The document discusses the importance of mindfulness in enhancing mental health, particularly within the legal profession. It highlights that many lawyers experience stress and burnout, and provides evidence that practicing mindfulness can alleviate mental health issues while improving performance. Techniques such as meditation and mindfulness during daily activities are suggested as effective methods for practitioners to adopt.

1. 42 PROCTOR | December 2017
Mindfulness
Enhancing mental health in the law
As a litigation lawyer, I often
found myself over-engineering
courtroom scenarios in my head
and when things didn’t go to plan
it would retrospectively cause me
mental angst.
Many of my friends practising law are burnt
out and share these sentiments, with some
maintaining that whilst they may have the
resilience to adequately deal with stress in
the workplace, they are seeing an influx
of their colleagues taking stress leave and
suffering from anxiety and depression.
Recent studies show that one in five
Australian employees have taken time off
work due to feeling mentally unwell in the
past 12 months and that untreated mental
health conditions cost Australian workplaces
approximately $10.9 billion per year.1
What is mindfulness?
You can be forgiven for being a little flippant
when you hear the term mindfulness, as it
seems to be the ‘buzzword’ used by every

2. self-proclaimed personal development guru
out there. In essence though, mindfulness is
simply the psychological process of bringing
our complete and undivided attention to our
internal and external experiences, as they are
occurring in the present moment.
What are the benefits?
The benefits of practising mindfulness are
abundant. From a mental health perspective,
it is a simple, non-prescriptive measure
that can be used to alleviate stress, anxiety,
depression, chronic pain and addiction.
Generally speaking, practising mindfulness
vastly improves mental health and
performance in the course of our personal
and professional lives.
Where’s the evidence?
As a lawyer I insisted; show me the
evidence! So I did some research and
found that a technique known as functional
magnetic resonance imaging, used to detect
blood flow in the brain, confirms that when
people are practising mindfulness, only
the pre-frontal cortex becomes enlivened.
This is the part of the brain associated with
awareness, attention, control, concentration
and decision making.
With prolonged practice, mindfulness
increases neuroplasticity, which in turn
enhances mental agility and performance.
It is because of this scientific evidence –

3. transcending it from a mere ‘buzzword’ to
being a credible and powerful tool to enhance
mental health – that we now have a range
of successful CEOs, business professionals
and leading institutions utilising mindfulness
to enhance their performance.2
The question I then asked myself was:
“If these successful bodies and people are
using mindfulness to reduce stress and
enhance their performance, why aren’t I?”
How can I start
practising mindfulness?
Daily meditation
The most powerful tool we know that can
be used to practise mindfulness is meditation.
I’ve personally been meditating for ten years
now and don’t believe I’d be able to get
through my day without it. It anchors my being
to everything that is important in my life and
has taught me patience, tolerance and how
to keep a birds-eye perspective on things.
If you haven’t meditated before, or perhaps
have tried and didn’t have any luck in keeping
your thoughts still, you should know that
there are a number of methods you can use
to meditate and that it isn’t necessarily about
keeping your thoughts still at all. Similar to
practising mindfulness, meditation is simply
about being completely present in the moment.
A minimum of 15 minutes in the morning and
10 minutes at night is the recommended time

4. one should meditate.3 If you’re able to maintain
this practice, after a few weeks you will feel a
tremendous benefit to your overall wellbeing.
If you’re a curious novice, you can visit
msia.org.au/how-to-meditate/ for a meditation
guide or simply Google ‘guided meditation’.
Prolonged acts
Harvard University released a recent research
paper that found we spend 47% of our
waking lives thinking about matters that
have either occurred in the past, or may/may
not transpire in the future, and that it is this
‘mind wandering’ that is the root cause of
our unhappiness and various mental health
concerns.4 The older we get, we become
more desensitised to our environment.
We repeat actions so many times that
they become a part of our subconscious
programming. It is when we are in this ‘auto-
pilot’ mode that our mind begins to wander.
You can introduce mindfulness during any
prolonged act you may consider to be
mundane or part of your daily routine to
circumvent ‘mind wandering’. For instance,
it can be applied to the act of brushing your
teeth, driving to work, having a cup of tea or
going for a walk. If we were to take the act
of your lunchtime walk for instance, your sole
objective would be to bring your attention
to your internal and external experiences as
they are occurring in the present moment
and to sustain this attention control from
the beginning to the end of your walk.5

