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Mindful leaders know that forcing mindfulness on employees won’t solve moral injury.

Updated: Mar 18, 2023



There is a common misconception about mindfulness popular with healthcare clinicians and leadership. We have gotten caught up in believing that mindfulness will help us be calmer, nicer people, who handle stress better and recover from burnout faster.


Mindfulness is a buzzword, and many hospitals and healthcare systems have adopted mindfulness classes as a primary employee wellness tool.


Seeing mindfulness as one tool is ok, but when healthcare systems get caught up in seeing mindfulness as a fix for their employees, we have a problem. Mindfulness classes are not a fix for burnout. Nor are they a fix for unhappy employees who have stopped coming to work on time or put in less effort than they should.


Using mindfulness to fix unhappy employees blinds healthcare systems to the reality of the failures of the system that lead to moral injury and burnout.


Using mindfulness as a leadership tool to lean into the painful reality helps leaders engage burnout hotspots to become part of the solution to reduce burnout and promote healing in our healthcare systems. Mindful leaders create healthy and high-performing healthcare systems when they bring their systems back into alignment with the core values of medicine and their employees.


Learn how to apply mindfulness skills within your healthcare system by listening to my conversation about a mindful approach to physician well-being with Colleen Camenisch. Colleen is the executive director of the Nevada Physician Wellness Coalition. She’s also a certified teacher in mindfulness-based stress reduction.


Listen to the whole episode







Mindfulness is not the fix for everything that ails our healthcare systems. It is a strategy that teaches us to turn toward problems.


Mindfulness is a way of being that helps us to turn toward pain and suffering with curiosity. Mindfulness helps us to become aware when something is wrong and teaches us to turn towards what’s not working so that we can make changes to realign our choices and healthcare system policies with our core values.


Healthcare workers become frustrated when encouraged to take mindfulness classes or practice yoga to manage their stress. While these are healthy practices that are part of self-care for some people, the unintended message is “fix yourself.” And burnout and unhappiness at work increase.


This relates to moral injury, which comes from the military when soldiers are put in positions that lead them to act or witness events that go against their moral compass. Or when soldiers are in situations where they witness overwhelming need and cannot help. They experience distress that leaves them feeling out of alignment with their values. This misalignment leads to moral injury.


This can happen in healthcare too.


There are moral injuries to physicians and nurses when system failures cause harm or force healthcare workers to make impossible choices. For example, if you have a patient who needs a specific treatment, insurance won’t approve it because it’s too expensive.


Or perhaps no specialist is available to see your patient, and you are stuck providing treatment outside your scope or skill level. Covid provides too many examples to count. But if you were in the position of deciding who was put on a ventilator and who was given palliative measures, you may still be struggling with the choices you had to make.


Systems’ failings result in moral injuries and contribute to burnout.


Healthcare leaders are also at risk of being harmed by systems failings. Nearly 30% of healthcare leaders are experiencing high rates of burnout.


As a healthcare leader, you may be forced to take responsibility for policies that you did not design and don’t believe in. You may be responsible for informing your team when the hospital does not have sufficient beds, funds, or PPE to care for the patients coming to you for treatment. And when you are burned out, it impacts your team and home life.


But here’s the good news. Even when you can’t control the situation or prevent systemic failures, you can use mindful awareness to be a part of the solution.


Use mindfulness to approach burnout hotspots and become a leader in the solution.


You can successfully address burnout using the strategies you already use to address patient safety concerns.


1. Start by asking yourself tough questions:


“What systems challenges are happening in this area?”
“Why does this department have higher levels of burnout than other areas?”
“How can I address these challenges as a systems leader?”

Asking these questions with mindful openness helps you to develop an awareness of the big picture.


When you look at hospital problems, it can be easy to take them personally.


Failing patient outcomes or employee unhappiness metrics is an attack on your leadership. But when you use mindfulness to take a non-judgmental and curious approach, you can look at your challenges from a constructive systems perspective. You begin to see what needs change without taking the challenges personally.


2. Then ask your people what’s not working. And listen to their answers, even when what you hear is painful.


“What prevents you from being able to do the job that you want to do?”

Mindfulness helps you develop the capacity to be with discomfort. It helps you to turn toward painful conversations. It helps you to be less reactive so that you can open your mind to see your choices or options. Mindfulness helps you be proactive and thoughtfully respond to your challenges.


Mindfulness helps you escape the automatic or habitual ways of thinking you get stuck in, such as “It’s all my fault that my people are suffering.” Or “The policies letting my people down are out of my control. There’s nothing I can do to change their workload. Talking about it will make things worse?”


And when you take a mindful approach as a leader, you will begin to listen more openly and problem-solve creatively.


You can’t stay sustainable as a healthcare leader or create the conditions for your employees to thrive without doing the internal work first.


Slowing down and practicing a mindful approach to leadership will help you sustain yourself over the long term. And developing the ability to turn toward painful conversations will help you to transform your healthcare system.


A mindful approach will differentiate you from the leaders who don't make it to the finish line – and ensure that you’ll still have the energy to be present for what matters most.


Your well-being. Your life outside of work. And your people on the frontline.


The things getting in the way of thriving healthcare systems and happy employees cannot be fixed by policy changes alone. You must do the internal work to sit with discomfort and step back to see opportunities where you once saw only roadblocks.


If you’re on this journey of doing internal work to transform yourself as a leader to maximize your impact on your healthcare system – I want something more for you. That is precisely why I got into working with healthcare leaders and leadership teams in the first place.


Join me for a complementary Mindfulness-Based Leadership Strategy Session where you’ll have a chance to consider your values and develop a strategy to realign your actions with your core values.


Contact me if you have questions or want additional details about this free Strategy Session. And keep in mind…because of the very special nature of this mindfulness-based work, just a few seats are available each month!


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