Bend don’t Break: Creating Cultures of Resiliency Jeanette Vinek RN, BScN, MHScN Senior Instructor – School of Nursing UBC Okanagan Dietetics Preceptor Education Event October 3rd, 2017

“is the ability of an individual to respond to stress in a healthy, adaptive way such that personal goals are achieved at minimal psychological and physical cost; resilient individuals not only “bounce back” rapidly after challenges but also grow stronger in the process.”

The Current Context

Is it Possible?

It Happens in the Present Moment Consciously and intentionally as the practitioner learns to make the choice to care and to be fully present their reality shifts.

A reciprocity of caring occurs It’s all Connected When we release our focus on constraints, they no longer drive our behaviour. We are fully present, and are able to connect and engage with our clients. Through this relationship, the circulation of caring begins from practitioner to client and back to practitioner. A reciprocity of caring occurs

The Ripple becomes a Wave....

What this means….. While contextual constraints may influence our current reality, our conscious choice to practice caring, despite these constraints, results in a relational and reciprocal process, replenishing the our reserve of caring and reaffirming our connection to humanity.

Okay....so how?

Tell me what you know....

Mindfulness “Mindfulness is awareness, cultivated by paying attention in a sustained and particular way: on purpose, in the present moment, and non-judgmentally”. ~ Kabat-Zinn, 2012, p. 1.

Mindfulness “Just by becoming aware of what is occurring within and around us, we can begin to untangle ourselves from mental preoccupations and difficult emotions” (Siegel, Germer, Olendzki, 2009)

7 Attitudes of Mindfulness Non-Judging: Notice, and then let go of your judging. Patience: Be patient with yourself and with the process Beginner’s mind: Remain open and curious Trust: Trust in ourselves Non-Striving: Don’t try too hard Acceptance: Accept the present moment as it is Letting Go: Notice, and then let go of attachments

Mindfulness Practices Pause Practice Sitting Practice Focused attention (breath) Open awareness (thoughts, sensations, sounds, emotions) Mindful Movement Standing, lying, walking Focus on sensations, proprioception Body Scan Focus on physical sensations in the body

Widely Researched Princeton, Stanford, UCLA, Umass, Berkley, Columbia, McGill, UWashington, UPenn, UFla, Europe, Netherlands….etc,etc.

The Neuroscience of Mindfulness

Mindfulness & Neuroplasticity Anterior cingulate cortex – Controls executive function Increases in size and density (more grey matter) Improves attention, problem solving, working memory and regulating emotions Insula – Interoceptive awareness Increases in size and grey matter Provides a sense of what is happening within your body Amygdala – Fight or flight response Grey matter shrinks Inactive during meditation

Mindfulness & Neuroplasticity Posterior cingulate cortex – responsible for mind wandering Decreased activation during meditation Posterior cingulate works with anterior cingulate Increases ability to focus and decreases mind wandering Prefrontal cortex – Executive order functions Increases in size and density Responsible for decision making, planning and abstract thinking, Over time your ability becomes improves

Mental Benefits of Mindfulness Sharpens focus Improves Memory Increases Attention Span Restores synapses without the grogginess of sleep

Emotional Benefits of Mindfulness Increases Emotional Intelligence Reduces Stress Regulates Emotion Helps with Depression Reduces Anxiety Improves Self-esteem

Physical Benefits of Mindfulness Reduces Blood Pressure Reduces Heart Rate Prevents and Reduces Pain Weight Loss Enhances Energy, Strength & Vigour

Mindfulness moves mainstream... Moving from Monasteries to the boardroom and hospitals Current interest is as much medical as it is cultural

What does this mean to your practice?

Based on the evidence…. we went all in…… Title of Presentation | Qualifier Text | Page Based on the evidence…. we went all in…… 30 years of research proves mindfulness: Improves academic achievement Improves mental health Promotes positive relationships Develops concentration and attention Develops executive function (planning, decision making and impulse control) Develops emotional balance, pro-social behavior, and compassionate action Promotes well being smartUBC Website: http://www.smartubc.ca/

smartNursing UBCO TV

Title of Presentation | Qualifier Text | Page Our Research Efficacy of the smartNursing program Dr. Mary Jung from HES is the PI 6 year study 4 years through the program – 2 years post graduation

Symptoms of depression decreased for the nursing students at UBCO but not for the students at the Okanagan College Symptoms of depression = Beck Depression Inventory (BDI) BDI BEFORE the Relational Practice I course: UBCO: Mean = 9.32 (SD = 7.08) Okanagan College: Mean = 7.58 (SD = 5.64) - normal range for both groups - not different between the groups, p = .591 BDI AFTER the Relational Practice I course: UBCO: Mean = 9.06 (SD = 7.08) Okanagan College: Mean = 10.39 (SD = 5.64) - symptoms of depression increased only for the Okanagan College students - symptoms of depression remained the same for the UBCO students F(1, 116) = 4.98, p = .028

Perceptions of quality of life and general health decreased for the students at the Okanagan College, but not for the nursing students at UBCO BEFORE the Relational Practice I course: UBCO: Mean = 4.10 (SD = .66) Okanagan College: Mean = 4.17 (SD = .53) - not different between the groups, p = .76 AFTER the Relational Practice I course: UBCO: Mean = 4.07 (SD = .70) Okanagan College: Mean = 3.84 (SD = .59) -quality of life decreased for only the Okanagan College students F(1, 125) = 4.60, p = .034

Efficacy of the smartNursing Program The Okanagan College students: Increased symptoms of anxiety UBC Okanagan Students: Anxiety remained the same Interesting finding is levels of stress did not change in either group. The UBCO students were more able to cope with the stress. They developed resiliency. The findings provide preliminary evidence that the smartNursing course offers coping techniques to nursing students to assist them with the demands of school.

Where are we now? School of Nursing culture has shifted Teachers and clinical supervisors are bringing mindfulness practices in their classroom and clinical practice Offering drop-in sessions daily across campus Offering SMART sessions to faculty / students / staff across campus Working with Interior Health to bring the program to their staff Working with Baptist Housing to bring the program to their staff Offering open community sessions to bring the program to our community Working with other Schools and Faculties across Canada to embed the program into their curriculum.

Remember.... a ripple becomes a wave... and then...

“is the ability of an individual to respond to stress in a healthy, adaptive way such that personal goals are achieved at minimal psychological and physical cost; resilient individuals not only “bounce back” rapidly after challenges but also grow stronger in the process.”

Questions?