopped breathing next, I wasn’t in the room. 

Carol had an uplifting story to share: 

“One of our patients was on PD for four years. Her local internist came to her home for each treatment, inserted the trocath [to make the pathway into the peritoneal cavity], and left. Her husband carried out each treatment. Even her little children helped with warming the bottles of dialysate. She switched to home hemodialysis for five years, then continued In-Center Hemodialysis for ten more years. At that point she received a cadaver kidney transplant, which lasted for a good number of years after.“ 

The following is from a speech Carol gave to nephrology nurses and technicians of North Jersey at Marriott Newark Hotel, Newark, NJ, May 6, 2011:  

“The role of the nurse has changed along with each modality of treatment, the changing needs of the patients and families, the advances in technology and the increasing demands for specialized education in nephrology.

. . . My knowledge of nephrology was ‘on the job’ everyday type of learning. I depended upon the physicians I worked with. . . .Working for the medical school had its advantages. The most important being able to be involved in research projects. e. g., vitamin studies, various solute clearance studies, cardiac output studies in the chronic PD patient and also, in developing the original cycler and starting home training programs for PD and hemodialysis.

 

(Carol was the first nurse to be included in a research study citation in the Annals of Internal Medicine.)

Today’s nephrology nurse is involved in direct patient care, teaching in all the fields: PD, hemodialysis, transplantation to the patients and their families as well as research and development. National and local organizations, such as American Association of Nephrology Nurses and Technicians were formed in order to ensure a high standard of education on both a local and national level and making nephrology nursing an accredited and recognized area of nursing. 

For me, the rapid growth and development in this area of medicine over the past 49 years, has been totally mind blowing, awesome, most exhilarating. The potential for future development is limitless!”

Carol married in 1968 and remained with the renal unit of the New Jersey College of Medicine and Dentistry Renal Division until mid 1969 when she left to have her first child. In 1971, she worked as a staff nurse in hemodialysis unit and later in the Hemodialysis Home Training unit at  Saint Barnabas Medical Center in Livingston, NJ. In 1976, she joined a Renal and Hypertension practice as both an office nurse and researcher in many drug studies. Carol worked  full-time, sometimes 50 hour weeks, before she retired in 2010 at the age of 70.  

After reflecting on Carol Passarotti-Novembre’s long career in nephrology, I ask the obvious question. How could the development of peritoneal and hemodialysis have progressed without the collegial partnership between nurses and physicians? 

Jersey Journal. Carol and Dr. Lasker are standing beside the first hemodialysis machine.

 

Home Visits Can Be Fraught With Danger

As I write my second book, which is about the home visits I have made over the years, I am resurrecting memories from my mind and the pages of my journals. Today’s post shows a time when I didn’t use common sense and how home visits can be fraught with danger. 

One day in early fall, on my drive back to the hospital after making all my scheduled home visits, I found myself passing by a patient’s apartment on the westside of Chicago. Since I was ahead of schedule, I decided to drop in, unannounced. I had the time. My patient had a caregiver: a tall, muscular man who always opened the door to the first-floor apartment wearing a long blond wig and thick make-up. Despite his flamboyant appearance, he gave competent care to his charge: a bed-bound, uncommunicative middle-aged man with multiple sclerosis. An exotic array of visitors wandered in and out of the apartment. My patient’s mother, strikingly average looking compared to the rest of the visitors, lived in rooms above her son’s and was often present when I came. However, this day I walked into an unlocked and empty apartment. Only my patient, lying in bed in the darkened bedroom, was present. 

Neither the caregiver, nor the patient’s mother, or anyone else familiar to me entered the apartment while I was there. However, as I finished with my evaluation, a man opened the unlocked apartment door. He wasn’t anyone I had seen before. My patient smiled at him knowingly.

The man removed his jacket and tossed it on the sofa. We introduced ourselves. His eyes moved down my body. Acutely aware of the precarious situation I was in—alone in that apartment with a strange man and unhelpful patient—a band tightened around my chest. 

“I’m just leaving,” I said as I promptly packed up my nursing bag. 

Safely back in my car, my breathing heavy and my hands shaking, I chastised myself for making this impulsive visit. No one back at the office knew where I was. It was a time before cell phones. What If something had happened to me?  I didn’t want to think of that. I never again made an unscheduled home visit. 

