Being Present With Patients

by | Jul 10, 2018 | Physician Mindfulness, Physician Resilience

Demystifying Physician Mindfulness: A 12-Part Mindfulness In Medicine Series

For many of my readers, the concept of mindfulness, and the act of being present with patients as a medicine seems out of reach. The term evokes imagery of tranquil monks and bucolic hillsides, existing miles away, both literally and metaphorically. I created this series to shorten these distances, and to introduce mindfulness to practicing physicians as an easily accessible tool to combat physician burnout. 

With the goal of demystifying mindfulness, I decided to create this 12 part series. Each post examines the relationship between mindfulness and a specific area of the practicing physician’s day-to-day life. They each include a physician’s story, and how the rigors of their practice currently hamper their ability to fully live that part of their life. After detailing their situation, I provide guidance for how that physician can utilize mindfulness to gain fulfillment in that area. 

With each post, I give you an actionable step that will help you integrate that post’s topic into your daily life. I’m also going to give you an exercise that you can practice in your free time that will help strengthen your resilience, calm, and fulfillment. My goal is to transform mindfulness from a daunting, unapproachable ideal into a broad toolkit that you have easy access to. Simply put, I want to help you be a happier, more productive version of yourself, in the workplace and at home.

Without further ado, here is the second installment of Demystifying Mindfulness.

Today’s Topic: Mindfulness and Being Present with Patients

Our Physician: Dr. J, an internist in outpatient practice in the northeast. Dr. J writes:

I’m finding it almost impossible to be fully present with patients. I want to be 100% focused on every patient, but my mind seems to be everywhere else. I feel like such a crappy physician…on top of being overwhelmed with the workload I can’t even empathize with the people I’m treating. What can I do to be more present and caring with each of my patients?”

Sincerely,

Dr. J

Dear Dr. J,

I want to emphasize two things: 1. This is something that almost every practicing physician experiences. And 2. As we continue our careers, it takes mindfulness as a medicine to humanize our patients and maintain presence. We are overworked, are pulled in countless directions, and often have other things on our minds, like responsibilities outside of work. It’s not easy to give 100% of yourself to the patient in front of you when all you can think about is the charts you need to finish. Not only that, but we weren’t trained to empathize with patients! We were taught to be diagnostic scientists, not present, caring doctors. Compassionately dealing with each patient you see requires intention and cultivation. Here’s what I recommend: Relationship of Mindfulness and Medicine

Set an intention.

You deciding that you want to be more present with your patients is powerful. Before each day of work, decide this again! Setting an intention for your day helps you chart your course, so you avoid finding yourself at the end of the day not having acted  the way you would have liked. The goal is not to be perfect here, but to begin to shift toward your goal. Intentionality is the root of mindfulness as a medicine,  and this is a concept that I’ll expand upon in future installments.

Cultivating empathy toward your patients, and toward yourself.

When you’re with patients, and you notice your mind wandering, remind yourself that you want to be more present, and return to the human being in front of you. The more times you remind yourself to feel this way, the more empathy you’ll develop for your patients and for yourself.

Accept imperfection

As much as you try, there will be times when you aren’t as present as you hope to be. Self-compassion is a crucial component of mindfulness. While it may seem counter-intuitive, the kinder you are to yourself, the more likely you are to enact the changes you want to make.

Deciding that you want to be more present and caring with patients is an important first step. Implementing these mindful strategies will take you the rest of the way. 

To your resilience,

Gail

  1. Embrace uncertainty

When you stop and think about it, uncertainty and change are the only things that are certain. Impermanence is one of the basic laws of our world.

After all, everything changes. Our relationships change. Our kids grow up and change. Our bodies age and change. Our environments change. Our planet changes.

All too often, however, we forget this basic truth. We somehow expect things to be predictable and stable.

The problem is that this expectation sets us up for difficulty. It leaves us struggling unnecessarily when something shifts. It adds a layer of suffering above and beyond that caused by all the VUCA around us.

What I’m getting at is that we have a choice. We can meet uncertainty with reactivity or we can meet it with mindful understanding.

More than meditating on a remote mountainside, mindfulness helps us have the calm, steadiness, and clarity we need to work constructively with all the change and uncertainty.

At the same time, while we can find ourselves resisting change, we can remind ourselves that it does not have to mean something bad! Just take a moment right now to think of all the difficulties you have faced in your life and work that are now resolved and far behind you. This can help you see how change has actually been quite the positive.

  1. Respond to complexity with compassion

Even knowing that change is the only thing that is certain, it can still be difficult to weather. Living in such a VUCA time is difficult. You deserve compassion for managing all the challenges.

With mindful awareness, we can bring ourselves compassion for what we’re going through. There is increasing evidence that self-compassion is a powerful antidote to stress and even burnout. From where I sit, I think that it is actually one of the most powerful medicinals available to us.

  1. Take purposeful pauses

With mindfulness, we are aware of what is going on within and around us. We tune in and pay attention to our experience. We learn to utilize our breath to take us out of the fears, worries, stories, and preoccupations our minds are so good at generating about what might come next, and bring us back to the present moment. Here in the present, we leave that overly activated limbic state and can experience a sense of calm.

A pause also serves to allow our prefrontal cortex to come online. It creates a critically important space between our emotional response and conscious, intentional action.

Once we have paused, we can then see more clearly that fear had taken hold. 

With a pause, we become the witness of our experience as opposed to the one trapped by it.

  1. View VUCA as opportunity

I don’t know about you, but I can find myself reacting to the VUCA environment with something of a fixed mindset. With a fixed mindset, I am telling myself things like ‘it shouldn’t be this way’ and ‘why is this happening?’

When I can utilize mindful awareness, I can see that I’ve boxed myself in with a fixed mindset. I can challenge myself to grow. By grow, I mean challenging myself to see whatever difficulty I’m experiencing as an opportunity to learn.

Here again, mindfulness again throws us a lifeline. Mindful awareness involves leaning into curiosity.

I can flip the script and ask myself:

What can I learn from this experience?

How can I use this to be a better version of myself?

How can I help others cope in this VUCA environment?

What do I want to look back and see about how I acted?

In summary, while VUCA is definitely the order of the day in healthcare and beyond, you don’t have to succumb. You don’t have to live in fear. There are constructive actions you can take to help you cope with uncertainty, build calm in chaos, and even thrive in chaos and VUCA. While we can’t control much that is contributing to the VUCA time, with mindfulness we can control how we respond to it.

I hope you’ll try out these 4 mindfulness strategies as I have seen them help countless people. I’d love to hear how it goes.

_____

To learn more about how mindfulness coaching can help you cope with this VUCA time, please reach out for a complimentary consult.

6 Free Resources To Help You During COVID19 And Beyond.

  1. 14-day meditation series 
  2. Imposter No More PDF
  3. Resilience Book Chapter
  4. Leading In Crisis PDF
  5. Balance To Burnout PDF
  6. 30-minute consult

Take advantage of one or more of these valuable resources created for clinicians and non-clinicians.