"Mindful practitioners attend in a nonjudgmental way to their own physical and mental processes during ordinary, everyday tasks. This critical self reflection enables physicians to listen attentively to patients’ distress, recognize their own errors, refine their technical skills, make evidence-based decisions, and clarify their values so that they can act with compassion, technical competence, presence and insight."— Epstein RM. Mindful Practice. JAMA. 1999;282;(9):833-39.
Mindfulness in medicine refers to a certain attitude or mindset where health practitioners are better able to bring their complete attention to what they are doing in the moment. Mindfulness is a Sanskrit word meaning awareness in Buddhist meditation. In medicine, the idea of mindfulness encourages self-reflection and a renewed awareness of one's body and feelings towards our patients and each other. In fact, mindfulness is important in meditation where "correct" or "right" mindfulness is a factor in the path towards enlightenment. According to Langer (2000), "...being mindful is the simple act of drawing novel distinctions; it leads to greater sensitivity to context and perspective and greater control over our lives. When we engage in mindful learning, we avoid forming mind-sets that limit us. Many of our beliefs about learning are mind-sets that have been mindlessly accepted to be true. Consideration is given to consequences that result from mindful reconsideration of these myths of learning."
Incidentally, "being mindful" is also the seventh element on the path of Buddhism, a practice which supports the development of wisdom. The Buddhist concept of mindfulness means to put all of your mental attention to the task at hand and to be in the moment. Mindfulness practice involves cultivating focus, attention, and awareness. In daily life, the practice also encourages simplicity, trust, and generosity. A key innovative teaching of Buddhism is that meditative absorption can be combined with contemplative insight.
In medicine, mindfulness techniques are used to help alleviate a variety of mental and physical ailments but also to focus the mind on tasks at hand. The notion of mindfulness is linked to narratives and patient histories in medicine. It acknowledges the often complex stories and narratives that arise between doctors, their peers and patients. Narrative medicine aims to validate the subjective experience of the patient, and encourages creativity and self-reflection in the physician.
In health librarianship, mindfulness is a focus on listening and awareness, both key to providing effective reference services or assistance to users in the library. When health librarians focus on the present, unencumbered by assumptions, judgments, thoughts of past or future events, they are more likely to listen attentively to and meet the needs of their users.
Mindfulness activity
For every hour of practice... integrate 5 min of mindfulness...
Sit and breathe. Take time, even for a few minutes in your office at lunch, sit and breathe, counting your breaths to ten and starting over
Physicians and medical librarians are notorious for multitasking over lunch, fork in one hand and book in the other
A psychologist once told me to take fifteen minutes twice a day to unfocus my eyes by looking off to the horizon
We can do something similar with our minds, given the constant attention we pay to others
Drop it all for a few minutes, close your eyes and spend time with yourself
As a health librarian, are you a mindful practitioner?
Do you listen to patients and physicians' narratives in a non-judgmental way?
Are you attuned to the developing narratives of those encounters?
Are you a supportive positive presence in your organization? library? clinical team?
Are you able to assume mindfulness with others including your colleagues and staff?
For some, the aim of mindfulness is to make it recursive (or continuous) throughout the day
Mindfulness in health librarianship can be practiced by paying attention to what we are doing throughout the day. What this entails is giving ourselves over completely to the moment, whether it's during the reference interview, questions being asked, catalogue searches or interactions with staff. Even though health librarians are trained to multitask, given the nature of our work, it's extremely important to be present during each task. Multitasking can lead to doing things poorly if we are not fully in the moment.
Mindfulness-based stress reduction program
Kabat-Zinn developed the mindfulness-based stress reduction program over a ten-year period at the University of Massachusetts Medical School. He defines it as "...the regular, disciplined practice of moment-to-moment awareness or mindfulness, the complete "owning" of each moment of your experience, good, bad or ugly." Kabat-Zinn explains the non-Buddhist universality of this practice. Mindfulness meditation is most-commonly practiced within the context of Buddhism, and its essence is universal. Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concern the relief of suffering and dispelling of illusions. MBSR has been shown to provide clinical benefits for people with depression and anxiety. Mindfulness-based psychotherapy is practiced as a form of complementary medicine in many hospitals. It is currently the focus of numerous research studies funded by the National Center for Complementary and Alternative Medicine. seehttp://clinicaltrials.gov/ct2/results?recr=open&no_unk=Y&spons=NCCAM&term=MBSR
Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol. 2010;78(2):169–83.
Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. Dell, 1990.
Kabat-Zinn J. Coming to our senses: healing ourselves and the world through mindfulness. Hyperion, 2005.
Kleinmann A. The illness narratives: suffering, healing, and the human condition. New York: Basic Books, 1988.
Langer EJ. Mindfulness and intelligence: the power of mindful learning. Reading, Mass: Addison-Wesley.
Novack DH, Kaplan C. Personal awareness and professional growth: a proposed curriculum. Med Encounter. 1997;13:2-7.
Novack DH, Volk G, Drossman DA. Medical interviewing and interpersonal skills teaching in US medical schools: progress, problems, and promise. JAMA. 1993;269:2101-2105.