Sometime after that impromptu visit, at a nursing conference, I sat fixated as another home health nurse told a story about the time that she had made a scheduled visit. She rang her patient’s doorbell. He didn’t answer. It was later that she found out he had been murdered. And in hearing more detail, she discovered that the murderer had likely been in the house the exact time she was ringing the bell. Good thing the door wasn’t unlocked. 

Home visits can be fraught with danger. 

Nurses are nuts or do they just need “secretaries?”

 

Nurses Are Nuts by Anthony Langley, RN

 

 

 

 

Anthony Langley contacted me to ask if he could send me a copy of his book to review and possibly discuss on my Blog. I am always happy to support a fellow nurse who takes the plunge and writes a book about nursing, so I said sure.

 

 

 

About the Author

Anthony Langley has been a registered nurse for twenty-nine years. He also has a bachelor’s degree in criminal justice. His interest in nursing started after getting a job as a security officer in the emergency room of a hospital. A male nurse who worked in the emergency room showed him the things that nurses did, which got him interested in nursing.

Anthony Langley

He got his bachelor’s degree in nursing in 1990. At his first job, he started on a medical-surgical unit. He has worked in many areas of the hospital, which include surgical stepdown unit, surgical intensive care, same-day surgery, and the post-anesthesia care unit (PACU) recovery room.

 

 

Continue reading “Nurses are nuts or do they just need “secretaries?””

Just a Nurse

Reblogged from 10/25/2015

Nursing Stories

bookmrk-sm1This is from Suzanne Gordon’s Blog. Ms Gordon is a journalist and stanch supporter and promoter of all things nursing.

Recently she asked nurses to respond with their version of “Just a Nurse.” I am delighted to see their feedback. May nurses continue to tell the public what they do and how important their job is.

I would like to post all the ” Just a Nurse” submissions people have sent me.  See below.  What do you think?  I think they are all great.  Thank you so much, all of you.

Suzanne Gordon

I’m just a Pediatric Intensive Care Nurse. I just manage my patients’ drips to keep to their vital signs in a stable range. I just make sure their medications are safely administered. I just make sure the physician is informed of any small but meaningful change in their condition so we can work together to prevent…

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Can nurses really speak out too much?

This article caught my attention from the Nursing Times (a monthly magazine for the nurses of the United Kingdom). I had to do some homework to learn about The Queen’s Nursing Institute and its function.

Healthcare policy is a key activity for The Queen’s Nursing Institute. The QNI works to influence decision makers across England, Wales and Northern Ireland on health care policy including primary care, public health, nursing education, regulation and skill mix and issues such as services for homeless people and reducing health inequalities. To do so QNI contributes to stakeholder meetings, responds to national consultations, takes up issues raised by local projects where it appears they may have wider significance, and provides examples and information to policy-makers.  Wikipedia

At the annual conference of the QNI held in London last week, Dame Donna Kinnair, chief executive of the Royal College of Nursing, was told by government representatives that “nurses voices are too loud.”

Read her response below. 

 

 

Let’s Shout Together for Community Nursing

27 SEPTEMBER, 2019 BY  KATHRYN GODFREY 

Nurses at the annual Queen’s Nursing Institute conference held this week in London were told about the government response to hearing the views of nurses.

Dame Donna Kinnair, chief executive of the Royal College of Nursing, told delegates that she had been told by government representatives to bring her membership “under control” so that the voice of nurses would not become “too loud”.

“Nurses do need to speak out about key workforce issues such as safe staffing”

This conversation occurred at a government meeting, but Dame Donna reassured the audience that she would ensure the nursing voice would be heard and in fact “amplified”.

But can nurses ever speak out too much? As a profession they have traditionally been known for getting on with their essential work and not shouting about policy and resource issues. It is therefore good to hear that there is concern that their voices are getting louder.

Nurses do need to speak out about key workforce issues, such as safe staffing as well as more specific issues that affect the patients that they care for. For example, patients who are incontinent are often not provided with adequate supplies of pads to manage their condition. It is big issues like staffing and more specific issues like incontinence resources that affect the care nurses can give and the quality of life patients experience.

Nurses who do speak out can feel like they are speaking in a vacuum and that it is hard to get their message to the decision makers.

Now Dame Donna is asking nurses to share their experiences with her so that she can amplify and communicate to government the concerns of all nurses.

She said: “What I want to do is make sure your voice is amplified through my voice and I can’t do that unless you share your voices and stories with me.

“So that every time I look around, every time I speak to a minister I have got the basics of that conversation, so I am truly representing how nurses feel,” she told attendees.

