The Practice of Embodiment
The demands placed on nurses at worksites around the province are unrelenting. Amid a worsening staffing shortage and growing patient acuity, BCNU members are struggling to keep their heads above water in the wake of a COVID-19 pandemic and ongoing toxic drug crisis.
There is no question that nurses are vulnerable to the trauma and moral distress that come with this new health-care reality. Last year, a staggering 82 percent of members polled reported their mental health had worsened since the pandemic.
That's why psychological health safety has never been more important.
To better support members, BCNU launched the Embodying Your Practice (EYP) education program in June 2021, in partnership with somatic educators Anita Chari and Angelica Singh. It began with a series of webinars that saw participants examining principles of nervous system regulation, trauma-informed practice, and equity and inclusion work to help them cultivate resilience.
These were followed by Introduction to Embodying Your Practice, an on-demand course in trauma-informed and embodied practices for nurses that has helped participants settle their nervous systems by recognizing and navigating feelings of overwhelm, trauma, and burnout while building and sustaining feelings of calm.
EYP is designed to provide participants with effective tools and protocols to help manage the stress of today's health-care workplace. The EYP resources are just one part of the educational offerings provided through BCNU's mental health strategy and are designed to support and strengthen members' psychological safety and mental well-being.
Aida Herrera is BCNU's executive councillor for health and safety. She says that health employers are legally obligated to provide psychologically healthy workplaces, and notes that BCNU and other health-care unions have done much to hold employers to account and advance safety on the job (see the feature story on page 26 about BCNU's work to strengthen and support workplace joint occupational health and safety committees). However, Herrera also says BCNU won't wait for employers while members continue to suffer.
"We wanted to continue with our commitment to provide mental health supports and resources to our members," she explains. "This education is just the first phase in the reactivation of BCNU's mental health strategy, and I look forward to providing more mental health support and advocacy for our members in the year ahead."
EYP is a team effort between BCNU and Chari and Singh, co-founders of Embodying Your Curriculum, a popular program first created to support post-secondary educators. Chari and Singh are both excited to be delivering EYP to BCNU members.
"We empower nurses," says Chari. "During the pandemic, nurses have not been provided with resources for self-care. Moral distress is very real and we designed this course to give BCNU members some nourishment to navigate those places within themselves," she explains. "We are meeting nurses personally and serving them during a time of so much burnout."
Chari stresses the attention to equity that runs through EYP.
"We work with nurses of colour and Indigenous nurses on social injustices in the health-care system, which they're always navigating. They're not just handling those issues with patients, but also with themselves, and within institutions and health-care systems," she remarks.
"These are very challenging issues that touch on historical oppression and trauma and our work with BCNU members delves into that. It's not only education about addressing trauma, but also how that works within systems, and in terms of historical injustice. We help nurses connect all those dots."
As an educator, Singh says she feels privileged to help those who help everybody else, and to take the time to dignify their experiences.
"We help nurses decompress, vent, and feel comfortable, seen and heard – all things essential to humanity," she says. "What matters is making sure that those working in health care – in the trenches, taking all the hits for everybody else – are also getting their needs met. We work to be present with BCNU members, to help them first feel their own dignity."
- Anita Chari
In an EYP course or webinar, the facilitators encourage participants to become aware of what it means to be grounded in their own bodies and contact the health of who they are, instead of the pathology.
"That may sound really simple, but it's very difficult," says Singh. "We live in a very colonized, pathologizing world, particularly in the medical system. But when people are at a crisis point, they are more able to access the different levels of vulnerability and connection that we need," she explains.
Both facilitators believe it's important for nurses to recognize they're not just a cog in the machine of meeting other people's needs.
Singh explains: "It's not just about 'coping strategies' and 'resiliency'. That all sounds really great, but those words function within the same system where somebody can take away your agency. We want language that re-dignifies how nurses are heard, how they communicate, and how they listen to themselves and others. It's about how we participate without losing ourselves to the frustration and powerlessness of systems designed to take our best and leave us empty. For nurses that's particularly true, and so obvious during the pandemic."
