1. Parchment, Joy PhD, RN, NEA-BC


A must-have skill, being mindful is essential for all nurses, especially in the chaotic healthcare environment.


Article Content

"Will this day never end?" Those were the words that echoed in my mind as I went through the rest of the activities for my four patients, closed out my documentation, gave report, and finally headed to my car for the 45-minute drive home. I turned on my music playlist, cranked the engine, took the car out of park, and rolled onto the highway. The next thing I knew I was pulling into my garage. Even though this incident happened several years ago, to this day, I can't describe the specifics of the route I drove, the names of the songs that were playing, or the thoughts that rambled through my mind. Clearly, I wasn't in touch with the reality of my experience of driving home. I was on autopilot. Has this ever happened to you?

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One day a clinical nurse expressed a desire to talk with me, a nurse leader, about a specific problem. Of course, the next step was to invite the nurse to a space where we could talk privately. Before even arriving at the space, the nurse immediately told me about the specifics of the situation along with the challenges. Throughout the conversation, I kept asking the nurse to repeat statements because I was missing key pieces; not because I couldn't hear the nurse, but rather I found myself distracted with other ideas running through my head-names of people to see and thoughts of things that must get done before the end of the day. Before leaving, the nurse remarked, "You didn't hear a word I said." That statement was a punch to the chest. Although I was going through the motions, I didn't truly hear the nurse and therefore didn't respond in a way that demonstrated caring, empathy, and intentionality.


This article describes the rationale of mindfulness for leaders, explores mindful leadership behaviors, outlines the benefits of being a mindful leader, and identifies key strategies to improve your mindfulness leadership competency.


The "why"

The healthcare environment is complex and can be described as organized chaos. Each shift, nurses constantly juggle numerous patient care activities. We admit, teach, and discharge patients and must learn, adopt, and integrate new policies and regulations that frequently occur into our practice.1 Due to this everchanging and chaotic environment, nurses are expected to quickly learn the latest protocols to care for patients with new and ongoing chronic diseases. Senior leaders expect healthcare providers to utilize best practices, so reimbursement payments can meet the financial goals of the organization. Even with electronic medical records (EMRs) to document care, nurses spend more time with the EMR than caring for and teaching patients.2 Regardless of our position or title, nurses are asked to be informed, present in the moment for our colleagues and patients, and mentally focused throughout long days and nights. Essentially, nurses are "always on."


Patients are sometimes negatively impacted because of missed care opportunities or errors of omission due to inherent systems and processes that hinder nurses from maintaining focused, deliberate patient care activities.3 Then, nurses in formal leadership roles are asked to do more with less: To be the coach, visible and accessible, while achieving budgetary metrics and building a culture of excellence, authenticity, and safety.4 In fact, scholars suggest that nurses leave leaders who can't create a work culture of caring, trust, and connectedness.4-5


The use of mindfulness by all nurses, coupled with effective leadership behaviors, serves to build a foundation of intentionality, connectedness, and appreciation of our unique abilities and those of our patients and each member of the healthcare team. If nurses fail to integrate mindful practices into their leadership arsenal, our patients, teams, organizations, and communities may continue to suffer harm.


Mindfulness and leadership behaviors

Every nurse is a leader, and effective leaders influence, inspire, and build positive cultures.1,5-6 Leadership is about connecting with others for the promotion of a common goal. Yet, the term leadership continues to have an obscure meaning, suggesting there's never an endpoint but a cyclical process of repetitive learning and growing.6


Leadership theories describe behaviors that serve to define, set, and guide leadership practice, which is an interactive process occurring between the leader and the individual.6 Although there's interaction, the leader is responsible for building the bridge to create the relationship and then supporting the relationship through the identification of a common purpose.5-7


Mindfulness is described as a state of awareness that's deliberate and purposeful. It's an active way of focusing on what's occurring in the present-the here and now.8 When used in this context, mindfulness is a non-meditative state where your full mental acuities are used to control your thoughts and, subsequently, your behaviors.8


A mindful leader consistently monitors the environment and the individuals within the environment with inquisitiveness, openness, compassion, and acceptance.8 In other words, a mindful leader is purposeful with knowing and communicating the common goal, intentional by studying the unique needs of individuals, and nonjudgmental when first seeking to understand. Through their authenticity, mindful leaders demonstrate that everyone is valued.7-9 Exemplary nursing practice can't exist without the core leadership skill of mindfulness.


Benefits of mindfulness

There are significant benefits to integrating mindfulness into your leadership tool box. Mindfulness reduces the inclination to respond to an interaction with an involuntary or automatic response and it's linked to employee well-being and increased performance.10-12 Mindful leaders have a keen understanding of self and the desires of others. As self-awareness and empathy grow, mindful leaders can recognize the unique needs of diverse patients and team members, reinforcing the individual's significance.13


When you change your mindset from being overstimulated with the numerous trigger points of the day to being more self-aware of your thoughts, behaviors, emotions, sensations, and environment, you can reduce mental overload, decrease your stress, and become more resilient so you can improve your productivity. As your self-awareness increases, every activity, conversation, and learning opportunity is experienced as a fresh start.13


Become a mindful leader

Key strategies to build the competency of mindfulness require ongoing repetition. These strategies include adopting healthy practices, developing your emotional intelligence, aligning your values with your goals, and taking charge of your present and future life, along with building a psychologically safe social network.14 However, the pivotal link for developing mindfulness is the cultivation of healthy behaviors to boost all aspects of your humanness. Without your health as a top priority, consistency with and repetition of mindful behaviors may be threatened.


An important component of mindfulness, self-awareness is the ability to understand yourself, including your thoughts and feelings, and the feelings of others. This awareness helps guide your thinking and decision-making. To gain a well-rounded understanding of yourself, the use of a values assessment tool to uncover what's important to you is crucial. Results of the assessment clarify your values so goal alignment can occur.7-8 Alignment of your values with your goals is a necessary process that directs your life.


Living in the moment is taking charge of your present and your future. Being present in the moment requires an authentic self, intentionality, and vulnerability, along with a clear knowledge of your "why" and how your actions can hinder or propel you to achieve your purpose.7-8,15 Believing in yourself and others, speaking uplifting words, practicing gratitude journaling, and verbalizing what's good about individuals and situations are additional approaches that can help you achieve clear, focused here-and-now thinking.15-17


Finally, developing and sustaining a social network consisting of healthy relationships built on trust, collaboration, and acceptance allows for deeper connectedness. Actively listening through the lens of asking "How's this person like me?" is the vital bridge to connectedness. This reframing allows you to discover the other person's story by seeking first to understand.8 Only as you comprehend the other person's story can you appreciate their experience.


Be mindful-it matters

Regardless of your title or practice specialty, the core leadership competency of mindfulness is critical for all nurses. Instead of becoming overwhelmed with changes within the chaotic practice environment, mindfulness increases your capacity to pause and focus your brain even when you're pressured to be all things to everyone. As a mindful leader, you build connectedness through intentional interactions and demonstrate respect and empathy for the uniqueness of your colleagues and patients. Utilizing mindful behaviors strengthens your awareness of your thoughts and actions, delivering a strong message to your patients and colleagues that they matter, they're understood, and they belong.


cheat sheet

Five ways to grow your mindfulness competency7,8,14


* Cultivate healthy practices


* Align your values with your goals


* Increase your emotional intelligence


* Take control of life's moments


* Expand your social network


on the web

American Mindfulness Research Association:

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American Nurses Association's Healthy Nurses Healthy Nation:


Duke Center for Healthcare Safety and Quality:




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