5. How mindfulness enhances
mental health at work
With such a large percentage of our lives
spent at work, employers not only stand to
benefit from educating employees about
mindfulness practice from an economical
perspective but also have the opportunity
to enhance the mental health, wellbeing
and performance of their people, which
is a win-win for everyone.6
When practising mindfulness, our conscious
mind confronts our subconscious
programming, so that we become the observer
of our thoughts, anchoring our awareness to
the present moment. When we’re completely
present in the moment, we’re not concerned
about matters outside our control, such
as incidents that occurred in the past or
may/may not happen in the future.
http://msia.org.au/how-to-meditate/
43PROCTOR | December 2017
The
MEDICO
-LEGAL
Mind
A monthly newsletter from

6. Professor David A F Morgan OAM
PROFESSOR DAVID A F MORGAN OAM
Orthopaedic Surgeon/ Medicolegal Reporter
More than 30 years experience in Personal Injury and Medical
Negligence analysis
Respected for Accuracy, Balance, Clarity, Objectivity and
Reliability
[email protected]
(07) 3832 1652
www.themedicolegalmind.com.au
Notes
1 This comprises of $4.7 billion in absenteeism,
$6.1 billion in presenteeism and $146 million in
compensation claims: ‘State of Workplace Mental
health in Australia – Beyond blue/ TNS Social
Research, 2017.
2 From Mark Zuckerberg & Richard Branson, to
Richard Gere, Sting & Labron James. Harvard
University also rolled out a mindfulness program
for its staff this year.
3 When meditating you should be in a comfortable
position, with your spine up straight. Then shift your
focus to your breath, being completely aware of the
airflow entering your body (causing your diaphragm
and stomach to expand as you inhale, and contact
when you exhale). Anchor your consciousness to
the present moment by focussing on your minds
eye (area between your eyes) whilst simultaneously

7. focussing on your breath, which should after a while
get into a drawn out, calm and sustained rhythm.
4 http://news.harvard.edu/gazette/story/2010/11/
wandering-mind-not-a-happy-mind
5 Starting with your breath, be aware of its tempo,
the airflow and its affect on your body, your heart
rate etc. before becoming aware of your senses and
their contact with the outside world. Then moving to
your external world, you’d be aware of the sounds
around you, other people going about their day and
the rest of your immediate environment; all along
doing your best to remain unbiased, limiting your
judgements and not labelling anything as good or
bad. You keep this process going until the end of
your walk and repeat it daily. In a matter of days you
will find a profound sense of calmness, focus and
clarity has been attained.
6 Organisations like The Open Mind Institute
(www.tomi.org.au) deliver Mindfulness & Mind
Fitness Workshops to employees that provide them
with mental based techniques that can be used
to achieve enhanced mental health & optimum
performance in the workplace.
Rather, we’re operating from an objective
birds-eye perspective, enabling us to remain
composed and make rational choices. It is
from this platform that we can also exercise
overlapping psychological processes such
as critical thinking, emotional intelligence
and metacognition, allowing us to execute
informed and unbiased decisions – skills that
are fundamental in the legal profession.

8. Life is 10% of what happens to us and 90% of
how we react to it. By practising mindfulness
each day, we strengthen our prefrontal cortex
allowing us to judiciously react to adverse
circumstances. This ultimately leads to calm,
rational and empowering decisions being
made in the workplace, enriching mental
health in the process.
Paul Pitsaras is a qualified lawyer, co-founder, speaker
and managing director at The Open Mind Institute.
Wellbeing
by Paul Pitsaras
Button 13: Button 6: Page 45:
BUSI 240
Discussion Board Example
Groupthink
Definition: Organizational Behavior notes, “Groupthink is the
tendency of highly cohesive groups to value consensus at the
price of decision quality” (McShane & Von Glinow, 2008, p.
257).
Summary: The article entitled “The Turn to Online Research is
Narrowing the Range of Modern Scholarship, a New Study
Suggests” written by Rebecca Tuhus-Dubrow (2008) discusses
how the internet has made accessing research and other things
on the internet extremely easy. The author asserts that by using
search engines, which often rank the importance of a result by
popularity, students leave themselves vulnerable to groupthink
when conducting research results (Tuhus-Dubrow, 2008).

