During the first session of a newly implemented mindfulness-based self-care series, Lisa Podgurski, MD, jokingly assured palliative care providers she would not be asking anyone to levitate. Later, she learned that at least one participant was reassured to know that things were not going to get too “touchy-feely.”

“One colleague told me she had been dreading coming the first time because she thought it would be ‘too kumbaya.’ But she found that she looked forward to it each month,” says Podgurski.

The intervention stemmed from strong interest in addressing providers’ well-being. “Burnout is a serious problem among healthcare providers in all fields, and palliative care is not spared from these concerns,” says Podgurski, medical director of palliative care services at UPMC Magee-Womens Hospital in Pittsburgh.

Some existing interventions, such as eight-week formal courses held in the evenings, were too time-intensive. “They are wonderful, but that just isn’t accessible to some of the people that might really benefit from this,” says Podgurski.

Podgurski condensed the more time-consuming approaches into five one-hour sessions, and invited palliative care providers to participate. Many reported increased mindfulness practices.1 “I was pleased to see that mindfulness levels improved and were sustained even after the session was completed,” says Podgurski.

Participants were made aware of a recommendation for 45 minutes of “meditation homework” each day. They were asked to begin very simply, with two minutes of meditation twice a day. Podgurski attributes high turnout to the fact that the sessions were held at a time and place when providers would normally gather for activities such as grand rounds or journal club.

A particularly encouraging sign: All but one participant indicated a desire to continue working on mindfulness as a group. The group continues to meet for one hour a month. To involve other areas, additional sessions are offered to oncology nurses and internal medicine residents.

The intervention was not linked to lower burnout rates. No statistically significant change was seen over the study period. However, the burnout levels of the group were much lower than reported national rates.

“Perhaps a more multipronged approach could have resulted in a statistically significant change in our group’s burnout levels, despite our low rates to begin with,” suggests Podgurski.

The study supports the idea that content from formal, time-intensive training programs can be condensed, and applied within a regular workday.

“This is part of the growing body of literature supporting institutional approaches to support providers’ well-being, rather than leaving the issue up to individual efforts only,” adds Podgurski.

The most important message, she says, is that providers’ paying attention to their own well-being “is not icing. It’s an important part of our role.”

REFERENCE

1. Podgurski L, Greco C, Croom A, et al. A brief mindfulness-based self-care curriculum for an interprofessional group of palliative care providers. J Palliat Med 2019; doi: 10.1089/jpm.2018.0550 [Epub ahead of print].

SOURCE

• Lisa Podgurski, MD, Medical Director, Palliative Care Services, UPMC Magee-Womens Hospital, Pittsburgh. Email: podgurskil@upmc.edu.