Chari and Singh employ person-centered language, absent of labelling, and make open inquiries to help nurses develop a nuanced sense of their own experiences and sensations.
"When we slow down," explains Singh, "and name our particulars using sensation words instead of typical words like 'fear' or 'anxiety', we contact ourselves differently. The naming skill is a skill of regulation – it's a down-regulating of the nervous system that discharges the trauma and imprinting causing so much of the 'rev' in the nervous system."
She illustrates. "Somebody might say: 'I'm really stressed! I feel really angry or anxious.' I ask: 'Where do you most feel it?' They respond: 'I feel a burning sensation in my shoulders.' I ask if it's okay to just feel the edge of that burning sensation, just for a moment, and to do this exercise with yourself is an embodiment practice – to slow down, make contact. From that quality of neutrality is a discharge that begins to metabolize or digest stress.
"We don't need a psychological or emotional narrative because it doesn't easily move the energy around. That's the process of regulation and the practice of embodiment. It happens through the gateway of slowing down and grounding, learning to inquire with neutral language and communicating in a way that re-dignifies and attunes a nurse's relationship to self. If we first learn that contact with ourselves, we can proceed to co-regulating with others, including patients. And that level of presence informs the other person's nervous system of how safe and regulating they can be too," says Singh.
Anita Chari and Angelica Singh developed and deliver webinars and online courses designed to support and strengthen members' psychological safety and mental well-being.
Chari adds another layer. "The emerging language lets us understand how our emotional state is so connected with the larger structure. Many of us are taught our emotions and mental health are our fault, our own business," she says. "That's a very toxic idea because we aren't educated to see that our own mental distress has everything to do with how a structure deals with issues of power around equality, justice, and history. From Embodying Your Practice, we emerge into a co-regulated field, and we see that an unhealthy system is saddling nurses with stress and responsibility rather than helping us to see the proper responsibility of an institution, of a society.
"When individuals bear too much up front – such as nurses in a pandemic – that contributes to burnout. We're not here to strengthen you for an exploitative system – it's about educating you to serve yourself and move into a more co-creative, more relational, more just health-care system," Chari says.
Singh recalls something unique they found working with BCNU members.
"It was remarkable how nurses' dynamics were much deeper than most people's. They're more capable of accessing deeper levels of resonance, attunement, and health, all of which is required for embodied transformation at a community level. It was both a surprise and yet, not a surprise. We saw that the nurses are literally warriors, arming up to the level required for what they're dealing with – to care for people – and then to see how incredibly resourced they are because of their profession, because they're helpers in service to others," she reports. "It was a real blessing to see, and working with BC nurses has been profound."
Chari says she also found something "cool" about working with BCNU members. "They're very real with us, down to earth about their struggles. That kind of openness and conversation is rare," she remarks. "The nurses are having very deep, painful experiences daily, or multiple times a day. I was honoured by how open they were about their experience."
Is everyone an open book?
"It's like popcorn," Singh describes. "They don't all pop at once. But there really was a remarkable amount of availability. When you're in survival mode, you develop defenses to tolerate it and your nervous system goes into dissociative states. Your adrenals are exhausted and there may be no bandwidth for emotional connections," she notes. "Despite this, BCNU members were remarkably available to each other as a group, and to themselves. When one person shares, it deepens the whole group. There are some incredibly intelligent and remarkably powerful people who are members of BCNU. They each have drawn on their group social intelligence, and that's empowering. We've been so fortunate to tap into that and provide our learning and resources to people who can genuinely benefit," she says.
Glenna Lynch is a steward-at-large in BCNU's West Kootenay region. She enrolled in Foundations of Embodying Your Practice and now encourages other members to do the same, convinced that the online self-paced course has been a tremendous learning experience.
"Sometimes I didn't understand my own behaviour," she says. "I'll have an automatic response to certain things – and that's my embodied behaviour, a result of somatic markers in the brain, the neuro pathways.