9. Tuhus-Dubrow (2008) suggests that this this can be mitigated
by using multiple sources to help provide a more well-rounded
research pool.
Discussion: The internet has made performing research for
students a matter of seconds. Students used to have to go to the
library and conduct research out of textbooks and other
publications but now by simply typing your subject in a search
engine a variety of choices are at your fingertips. “Millions of
journal articles are available online, enabling scholars to find
material they never would have encountered at their university
libraries” (Tuhus-Dubrow, 2008, para 2).
The internet just like everything else has it costs as well as
benefits. Just like the article states the internet has started to
dominate people’s lives. People rely on the internet for
everything for both work and personal use.
The internet is considered to be a new form of groupthink
because when searching for articles students are not highly
selective in the choices they make and they tend to pick one of
the few search choices that comes up. Also, the other
alternatives of research are now not used due to the convenience
of the internet. Tuhus-Dubrow (2008) make the case that
outcomes should be portrayed by search engines in some
organized way because most websites depend on devices that
classify primarily in a couple of ways. The ways they are
classified are by chronological order and by popularity (Tuhus-
Dubrow, 2008). If a search engine filters results by popularity
then this is groupthink because others are succumbing to the
will of the group by choosing the same articles that show up
first as results.
Do you feel that internet search engines cause groupthink? If so,
elaborate on why you think this. Do you feel that this is why
many professors at Liberty University want students to not
choose the same discussion board topics? I personally feel that

10. the reason professors want us to chose different topics is so that
we will not reflect the same views and chose the same articles
which would therefore be groupthink.
References
Adler, S. (2009). At davos, beware the tide of groupthink.
Bloomberg Businessweek. Retrieved from:
http://www.businessweek.com/bwdaily/dnflash/content/feb2009/
db2009021_878209.htm
McShane, S., & Von Glinow, M.A. (2013). Organizational
behavior (6th ed.). New York: McGraw-Hill.
Mulrine, A. (2008). The army trains a skeptics corps to battle
groupthink. US News. Retrieved from:
http://www.usnews.com/articles/news/world/2008/05/15/the-
army-trains-a-skeptics-corps-to-battle-groupthink.html
Tuhus-Dubrow, R. (2008). Group think: The turn to online
research is narrowing the range of modern scholarship, a new
study suggests. Boston.com. Retrieved from:
http://www.boston.com/bostonglobe/ideas/articles/2008/11/23/g
roup_think/
Page 2 of 2
nursingstandard.com7 2 / 19 April 2017 / volume 31 number
34
evidence & practice / revalidation
The authors
of reflective
accounts that
are published in
Nursing Standard

11. receive a £50
book token.
£50
REFLECTIVE ACCOUNT
Mindfulness
A CPD article improved Toni McIntosh’s
understanding of how mindfulness can be
used to enhance compassionate care
This reflective account is
based on NS877 Barratt C
(2017) Exploring how
mindfulness and
self-compassion can
enhance compassionate
care. Nursing Standard. 31,
21, 55-62
These questions are the
same as those on the NMC
templates that UK nurses
and midwives must use
for revalidation
Write your own reflective account
You can gain a certificate of learning by reading a
Nursing Standard CPD article and writing a reflective account.
Turn to page 61 for this week’s article. To write a reflective
account
for Nursing Standard, use the NMC reflective accounts form
available here: revalidation.nmc.org.uk/
download-resources/forms-and-templates
Complete the four questions about the CPD article you have just

12. read, writing about 800 words in total. Details of how to submit
your
reflective account are available at:
journals.rcni.com/r/reflective-account
What was the nature of the CPD activity,
practice-related feedback and/or event and/or
experience in your practice?
The CPD article discussed mindfulness and self-
compassion, and how these concepts can improve
nurses’ well-being and their ability to provide
compassionate care.
What did you learn from the
CPD activity, feedback and/
or event and/or experience
in your practice?
The article stated that
the aim of mindfulness
practice is to develop a
non-judgemental awareness
of the present moment.
The article helped me
to understand how
mindfulness relates to self-
compassion, and how this
can enhance compassionate
care.
I recently experienced
a period of anxiety and
depression, which resulted
in me taking time off work.
When I returned to work,
I remained anxious at times
because I put pressure on

13. myself to perform well. I
realised that I had been
giving all of my energy to
my work, and prioritised
the well-being of patients
over my health and well-
being.
After reading the
article, I realised that
self-compassion is not a
selfish act, and that without
looking after yourself, you
are not able to provide
optimal care to others.
Thus, by neglecting my
mental health, I was also
unable to give patients the
best possible care that I
could. I have learned that
by promoting mindfulness
for nurses, managers can
improve the health of their
staff, as well as enhance
patient care.
How did you change or
improve your practice?
One issue I experienced in
my practice was that after
visiting a patient, I would
continue to analyse my
actions and worry that I
had done something wrong.
The cumulative effect of

