Finding the Space to Lead in Healthcare Today

By Rose O. Sherman, EdD, RN, FAAN

If you are like most nurse leaders in today’s environment, you are maintaining a relentless pace yet may not feel like you are keeping up. In a new book, Janet Marturano (Director of the Institute for Mindful Leadership) describes strategies that leaders can use to slow down and move away from a constant state of partial attentiveness. The strategy is to become a more mindful leader. There is good evidence that cultivating mindfulness, a practice inherited from the Buddist tradition, can help leaders to relieve some of their stress and feel more in the moment with their work. Mindful leadership will improve your work by helping you to be present, maintain better focus, become more authentic and expand the repertoire of possibilities and responses in your leadership. In a recent article in Hospital and Health Networks, Wendy Leebov suggested that mindfulness is the one skill that can transform healthcare.

The Power of Mindfulness

Mindfulness is defined as knowing what you are doing, feeling or thinking in the present moment. For leaders, it also means the cultivation of leadership presence. Nurse leaders are expected to solve complex problems and work with teams of individuals who often have differing points of view. These activities can be very stressful and it is often difficult for leaders to stay present in these conversations and not to drift to other work which may be left undone. Mindfulness is practiced by focusing your full attention on whatever is happening in the moment with clarity and acceptance.

By bringing ourselves into the present moment and away from thinking about the past or future, we can shift our relationship to stress. We can think of the present moment as a vacuum chamber and that stress, anxiety, and depression-generating thoughts require an oxygen rich atmosphere to thrive. By being in the present moment we help ourselves as nurse leaders to deal with the challenges of stress and attempt to successfully confront what captures our attention in the present. This is important for nurse leaders to consider because sometimes our greatest strengths (energy, ambition, willingness to act quickly) can become our greatest liabilities in maintaining the pace of our work. In today’s environment, nurse leaders spend a great deal of time trying to multitask, often unsuccessfully.

Being present as nurse leaders means that we are more available to those that with are with, and can be more empathetic, compassionate and caring. There is evidence-based literature to support the use of mindfulness in nursing leadership. Pipe et al. (2009) did a randomized research study at the Mayo clinic in which 33 nurse leaders were assignted to either a 4-week mindfulness-based intervention or a control group that received a leadership development course. The mindfulness intervention was found to significantly reduce self-reported stress symptoms among nurse leaders when compared to those in the control group.

Strategies to Cultivate Mindfulness

For some nurse leaders, mindfulness comes very easily but for most of us, we will need to cultivate mindfulness in a very intentional way. The art of being present in the here and now can be more difficult than you think. Here are several strategies that can be used to cultivate mindfulness:

1. Meditation

Mautarano is a big believer in short meditation breaks for as little as 10 minutes a day. This slowing of the mind allows us to listen and pay attention to what we might otherwise overlook—whether it’s a fresh idea or a new way of perceiving a situation—enhancing our creativity and letting go of our obstacles to innovation. During this meditation, accept all your physical, emotional and intellectual experiences, even the negative ones. Focus on your breathing and have a sense of the space around you.

2. Attune yourself to the Feelings and Actions of Others

Closely listen and observe others while suspending all judgement of what you see. This “leadership moment” is called purposeful attention and blocking out everything else in the environment. The goal here is to be nonreactive and carefully choosing your response to a situation. It also means recognizing that you don’t always need to respond. For nurse leaders, this also means closing the space (shutting your door) during the conversation so you can truly focus on what is being said.

3. Exercise Daily

Daily exercise has been found to both help leaders become more attune to their bodies, reduce stress and improve mind fitness.

4. Finding Space to Reflect and Be Creative

Cultivating mindfulness also involves becoming more attune to our own thoughts and feelings. This involves intentionally carving out time each day for reflection on our leadership. It is important to ask questions such as, Am I acting in concert with my values? Am I the leader I aspire to be? How am I doing managing the stress of my current situation?

Victor Frankel once astutely observed that “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom” Many nurse leaders, such as the manager I discussed in the introduction, respond to the pressure inherent in leadership by working harder and doing more of the same. Through mindfulness, we can learn to reflect, and to attend to both the quiet voice inside and the subtle clues from others and our environment, which can steer us in the right direction as nurse leaders.

Read to Lead

Alexander. R. (2010). Learn how to become a mindful leader. Psychology Today Blog

Mauturano, J. (2013) Mindful leadership: Finding the space to lead Youtube

McKee, A., Johnston, F. & Massimilan, R. (2006). MINDFULNESS, HOPE AND COMPASSION: A LEADER’S ROAD MAP TO RENEWAL. Ivey Business Journal.

Pipe, T. B., Bortz, J. J., Dueck, A., et al. (2009). Nurse Leader Mindfulness Meditation Program for Stress Management: A Controlled Randomized Trial. Journal Of Nursing Administration, 39(3). 130-137.