Hot topic - presence and steadiness

The art of nursing and midwifery is based on a wholesome presence and steadiness… how do we maintain this when life spins ever more frantically? 

Jun 22, 2022 | Hot Topics

Everything was going along beautifully and then all of a sudden it was out of control… a pattern that I have noticed is common as shifts come to an end…  but I did not feel out of control. In fact I started laughing quietly inside at the ridiculousness of it and realised that it is taking things lightly that keeps things simple and flowing at work.

When I do not feel light I know that something is not right, that I have taken something on that then weighs me down and this in itself makes things weighty and burdensome.

When I can observe the madness (rush, chaos, stress, angst…) that is life these days, without getting caught in it, I can maintain clarity and presence, keeping it simple and sometimes stating what is going on so that everyone can see the outplay. 

So rather than constantly trying to appease, acquiesce, smooth over, keep up, try harder… we need to stand up for what is true in any given moment. The impact of this is amazing.

I really appreciate that I see the importance and magic of the love and authority that it is to advocate for ourselves and each other. (Nurse, Australia)

I love this question and what it offers and invites me to consider. There is no doubt that our work environments can have us in a constant state of raciness, motion and activity. This is our statistical norm.

When I am connected to my body and how the above feels, there is also no doubt that this set up is absolutely not natural.

Being willing and able to observe the frantic spin of life is step one. Once aware of this constant rush it is more possible to step aside, review and consider a way to be that is not at the mercy of it. 

I am blown away by the impact of being present in my body, aware of my breath and the physical experience of a footstep, a touch and/or a smile. Awareness of my physicality keeps the door open to the settlement that is possible in each moment. When in the spin it is nigh on impossible to realise we are caught. Freedom comes from founding each moment with settlement rather than buzz and we can be the stillness in the storm. (Midwife, UK)

I am a palliative care nurse working in the community- meaning that managing a vast array of symptoms and providing support to many distressed families makes up a good part of my day. There seems to be an endless number of meetings in a week, spread throughout my working day and liaising with colleagues and other services also takes time.   In the time that I have been doing this work I have noticed the complexity of palliative care symptoms and the rapidity of patient decline increasing, with patients often having cancers that are no longer always textbook defined. 

Yes, the life of a nurse is indeed spinning ever more frantically.

I am often called to visit patients who are becoming unwell and/or deteriorating which can be distressing for the patient and their family. I often have little idea about what is needed until I have assessed the patient and spoken to them. 

I remember attending an urgent visit, outside of my normal hours, to a patient whom I had only visited once before and who the distressed family reported was deteriorating, possibly dying. The weather conditions were atrocious so my journey there was slow. 

I was nervous and glad I had met the family prior so I would not be unfamiliar to them. 

What was I going to find? Would I be able to manage the patients’ symptoms? Had I bought the right glasses to read the medication ampoules in the emergency bag? 

As I walked inside, I felt welcomed but their anxiousness was palpable. I walked into the bedroom, all eyes on me. I could see the patient was in her last stages of life – possibly only minutes away from death. There was nothing for me to do but to just be there. I could feel a steadiness in my body as I sat beside her, her daughter and husband on the other side. They wept quietly as they knew this was her time too. 

I held myself in stillness, observing, sharing occasional words with the family.

There was nothing more required from me. My presence was enough.

This was an early start to a busy day, but time of day did not bother me. 

When I am with a patient and their family there is no feeling of time – I am present to them for as long as what is needed is complete. This supports me to feel a completeness in myself when I leave and can then be fully present for my next visit. Conversely, when I rush, I feel the incompleteness as I drive away… an unsettlement in my body that quietly torments me for the rest of the day.

There always seems to be time in my day for everything I need to do even on the really busy days. I am not clock watching so much now – sometimes I work extra time in a day balanced out by taking some time back on another day, although this does not always happen.

When I notice a franticness creeping in, I know I need to stop, to feel what is going on. 

Have I taken on too much? 

Am I rushing or speeding along the road to get somewhere? 

Have I adequately nourished myself with food and fluids?

A conversation with myself, a few minutes quiet time, often on the side of the road, brings me back to myself, the present and what is happening next.

When I work and live with both steadiness and presence my days flow better, I feel a vitality within and the appreciation I have for myself and others around me is magnified. (Nurse, Europe)

We are part of a system that has been structured to take care of patients in times of illness and vulnerability, we hold them and support them to recover and to heal.  We assist with personal hygiene, greet them, give out medications, support them when they are in pain, listen as they express what is happening and how they are feeling, examine and dress wounds, give guidance with breastfeeding… the list is endless.

And it is how we do all these things that counts… the quality we are being, moving, speaking. Do we stand slumped with our head forward, the perfect depressed stance as in the famous snoopy cartoon? Or do we stand tall with our spine straight, switched on, alert to all the little nuances, being receptive to what is happening all around us. Our body is the ultimate receiver of energy it registers everything therefore it makes total sense to stand at the ready and to always treat with respect; fill it with premium fuel, deep expanding breaths, hydrate it with water, rest, rejuvenate, stretch and nourish it with food, all things to keep the body alive and in tip top condition. It really is simple.

