Mindfulness can be cultivated through mind-body practices[horizontal ellipsis](American Mindfulness Research Association, n.d.)

It is well established that work in the healthcare arena is both stressful and demanding. Left unheeded, over time, fatigue, dissatisfaction and disengagement insidiously sets in. Ignored, the process accelerates and barrels down the pathway towards burnout while damaging everyone in its path. The American Nurses Association (ANA) recognized this challenge and began the Healthy Nurse/Healthy Nation Challenge in 2017 (ANA, 2017). Using the five focus areas as overarching themes (activity, rest, nutrition, quality of life, and safety), the ANA suggested ways that nurses could improve their own health and also influence the health of others. In addition to physical aspects of health, combating stress and improving wellness were also emphasized (http://nursingworld.org/yearofhealthynurse).

Kari Schmidt, in her JNPD editorial from May/June 2017 titled, "Mindfulness Increases Clarity," challenged nursing professional development (NPD) practitioners to seek out approaches that "increase our capacity to lead change and increase our resilience" (Schmidt, 2017, p. 55). There is increasing discussion not only in healthcare, but also in other fields, about the power of mindfulness practices in the workplace and how it can help transform previously negative actions into positive forces. By developing our own mindfulness practices, we can also role model for others how to develop theirs.

Mindfulness is the state, process, and practice of remembering to observe moment-to-moment experience with openness and without automatic patterns of previously conditioned thoughts, emotions, or behaviors. (American Mindfulness Research Association, n.d.)

Often overlooked, but important to mindfulness training, is becoming aware of one's own triggers in the workplace. As NPD practitioners, we can make a huge impact in reducing workplace stress by raising awareness of this topic and providing space for safe immersive experience of mindfulness. When someone triggers us, we often react with anger and frustration, which can then lead to harsh, defensive language and potentially damage important relationships. Practicing simple techniques, such as pausing for a few moments when sensing discomfort and taking a deep breath, can help us transform our environment from a place of discord to a more positive arena.

These simple techniques may seem obvious. Chances are, most of us are intellectually aware of these techniques and, in the past, may have even given it some thought. In reality, however, very few of us routinely put them to practice in our clinical arena. This presents an excellent opportunity to offer experiential and immersive learning in the area of "mindfulness" training. Simulation offers an unique safe training environment to learn, experience, practice, and appreciate how these techniques can help us remain present in the moment and how best to respond to negative stimuli.

Because these techniques are simple, they can be integrated into existing educational offerings. Nursing orientation, emergency response simulations, interprofessional teamwork, and difficult communication scenarios are some examples of where mindfulness skills can be cultivated and practiced. Howland and Bauer-Wu (2015) suggest that clinical nurses who practice mindfulness can improve their assessment skills and technical performance, as well as enhance their communication with patients, families, and other team members. Such improved practice can help reduce symptoms of stress and burnout in the workplace.

As change agents, NPD practitioners work to transform our environments through "inspiration, initiation, adoption, and sustainment of adaptation to change[horizontal ellipsis]" (Harper & Maloney, 2016, p.16). We focus not only on how to educate our learners about clinical skills, but also on how to help them become more motivated and engaged employees. Developing and delivering mindfulness educational activities can change work environments by enhancing collegial relationships and minimizing discord, thereby leading to improved employee morale.

In this next series of Simulation columns, we will explore basic and intermediate techniques that NPD practitioners can use to promote mindfulness for nurses and other interprofessional learners. We will explore ways to create safe, immersive, and experiential sessions that assist our learners to become less reactive to their external stimuli and more thoughtful in their responses. We will also analyze ways that mindfulness practices can be integrated into existing educational offerings. We believe simulation provides a powerful avenue for engaging learners in a deep and meaningful manner that cannot be achieved in the lecture setting. As we progress in this series, we invite you to share your own experiences on mindfulness and self-management practices with us so that we can further enhance this important aspect of our professional role. E-mail me at mailto:[email protected] to share your experiences.

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