14. this was that I became
emotionally exhausted and
felt unable to cope.
My manager suggested
that I use a mantra, as
discussed in the article. This
is a phrase that I would
repeat to myself after each
patient visit, to enable me to
feel confident that I did my
best and to move on to the
next patient with no residual
anxiety. This enabled me
to focus my attention and
energy on each patient,
improved my confidence and
helped to challenge my self-
doubt. I have learned that
effective mantras are short,
powerful and individual to
the person.
Another change I made
Ge
tty
nursingstandard.com volume 31 number 34 / 19 April 2017 / 7
3
Revalidation
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15. revalidation.nursingstandard.com
PATIENT VIEW
‘My midwife made childbirth a
positive and enjoyable experience’
Nurse Heather Scott praises the exceptional care that she
and her partner received from midwife Anna Marley
I was expecting my first baby. I was
nervous and in slow labour. When
I called the maternity unit at Queen
Elizabeth Hospital in Gateshead
for reassurance over the phone,
midwife Anna Marley was on shift.
I didn’t know what to expect,
but Anna was there throughout
the night, on the other end of the
line, giving me reassurance that
everything was okay, even though
the labour was taking a long time.
The following night I went into
active labour and Anna was on
shift again. She would be the
midwife who delivered my baby,
and she made sure it was a good
experience for my partner and I.
From the moment Anna greeted
us at the door, to showing us to
our room, through to delivery and
aftercare, her bedside manner
and professionalism was beyond
anything we could have expected.

16. As first-time parents, my partner
and I were anxious, but she made
everything easier and more
bearable. She constantly included
my partner and patiently explained
the different processes, as well as
giving him advice and support.
My partner is scared of hospitals,
but afterwards he said to me that
if he had been paying hundreds
of pounds for a private service, he
would not have expected such a
high level of care and attention.
As a nurse myself, I think this is
a big compliment.
Strong support
After the slow start, my labour took
hold quickly and I had to deliver
without pain relief. If I hadn’t had
such a supportive midwife, I don’t
know how I would have coped.
It is because of Anna that my
experience was positive and
enjoyable. She deserves to be
credited for what she does,
because I can see that she shows
the same commitment to everyone
in her care. That means there are
a lot of happy mothers out there.
after reading the article

17. was to try to ‘live in the
moment’. I realised I was
constantly ruminating
about the past and
worrying about the future,
which meant I was not fully
present in each moment.
After incorporating
mindfulness into my
practice, I feel more relaxed
and confident, and
I have more emotional
energy to give to patients.
How is this relevant to
the Code?
Select one or more themes:
Prioritise people, Practise
effectively, Preserve safety,
Promote professionalism
and trust
The Code states that nurses
must treat people with
kindness and compassion,
as part of the theme of
prioritising people. The
article discussed how
mindfulness practice can
enhance the compassionate
care that nurses provide
to patients. Mindfulness
activities can support nurses
to practise effectively and
preserve safety by focusing
on the task in hand, rather
than worrying about the

18. past or future.
As part of the theme of
promoting professionalism
and trust, The Code
states that nurses must
maintain the level of health
necessary to carry out
their professional role.
The article emphasised the
importance of having self-
compassion and looking
after your health and well-
being.
Toni McIntosh is a community staff
nurse at Ailsa Hospital, Ayr
Heather Scott, with her son John, is full of praise for her
midwife’s efforts
nursingstandard.com6 4 / 14 June 2017 / volume 31 number
42
evidence & practice / revalidation
The authors
of reflective
accounts that
are published in
Nursing Standard

19. receive a £50
book token.
£50
REFLECTIVE ACCOUNT
Mindfulness
A CPD article improved Georgina O’Reilly-Foley’s
understanding of how mindfulness can be
used to reduce stress and enhance
compassionate care
This reflective account is
based on NS877 Barratt C
(2017) Exploring how
mindfulness and
self-compassion can
enhance compassionate
care. Nursing Standard.
31, 21, 55-62
These questions are the
same as those on the NMC
templates that UK nurses
and midwives must use
for revalidation
Write your own reflective account
You can gain a certificate of learning by reading a
Nursing Standard CPD article and writing a reflective account.
Turn
to page 54 for this week’s article. To write a reflective account
for
Nursing Standard, use the NMC reflective accounts form
available

20. here: revalidation.nmc.org.uk/
download-resources/forms-and-templates
Complete the four questions about the CPD article you have just
read, writing about 800 words in total. Details of how to submit
your
reflective account are available at:
journals.rcni.com/r/reflective-account
What was the nature of the CPD activity,
practice-related feedback and/or event and/or
experience in your practice?
The article discussed how mindfulness and
self-compassion can enhance compassionate care. At
a time when the NHS is under increased pressure and
media scrutiny, it was useful
to read about strategies that
support nurses to manage
this pressure and maintain
high standards of care.
What did you learn from the
CPD activity, feedback and/
or event and/or experience
in your practice?
The article defined
mindfulness as a non-
judgemental awareness
of the present moment. It
described how mindfulness
is an important aspect of
self-compassion, because
by becoming aware of their
experience, individuals
can learn to identify and
address harsh or critical