"This course taught me that our bodies can naturally heal emotionally as well as physically – you simply acknowledge they're real and happening in your body. It's like when you cut yourself: you don't tell your body to heal, it just automatically mounts an immune response and heals! The same capacity exists for our emotional being. Simply being present and neutrally naming what you're experiencing allows the natural healing process to happen. That was a huge epiphany for me. I was shown another way to self-regulate, and that's a huge benefit to me, professionally and personally," says Lynch.
The seasoned nurse says she's really impressed that BCNU is offering this type of somatic education for members.
"It's a way to help us address our physical and mental health so we can increase resiliency and, importantly, maintain our practice," she states.
- Glenna Lynch
Lynch describes "boundary creation," when asked to share one of the key skills she learned through EYP.
"Close your eyes, picture a bubble all around you, from your head to your toes, as big as you need it to be in order to feel like you have a safe space around you. When you sit within that bubble, you are maintaining personal boundaries," she explains. "This helps when dealing with a crisis and someone else's emotions – which are not your own. I learned there is a boundary between me and those things – the space between is a safe space to recharge."
"Neutral naming" is another skill Lynch is now using in her practice.
"It's about grounding yourself and experiencing how your body feels," she says. "A pain in your heel might be described as 'a pressure in my heel.' Our bodies make us feel things physically, but neutrally naming them activates related emotional healing to help alleviate the physical aspect. We must address internalized stress that presents as physical pain to help resolve all the physical and emotional components connected to it," she says.
Lynch says she found comfort in the confidential learning space. "I knew a couple people in my group," she says. "Right away, I acknowledged to myself and the rest that we were in a safe space where anything said does not go elsewhere. The facilitators reiterated that. We were on Zoom and were allowed to turn off video. But it's an active, engaged process so seeing each other increases vulnerability and the resulting benefits. It was a very supportive environment. Sometimes we just sat quietly with each other as we worked through individual needs. Even on video, we could really feel the emotions present, and it felt like a safe space for all," she says.
Lynch believes Embodying Your Practice is an extremely valuable personal health resource and recommends it to other BCNU members.
"It's a tool I can engage anytime, anywhere, and take some time to just breathe and ground myself – even if I'm only on a coffee break. I now just close my eyes and simply engage with myself, to become more resilient…"
(At this moment in the conversation, Lynch closes her eyes while speaking, and holds them closed for 12 seconds before speaking again.)
"…to be able to not just exist in health care, but to thrive."
Since its launch, over 900 BCNU members have accessed EYP resources. And to better facilitate ongoing demand, future courses will be offered through BCNU's new Learning Centre platform.
In addition to providing the successful on-demand resiliency course, Chari and Singh will host regular webinars throughout 2022 and 2023 to help build a BCNU community of practice. •
Contact education@bcnu.org for more information on the BCNU Learning Centre or assistance with course registration. For questions regarding EYP, please contact Melissaminter@bcnu.org. •
UPDATE (Fall 2022)DID YOU KNOW
EMBODYING YOUR PRACTICE IS NOW offered through the brand new BCNU Learning Centre – your new home for union education and professional development.
The Learning Centre is an online learning management system (LMS), a holistic one-stop tool where you can easily manage course activities, collaborate with classmates, post in discussion forums, and track your progress – all aimed at improving your learning experience and helping you do your work.
This fall BCNU is transitioning courses to the Learning Centre and expanding the suite of blended educational offerings. Given nurses’ schedules, busy lives, and travel challenges, these new, flexible deliveries will better serve BCNU members moving forward.
Introduction to Embodying Your Practice is the first on-demand, self-paced Learning Centre course, which features a variety of engaging, multi-sensory learning activities and a series of live support sessions. To participate, you first need to create a user account on the Learning Centre and then apply for your chosen course.
Visit the BCNU Learning Centre today to view all available courses.
If you have any questions, contact education@bcnu.org.