“No, cellphones at the dinner table!”
My husband said this to my daughter a few weeks ago. She’s not a teenager (she’s 20 months old), and it wasn’t a real cellphone. It was a hand-held Tetris game that she likes to hold up to her ear and say, “Hello? Hello? K, bye.”
Nevertheless, no cellphones at the dinner table is a good rule of thumb. Have you ever been out to dinner with people who couldn’t take their eyes off their smartphone? Or how about those folks who drag their laptops to meetings and then become so engrossed in whatever is on their screen (maybe it’s Tetris) that they have to have the major points of discussion repeated to them? Irritating isn’t it?
Technology is supposed to save time, save money and increase efficiency. But in many cases it’s having the opposite effect and becoming a distraction rather than a useful tool. Digital distractions are becoming such an issue that companies like AG Chrysler and the technology firm Atos are assessing how employees use technology and creating some interesting new policies regard its use For example, during an employee’s time off, Chrysler reroutes their emails to a back-up person so those on vacation aren’t faced with an exploding inbox upon their return. Atos is moving to a zero email policy and phasing out internal emails. For a great discussion about digital distractions, check out this piece from the radio show,”Here and Now.”
After I heard the episode, I started thinking about how digital distractions don’t just occur in the corporate world, they happen in healthcare settings as well. I’ve heard from both patients and nurses that when using EMR, healthcare workers are more focused on the technology than on the patients. Nurses say they feel like the patient is just there to give them data to so they can check off boxes on computer screens. And patients often complain healthcare providers don’t make eye contact with them. Add in alarm fatigue, which happens when clinicians are so overwhelmed by healthcare device alerts that they miss significant alarms, and you can see how digital distractions can effect healthcare delivery.
So how can healthcare providers regain clarity amid technological chaos? Applying the low-tech concept of mindfulness to technology use is one place to start.
What exactly is mindfulness? It’s simply the act of paying attention. When you are mindful, you’re not thinking about the past and you’re not making a mental to-do list for the future, you’re just paying attention to the present moment.
Go back to my example of the serial smartphone checkers. Were they being mindful? Nope, they were distracted and not paying attention to the situation. The same goes for the healthcare providers who don’t make eye contact when using EHR. Their minds aren’t focused on the patient, it’s focused on the charting.
Mindfulness sounds like a simple solution but because we are so used to being bombarded by email, text messages and device alarms, it may be harder than expected to stay focused on one thing. It will take purposeful thought to incorporate mindfulness into your day, but it will be well worth it.
I suggest that all clinicians take a minute to become mindful before they enter a patient’s room. Stand still and mentally scan your body from head to toe. What are you feeling? Just note it and don’t decide whether it’s good or bad. Perhaps it’s a busy day and you’re getting pulled in all directions. When you scan your body you may notice you feel anxious or rushed or that you have a headache or feel tense in your shoulders. When you notice things like that just say, “Oh, I’m feeling anxious. Oh, my shoulders are tight.”
Then move on to taking some breaths. Count how long it takes you to inhale and exhale and extend that time. For example, if you notice it takes you to the count of three to inhale, try to make your exhale twice as long (to the count of six). Do this “two-to-one breathing” for about five breathes and then stop. Again, take note of how you feel.
Now you’re ready to meet your patient. But before you enter the room take one last second to tell yourself, “I will be present and focused.”
Once you enter the room, make eye contact with your patient and introduce yourself to him or her. Talk to them for a minute before you start typing on the computer or pushing buttons on the IV pump. If you notice your mind straying and starting to think about other things, label it “thinking” and then return your focus to your patient. This act of mindfulness will help you and your patient feel more connected.
Once you have mindfulness down, perhaps you can expand it to your unit, your department or the entire facility. One amazing act of mindfulness (though it’s not labeled as such) is the Sacred 60 at Texas Health Presbyterian Hospital in Dallas. Everyday between 9 a.m and 10 a.m, nurse managers have an hour with no interruptions to talk with patients and staff. There are no calls, no emails and no meetings. The hospital’s Chief Nurse Exectuive Cole Edmonson, RN, began this program in 2010. Since then, patients’ “likelihood to return” went from 15 percent to 90 percent and nurse managers’ job satisfaction rates increased by 23 percent.
Amazing what mindfulness can do! ♦
Jennifer Thew, RN, MSJ
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