21. ‘self-talk’.
Throughout my pre-
registration nurse training,
my mentors encouraged
me to be mindful and
to analyse challenging
situations before acting,
so that I do not become
overwhelmed. Nurses are
often required to provide
care for several patients
with various needs at once;
for instance, one patient
might require their dressing
to be changed, another
might need a commode, one
patient has a low oxygen
saturation level and another
requires pain relief.
Before reading the article,
I would often feel unable
to cope in situations in
which I felt under pressure.
However, I have learned to
take a step back and assess
the situation, thus allowing
time for me to prioritise
patients based on their
needs. Therefore, in the
scenario described earlier,
care of the patient with
the low oxygen saturation
level would be prioritised,

22. followed by the patient
requiring pain relief, then
the patient requiring a
commode, and then the
patient requiring their
dressing to be changed.
How did you change or
improve your practice?
After reading the article, I
have attempted to become
less self-critical and have
more self-compassion.
When I feel stressed, I
take a step back and try to
self-talk in positive ways,
as suggested in the article.
Adapting this mindset has
improved my ability to
manage stress.
One issue I have
experienced in my practice
is that in the final year of my
nurse training, I have had less
time to spend with patients,
iS
to
ck
nursingstandard.com volume 31 number 42 / 14 June 2017 / 6

23. 5
Revalidation
Find out more at:
PATIENT VIEW
One-to-one care from dedicated
nurses helped allay my anxieties
Sarah Broom explains how two nurses in different hospitals
took the time and trouble to offer her personalised support
I have had excellent
care from two nurses
at two different
hospitals in Heart
of England NHS
Foundation Trust in
the West Midlands.
Staff nurse Katie
O’Neill has looked
after me on numerous
occasions, and even
though Ward 10 at
Good Hope Hospital
in Sutton Coldfield is so
busy, she always makes you feel as
if you’re her only patient.
I have watched her with other
patients and she always takes the
time to make people feel as if they
are the most important thing.
She makes me feel less

24. anxious and more at ease, which
is especially important on a
respiratory ward. She always does
this with a smile on her face, and
you usually end up with one on
your face after she’s been looking
after you.
Reassurance
Senior sister Judith Paintain,
who works in the day surgery
unit at Birmingham Heartlands
Hospital, also showed herself to be
professional and dedicated to her
patients.
She looked after me before
and after a procedure. I was very
anxious and scared because of
bad previous experiences.
Jude spent a lot of time talking
to me about the procedure
beforehand to ease my fears and
arranged for me to look round
the unit before I was due to go in,
so it was more familiar and less
daunting.
Although she was extremely
busy – her door was knocked on
five times during our meeting – she
never made me feel rushed or less
important than the other things
she had to do.

25. On the day of the procedure
she made sure she was around,
came to talk to me and reassure
me beforehand, and even
accompanied me when I went for
the procedure. I am so grateful that
she took the trouble to help me
through this difficult time when I
am sure she had hundreds of other
jobs to do.
As the senior sister, she could
have let one of the other staff
look after me, but she knew I
was anxious – we had built up
a rapport. She realised how
important it was to me that I had
someone there who would make
me feel at ease and comfortable –
and she did just that.
because my responsibilities
have increased. I had felt I
was losing quality time with
patients; however, after
reading the article, I realised
the importance of being in
the moment. For example,
when testing a patient’s
blood glucose level, I am
aware it is important to
talk to them and focus on
the present task, rather
than worrying about the
next tasks that have to be

26. completed.
I have also improved my
ability to delegate tasks
to other members of the
multidisciplinary team, which
has reduced the pressure I
felt. I intend to improve my
delegating and prioritising
skills over time, and to teach
others these skills.
How is this relevant to
the Code?
Select one or more themes:
Prioritise people, Practise
effectively, Preserve safety,
Promote professionalism
and trust
The Code theme of
practising effectively states
that nurses must practise in
line with the best available
evidence. Evidence indicates
that mindfulness can reduce
staff burnout and stress,
and may improve resilience.
The theme of prioritising
people emphasises the
importance of treating people
with compassion. The article
emphasised that mindfulness
and self-compassion are
important aspects of being
able to provide sustained

27. compassionate care.
Georgina O’Reilly-Foley is a nursing
student at Southend University
Hospital, Essex
Excellent nursing care eased Sarah Broom’s fears
Reproduced with permission of copyright owner. Further
reproduction prohibited without permission.