“This is a crucial time for nurses to raise their voices and have their points heard”

“My pledge to you is that I will continue to amplify your voices and in return I ask you to share your voices and your stories with me, so that we can collectively be a unified profession.”

These are difficult times. We hear little other than Brexit in the news, which means key issues for the health and welfare of the population are being neglected. This is a crucial time for nurses to raise their voices and have their points heard.

The new advertising campaign We are the NHS is timely. The video about nursing is an excellent showcase for the many and varied jobs nurses carry out. It is a great illustration of how highly skilled and essential a workforce nurses are, the glue that holds the NHS together. So the more we hear from them the better. Let’s hope that those who need to listen don’t put their fingers in their ears.

nursing times

I wish our fellow nurses across the pond every success in making their voices heard.

Nurses Give Their Expert Advice on Understanding the Broken Health Care System

I have been on the lecture circuit. My topic is Empowering the Patient: How to Navigate the Health Care System. Two presentations down and two to go with another in the negotiating stage.

I’m fine-tuning the presentation based on the feedback I have received from my audience each time I give the talk. Sana Goldberg’s recently released book: How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine has added an extra layer of emphasis on the importance of nurses’ influence in the health care system.

She writes:

 

I believe nurses are best poised to change the future of healthcare.

Today, registered nurses spend more time physically present with patients than any other healthcare professional, and as a consequence we see and hear a lot. We maintain a vantage point markedly different from that of the MD, the scholar, the journalist, and the policy maker. We are intimately familiar with the complexity and multiplicity of the patient experience, as well as the systems in health care that fail to acknowledge it. We witness the system’s barriers regularly, and in turn we come up with creative solutions to side step its most vexing realities.

(Sana Goldberg, How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine, page XXIV)

Doesn’t that last sentence remind you of Teresa Brown’s New York Times Op Ed essay that I posted just last week? Side stepping vexing realities is another way of describing the “workarounds” that Brown described.

I’m using another book written by a nurse for my talk. Finish Strong: Putting Your Priorities First at Life’s End by Barbara Coombs Lee, who besides being a nurse is a lawyer and President of Compassion and Choices.

Both books are well written and easy to read and full of great information that older readers will find helpful. And, of course, I am pleased that they are written from a nursing perspective.

How Mindfulness Can Be an Act of Self-Care for Nurses

I recently came across a new, to me, Blog: Nightingale. A 2017 post by Teresa Brown describes her initial exposure and reservations about mindfulness—I am not giving away the ending. Given I had just spotlighted Julia Sarazine, a qualified mindfulness instructor, I decided to reblog Teresa’s essay.
The Nightingale website looks interesting and promising, however, I didn’t notice any recent activity. Sara Goldberg, founder of Nightingale, may have been busy with her new book: How to be a Patient: The Essential Guide to Navigating the World of Modern Medicine, which was recently released. I read her book and will review it in a future post.

Nightingale

Nurse Burnout Won’t go Away Until the Industry Changes. But in the Meantime, Mindfulness can Help Nurses Prioritize Their Well-Being.

suzy_4

This past November I attended a workshop on nurse burnout at the Johnson Foundation at Wingspread in Racine, Wisconsin. Clinical nurses, administrators, and researchers came together for three days to discuss this pressing issue that is epidemic in nursing. One survey found that almost half of nurses are burned out, meaning they’re so overwhelmed by the job that they’ve lost the capacity to really care about it or their patients.

I tend to be suspicious of talk about mindfulness in health care because it seems to place the onus for change on individuals instead of the overall system.

Several of the workshop presenters discussed “Mindfulness” as a way to alleviate burnout. I tend to be suspicious of talk about mindfulness in health care because it seems to place the onus…

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The National Institutes of Health Disappoints

When I worked at the National Institutes of Health, a colleague and I wrote an article: The Role of Nurse Practitioners Expands at NIH for the NIH Record newsletter in May of 2000 about the increase of Nurse Practitioners at the Institute. My short time there was exciting, especially as I witnessed NP positions increase and opportunities to become involved in research grow. I saw patients in the weekly clinic along with the Fellows, interviewed and examined potential research volunteers, mentored student interns, and participated as a team member in various research studies. And best of all, I had supportive relationships with a cadre of other NPs. I left because my husband accepted a job in North Carolina.