Nurses and midwives are a team united, a collective walking beside and with patients. It is in our solidness and steadiness inherently acknowledging our value and not ever questioning it as we are all as one and stand with that cloak of V (for value) on our back walking tall and switched on, ever ready. (Nurse/Midwife, Australia)

Only in recent years have I valued the wealth of information my body shares with me and how that determines how I will be in my working day and in every other part of my life. Pretty crazy for someone who, as a nurse, has been trained to pay a great deal of attention to other people’s bodies and states of being!

It is strange isn’t it that as nurses we really don’t get training in listening to and caring for our own body and our state of being first and foremost. 

This has become a fundamental in my working day. If I had only known this 50 plus years ago!

There are so many simple things that have supported me back to full presence with myself and what is happening around me, and with the steadiness I feel now but I will share just one aspect here, one that made a huge initial difference and opened the way to the other steps I took, a gradual and loving unfolding back to loving my work. 

In my late 40’s I was forced to pay attention to my body and seek treatment and healing for it.

I was in constant pain, a dull and persistent ache in my back and shoulders and neck and my right hip and struggling through. I thought I was old!

I was much heavier than I had ever been at that time, had migraines and sinus headaches constantly for years plus bloating and abdominal pain, and felt so heavy and dull a lot of the time. I wasn’t enjoying nursing or people much at all, hadn’t been for some time and resented the way I ‘had’ to work. I didn’t see how I could keep going and felt like I was trapped on a wheel. I really felt old and I longed for retirement. With about 15 years to go before that was possible the yawning gap felt insurmountable and I knew something had to change.

With the stopping and paying attention I began to feel how much stress, anxiety and rush I was perpetually in. The constant turmoil in my tummy was awful. And I had just accepted it; this was how life was and it just naturally gets harder as we get older.

Amongst a number of other supportive things, I first looked at my diet, as a friend had given up having bread and cakes etc., in fact any stuff with gluten in and was looking and feeling amazing.

After some months of experimenting with reducing and eventually eliminating these I felt incredible compared to how I had been and decided to make my whole pantry gluten free.

I eventually became dairy free as well as I came to realise the nasal congestion, to the point of choking on mucous in my sleep, and sinus headaches were most often caused by this. I was a cheese addict so it was a slow process paring it down (haha, that there is an unintentional pun) but I didn’t rush or force it. And one day it came to its natural conclusion. I had begun introducing herbs and spices to my meals and devising my own recipes. Food became so much more interesting and fun to experiment with.

A by-product of this was that I lost a lot of weight, very naturally with no trying as it wasn’t the focus. I no longer had anyof the pain or symptoms I described earlier and felt very light and clear headed. I had much more energy and began to walk more again without trying to.

Everything became so much easier to accomplish. I could feel and sense more immediately what was needed for my patients and the situations they were in rather than getting caught up in complication due to the lethargic fogginess I had operated in without ever realizing how lethargic and dulled I had become. I also became more reflective in my practice and my day-to-day interactions and somehow more available to people.

18 years on and nearing 70, I am fitter and healthier than I have ever been. I love my job, connecting with my patients and their families, my colleagues and those in allied fields.

I enjoy people very much now and mostly they feel the same about me. All this, simply because I choose to be present and more caring of myself as well as them. Truly caring for myself means that people feel this honouring and they can also feel that I offer them nothing less. I value them as much as I value myself.

The steadiness and presence I feel is a vast contrast to the shutdown, exhausted, anxious and resentful person I had become years earlier.

For me it always seems to simply comes back to value. Because of this I know I can easily work for a few more years yet, and what’s more, even though the craziness of what is going on in the world and in nursing has gotten so much more intense, I want to. 

Life and work have become a rich unfolding. (Nurse, New Zealand)

Wholesome presence and steadiness. Not a phrase that I have heard any nurse mention ever. Not in any training, education or tearoom discussion. But yet, talk about the franticness of our days and even lives, yes definitely.

It’s interesting to consider that we talk, if not incessantly, about all the things that we see very clearly as affecting how we work, and how tired we are, but no focus on what keeps ‘the ship steady’. It’s not about finding fixes at all, let’s face it, how can we fix something whose foundations are crumbling, unless we turn inward to explore our own.

And so, can we then return to wholesome presence and steadiness?

I know that everything I live, I bring to my work… good, bad and indifferent. Which means that if I am living a deeper level of care and love for myself, then everyone I interact with at work receives that which I have been living. I know that I have absolutely no control over what happens at work. But the deeper I allow myself to connect inwardly, the less I am affected by what goes on around me and I seem to be able to see more clearly what is going on underneath everything that’s happening.

With that, I am then able to offer a much steadier presence, more of me (without compromising me) to colleagues, patients and families and walk the joy that I feel in my feet and bring that to my nursing work… day in and day out.

Now that’s something I would want to be offering everyone in my care and everyone in my workplace. (Nurse, Australia)

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