A series celebrating nurse leaders who go above and beyond.
Nurses busy with patient care generally don't take time for their own self-care and nurse executive Mary Sullivan Smith, DNP, RN, NEA-BC, wanted to change that.
Around that same time, she was pursuing her Doctor of Nursing Practice degree, so Sullivan Smith, senior vice president, chief operating officer, and chief nursing officer of New England Baptist Hospital, chose as her capstone project, "Mindfulness training for acute care nurses to promote a healthy workplace."
Smith Sullivan received her DNP in 2020, and research from that project has resulted in wellness programs at New England Baptist.
Smith Sullivan spoke with HealthLeaders about how mindfulness training can benefit nurse and help create a healthy workplace.
This transcript has been lightly edited for length and clarity.
HealthLeaders: How did you become interested in helping nurses adopt mindfulness?
Mary Sullivan Smith: I was always interested in how oneself—a nurse—takes good care of themselves in the course of a very dynamic and busy day. At this organization, we do so much surgery and the turnover of patients is very rapid that nurses could care for and discharge four patients in the same day, so it's very busy throughput. The average age of our patients is 64, and along with that we have all the comorbidities of caring for people as they have other system involvement during the aging process.
I don't think there's a better profession than that of a registered nurse in terms of the depth and breadth in which one can make a contribution throughout their career, but it's a job that takes a lot also from people—from their heart, their soul, their spirit, and physically—and I got curious about that for my DNP project.
I started to do research on my own and came upon a study by the American Nurses Association that studied the health of about 11,000 nurses over the course of a period of time, and it illustrated that in this fast-paced, dynamic, 24/7 environment that there was definitely opportunity for nurse health to be increased and improved.
I thought there must be ways to incorporate some of the some more healthy habits into the organization … and that's when I started looking into opportunities. Establishing a mindfulness practice is beneficial in so many ways, but it certainly hits that those areas that I was concerned about—caring for others more than oneself and not taking enough time to hydrate and get good nutrition.
I partnered with a colleague who is a certified mindfulness instructor and one of the inpatient care units agreed to work on my project. We carved up the time for them to do these mindfulness meditations and some were very short. And this colleague of mine really taught people how to do short meditations and give resources for all kinds of things that could help one center oneself and get a break.
Not only did the nurses take advantage of it, but other disciplines as well because we put them on Zoom and invited people to participate. Once I finished with the pilot project, I introduced this into our nurse residency program, so one of the aspects of our curriculum is on wellness and self-care and they learn the benefit of meditation.
I'm also opening that up again with the mindfulness instructor to do Zoom meditation training again. It's designed to meet people's needs while they're at work, to free up their minds for a bit to center themselves and to take some deep breaths. I'm trying to establish a body of mindfulness work and practitioners—those who have learned it and been certified with it—and continue to advance that.
HL: How, specifically, can mindfulness training benefit a nurse and, therefore, promote a healthy workplace?
Sullivan Smith: It teaches a nurse that in a very short period of time, you can clear yourself with some deep breathing, stretching, sitting, and meditating, and you don't have to do it for long. You can do it for a few minutes. It provides a respite and helps people feel better.
[A colleague] was saying how in our busy preoperative unit they stop every so often and they all walk away from their computers, they stretch, and they'll have a moment of quiet, which helps them reframe and reset. So, it's very small work, but it has great outcomes, or consequences. And the literature is replete with the benefits of mindfulness.
It has come into its own again from the 1960s and '70s, and now it's a well-understood opportunity to incorporate mindfulness practices to manage stress in a time that is beyond some of the worst stressors that healthcare professionals have to deal with.
HL: A recent study said that most nurses experienced moral distress, especially in the early days of the pandemic. How does a nurse leader build a healthy workplace considering so much emotional damage?
Sullivan Smith: Yes, it was incredible moral distress that nurses experienced. What many have done is to take advantage of employee resources that exist at organizations. Other nurse leaders have done a lot of rounding and talking with nurses individually, making sure that there was debriefing after really difficult situations. A lot of it has been hands-on, face-to-face work to make sure that what someone has been through is acknowledged.
Many nurses in this country have gone through other bleak periods of time. The AIDS epidemic is different in terms of the amounts of people that were affected, but that's probably the closest thing to what anyone could imagine this COVID-19 pandemic to be like in terms of the devastation, loss, and youthfulness and everything that happens to the patient. And nurses were at the center of that, so there is nothing more important than acknowledging what a nurse has been through.
HL: What would you advise for nurse leaders who are working to create a healthy work environment for nurses?
Sullivan Smith: Whether it's the chief nurse or other members of the nursing leadership, it's important to pay attention to nurse resilience and promote a workforce that can be sustained into the future. It's also important to pay attention to how people respond to small tests of change, because that's what this was and it's had very good response, and to try different modalities of stress reduction.
It's all important. It's critical for us to make sure that we're creating an environment that is good and healthy in which to work every day.
See the other nurse leaders featured this week:
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“[Mindfulness training] is very small work, but it has great outcomes, or consequences.”
— Mary Sullivan Smith, DNP, RN, NEA-BC, senior vice president, chief operating officer, and chief nursing officer, New England Baptist Hospital
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.