Imagine my shock to learn that the National Institute of Nursing Research chose a dentist to be the interim director. I can’t fathom that there was not a talented, qualified nurse to fill this position. I agree with latest post (below) from The Truth About Nursing that the appointment of a dentist smacks of undermining nursing autonomy and stripping away support for nursing practice. I will write a letter voicing my support of a nurse in this leadership position and disappointment in the poor judgment of the NIH leadership.

Please consider doing the same.

 

 

 

Anyone will do

U.S. nursing research institute appoints dentist as interim director

The National Institute for Nursing Research, which disburses federal grants, announced in August 2019 that its interim director would be…a dentist. And the interim deputy director is a biologist. But non-nurses are non-qualified to evaluate grants for nursing research. These appointments also reinforce the inaccurate stereotype that nurses are unskilled handmaidens, rather than autonomous health professionals. After some of our supporters sent messages asking NIH to rescind the appointments, NIH sent a newsletter proudly announcing the appointments, and then sent emails to our supporters assuring them that it was searching for a nurse to fill the permanent director position. But it did not comment on the interim appointments, so it seems those stand. And filling high-level federal government vacancies can take quite a while. We need your voice on this. Please join us in asking that qualified nurses be chosen for these interim positions! Thank you!

Click here to sign the letter–or write one of your own!

Mindfulness: Julia Sarazine

I met Julia Sarazine this past June when I spoke to Rush University nurses in Chicago about my book: Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers. We agreed on the need for nurses to tell their stories.

When I discovered Julia’s background in teaching mindfulness techniques to nurses in order to reduce symptoms of stress (see How PTSD Is Hurting Nursing) I asked if she would share her expertise and experience about how mindfulness can help reduce Burnout syndrome/Post Traumatic Stress Disorder (BOS/PTSD).

I’m honored that Julia agreed.

 

You’ve said that some experts feel that Burnout syndrome among nurses is a public health crisis. BOS has been affecting nurses for as long as I can remember. Why do you think this problem has been so insidious and tenacious?

Burnout syndrome is now receiving attention as demonstrated by The World Health Organization including it in the Revision of the International Classification of Diseases as an occupational phenomenon.

Levels of burnout are higher in professions that have high risk associated with them, such as a nurse administering medications and treatments that may have a significant impact on someone’s life. Also, nurses are usually the ones that hear and witness the patient and families suffering.  In most situations, nurses see people when they are worried about their health, in pain or being treated for a serious illness.  Over time, this constant exposure to suffering can take its toll on the ability to maintain our own health and wellness.

Moreover, the demands of the healthcare system continue to increase with technology and integration of electronic medical records.  As more patient care is being provided in the outpatient arena, patients are sicker and may require more care than in the past.

 

You left a hospital nursing position because you had symptoms of BOS, yet a few years later you returned to the same position you left. How did you find the fortitude to do that?

 Once a nurse, always a nurse definitely applies to my situation and decision to come back to the nursing profession.  I missed working with patients and the sense of accomplishment I received while helping others.  It is the same reason I was drawn to the nursing profession in the first place.  I know it has been over communicated, but being a nurse is truly a calling, not just a job. It was not an easy decision, but it felt right for me at the time as I changed how I handled stress and suffering.  I basically learned to take care of myself with mindfulness at work and how to transition to be fully present at home.

 

What advice would you give to other nurses who have left nursing?

To leave the nursing profession is a very individual decision.  I believe all nurses are caregivers.  Where nurses are providing care may change and whom they are providing care to may also change.  For example, nurses may be taking care of their children, parents, family, friends or community members.  It may look different, such as volunteering for the food depository, listening to a friend discuss her new cancer diagnosis or asking the cashier at the grocery store how they are doing today.  Nurses are usually empathetic people and naturally take care of others throughout their lives.

 

There are terrible statistics about how many new nurse graduates leave the practice after a couple of years because of BOS. Among all the other tools out there to deal with this issue, what does mindfulness contribute?

 Mindfulness is not the magical wand that can solve all our problems and prevent burnout.  But it is a tool we can use to take care of ourselves so we can take care of others. I think all nursing students should be taught a few mindfulness skills when they begin nursing school.  If you can learn just a few simple skills to protect you while witnessing and feeling someone’s suffering, it can help prevent burnout and lower your stress levels.

 

What is your definition of mindfulness?

The mind naturally wanders from the present moment to the past or future. This is often referred to as autopilot.

  • Have you ever commuted to work and not remembered the drive or train ride?
  • Have you ever eaten something and not remembered tasting it?
  • Have you ever reacted to a situation and later regretted how you handled it?

