If you are anything like me, right now, you are probably pretty over this COVID climate. At this stage, we are facing the prospect of living a ‘COVID-19 life’ for a while to come. For many doctors this means endless PPE changes at work (and the associated heart-breaking concern for the environmental costs of all that used and un-recycled material), social isolation, cleaning, and washing (just so much hand-washing). For trainee doctors it may also mean delayed exams, altered and reduced trainee places, continued terms and amended rosters. There are concerns about picking up the virus at work, and potentially contaminating your home environment and putting loved ones at risk. Those with kids have had to adapt to daycare and school changes. For some partners and friends it has meant lost jobs and financial stress. Enter mindfulness…

What is mindfulness?

If you have not already, you may want to consider adding some mindfulness into your everyday to help you stay calm, focused, and present. Mindfulness is the practice of attending to the present moment without analysis or getting lost to mental distraction. Mindfulness is a state of non-judgemental awareness. It is the practice of receiving chosen data, occurring in real time, and letting go of anything else.

Why mindfulness can help you on the wards

So why is mindfulness relevant to this COVID climate? Well, there are so many reasons! COVID life or not, mindfulness offers the opportunity to detach from the mind and distraction. It strengthens our neuronal ability to attend to the present more clearly so that we may perceive data more cleanly. Imagine you are on a ward round and have been asked to examine a patient. If you are like most junior doctors, you’ll probably get anxious and experience some distracting negative thoughts and self-limiting beliefs. This can limit your ability in the moment to address the task. But if you are a mindfulness practitioner, you’ll notice this pattern of attention distraction, let go of those unhelpful thoughts, and instead turn your focus to the task at hand. Voila! That is mindfulness at work on the wards. Using your breath as a route away from the mind and back into the present means you will be able to apply yourself more fully to the examination and maybe even notice the patient at the end of the bed!

This COVID climate means that we have additional distractions and stressors to accommodate and adapt to at work. Now, more than ever, a work mindfulness approach will serve us well. It requires mindfulness to remember to wash your hands, wipe surfaces and equipment and don/doff PPE correctly. Is it just me or is it confusing and super easy to forget all this stuff? This is where your mindfulness helps. Be present at work. Take one step at a time. Breathe.

Breathing mindfully

A great place to start practising mindfulness is with mindfulness of breath. The breath can be seen as an anchor to the present. It occurs in real time and it can be involuntary. During a mindfulness of breath practice, you commit to gently resting your attention to your breath as it occurs in real time. You let go of any other stimuli occurring and when distracted, simply re-attend to the breath. You feel your breath. You let go of thoughts and simply notice the feeling of breathing.

Many Australians feel isolated, lonely, and even depressed. Emotions and the thoughts of the mind can be overwhelming. By practising mindfulness, you will develop the neuronal strength to detach from unhelpful overwhelm when needed. A mindfulness practice can be conducted with a sense of surrender, acceptance, and even peace. If you notice moments of overwhelm I urge you to find the time (even if it’s during a work toilet break) to take a break and breathe through the experience. With acceptance and breath, these moments of extreme emotion do dissipate. At work you may need only a couple of minutes of mindfulness to lower the overwhelm to a more manageable level, shift perspective, and reset, allowing you to return to your work with a clearer headspace and get through the day unscathed. In my fantasy, junior doctors feel confident to request mindfulness breaks at work during times of stress, and this is received by their team as a responsible human mastery, and encouraged medical skill. As an aside, I also believe mindfulness should be prescribed in Medchart for patients.

Whether this COVID climate has made you more busy or added disruptive changes to your life, mindfulness is a tool to serve you. Mindfulness breeds presence despite distraction. It facilitates calm despite stress. It enables the opportunity to efficiently and effectively respond to the needs of the present moment, rather than impulsively react. Now, more than ever, doctors need to pause, breathe and respond with measured caution.

You may have come across the catch phrase ‘there is no emergency in a pandemic’. So remember: breathe, be cautious and mindful.

Key Points

• Mindfulness is a practice of staying present to a chosen focus without thinking. Stay present, breathe, feel, and let go of the inevitable distractions, returning to your chosen focus over and over again.
• Mindfulness strengthens our neuronal ability for attention and non-judgemental awareness in everyday life.
• Mindfulness allows us to notice what is going on within us and around us so we can perceive more clearly and completely the needs of the moment and respond in ways that we choose.
• Mindfulness is needed to manage the busyness and disruptive changes from COVID to training and work.
• Mindfulness helps to correctly use PPE, apply hygiene measures, and take precaution during emergencies.
• Mindfulness is a self-management tool for cognitive and emotional overwhelm or stress.
• Mindfulness needs to be recognised as an essential medical skill.
• Mindfulness is something you can practise in private at home but also during work breaks.
• There is no shame in taking a little time to be mindful. Rather, it is a leadership and human mastery skill that all doctors need. Even if not for you, learn it and use it to teach and share with your future JMOs and your patients.

Homework

Next time you feel overwhelmed or distracted at work, carve out 5 minutes from your day to find a private place to practise 5 minutes of mindfulness. Use your phone timer, get still, relax, commit, and breathe. Simply attend to your breath. Feel the breath. There is no need to change it in any way. Just rest your attention on your experience of breathing as it is occurring right here and right now. Remind yourself that everything can wait, let go of distractions and simply allow yourself this time to decompress and breathe.

This pause may be pleasant, but it may also be hard (if not seemingly impossible). Do it anyway. The more you do, the more effortless it becomes, and the more clear the benefits.

Use a beginner’s mind and take faith in the practice, knowing that all of the best leaders learn this skill. It’s a must for any doctor.

If you find yourself very distracted, count the breath, use mental imagery to follow your breath, and place your hands on your belly to feel the movement of the body with the breath.