These are all examples of mindlessness. In contrast, mindfulness focuses on being aware in the present.

There are multiple definitions of mindfulness, but the most commonly quoted is from Jon Kabat-Zinn: “Paying attention on purpose in the present moment, non- judgmentally.

 

How did you first learn about mindfulness?

Right after I left nursing, I was struggling with trying to process all of the deaths I witnessed. A friend recommended The Power of Now by Elkhart Tolle.  I read it and then began to meditate each morning. I found I was able to focus more and notice moments of joy in simple things such as a warm breeze on my face, a smile from a stranger and the taste from the first sip of coffee in the morning.

I continued to develop my own practice by taking mindfulness courses, attending silent retreats and eventually becoming a mindfulness instructor.  Mindfulness is never complete; everyone who practices is always learning and evolving through increased awareness.

 

How has mindfulness changed you?

Mindfulness allowed me to process all of the suffering I witnessed and absorbed while working at Cook County Hospital as a palliative care nurse practitioner.  During one of the mindfulness retreats, the teacher said, “ You don’t have to jump into the deep in of the pool, just dip your toe into the water as far as you can at this time.”  This was very helpful for me at the time because I was resistant to processing the deaths for fear I would drown in grief.  From this simple instruction, I was able to process each patient’s death by allowing myself to feeling the sadness and grief; then the grief lessened and I was able to wish the patient and family well.  I realized I was frozen in time, but the family and friends had moved on with their lives the best they could.

When I returned to my nurse practitioner position five years later, I used mindfulness to keep myself grounded in the moment so I could think critically and also not absorb all of the patient’s and family’s emotion.

Now I use mindfulness all day long to recognize when I am stressed and choose how to respond, enjoy pleasant moments more fully and to accept when I have feelings of sadness or grief while taking care of aging parents.

 

Please tell us about the success you have had in teaching mindfulness to the nurses at Rush University Medical Center.

 It is an amazing experience to be able to share the worst moments in my career and now teach how I processed the grief with mindfulness and continue to use it every day.

At Rush University Medical Center, we completed a study and determined that six months after nurses participated in a four-hour mindfulness and resilience workshop; they had reduced burnout and perceived levels of stress and increased mindfulness skills. We were thrilled with the results discovering that a short four-hour workshop can have an impact six months later.

 

 Please add anything else you think my Blog followers need to know about mindfulness.

 Here are some strategies and tips to incorporate into your daily life through informal practice, especially at work, where stress levels can be elevated. Just as a reminder, it is important also to practice informal mindfulness in times of minimal stress since it is easier to focus on being present and will make it more accessible during times of higher stress. Remember, it does not take any more time to be mindful.

 

Informal Mindfulness Practice:

STOP

STOP is a mindful technique that can be used in any situation to slow us down and reconnect with ourselves. It can be used before entering a patient’s room, sending an email, charting, speaking, or entering your home after work. The acronym STOP stands for:
• Stop whatever you are doing to pause for a moment
• Take a deep breath or two
• Observe any specific thoughts, emotions, or body sensations
• Proceed with more awareness

Two Feet, One Breath

This mindful technique can be used in times of stress to ground us and create a little space from the stressful situation being encountered.

With both feet firmly on the ground, while either standing or sitting:

  • Focus as much attention as possible on sensations in the sole of the left foot—perhaps pressure or sensations from contact with the sock or shoe.
  • Then shift attention to sensations in the sole of the right foot, with as much attention as possible.
  • Tune in to your breathing—just feeling the breath as it moves in and out.
  • Now, continue whatever you are doing in a more grounded and present manner.

Mindful Hand Washing

Use all the senses to bring awareness to the activity of washing the hands. Feel the temperature of the water and the sensations of the hands rubbing together, the smell of the soap, and the sound of the water running, and notice the bubbles forming from the soap. This awareness can be applied to any routine activity, such as brushing teeth, taking a shower, or typing an email.

 

Formal Mindfulness:

On-Line Mindfulness Workshop Opportunity:

TheMindfulness and Resilience 4- Hour Workshop has been shown to decrease stress and burnout symptoms and increase mindfulness skills 6 months after participating.

I am teaching it on Saturday, October 19thfrom 8 am – 12 pm CST.

For details:

https://www.sarazinemindfulness.com/corporate-mindfulness-programs

 

 

Julia Sarazine

Sarazine Mindfulness, LLC

www.sarazinemindfulness.com