Caring for What Matters Most

Noticing What Supports Quality of Care

Pam Mulligan, BSN, RN, NBC-HWC

“Care begins with noticing what is being held.”

Clinicians are trained to notice early signs of instability in others long before lability becomes overt. We recognize subtle shifts, small deviations, and patterns that signal the need for attention. We rely on monitoring devices to alert us when values move outside expected limits, yet more often, it is the clinician’s felt sense, refined through presence and experience that prompts early intervention and helps prevent escalation.

This capacity for curious, whole-person attention allows for small, timely adjustments that restore stability before crisis unfolds, yet we rarely apply it with the same care toward ourselves.

Caregivers could benefit from applying the same quality of attentive assessment inward. We don’t have monitors or alerts to notify us when we are drifting out of range. Many of us are trained to override our own needs while attending to others. We silence internal alarms, postpone rest, and push through discomfort until distress reaches a crisis level. Over time, cumulative exposure to high-acuity environments, grief, and moral injury can quietly erode our health and well-being.

Caregiving work has always involved stress and disruption. Most are practicing in conditions of sustained uncertainty and rapid change. The question is no longer how to avoid stress, but how to notice when internal balance is shifting early enough to respond with care rather than react under pressure. Homeostasis is not about maintaining perfection, but about the capacity to adapt and return. For caregivers, this means cultivating clarity and connection that allow for early, compassionate intervention.

A significant disruption in my own life sharpened my awareness of how fragile internal stability can be when external conditions are overwhelming. That awareness, alongside my ongoing work with caregivers, led me to palliative care studies at the University of Washington, reinforcing the importance of whole-person care, values-based alignment, and sustained attention to what matters most —especially in the presence of uncertainty, distress, or change.

This perspective continues to deepen how I understand what supports stability and quality of life for those who give and receive care.

The Take a Moment practice is a brief pause to check in with the mind, body, and heart. We call this a ”pulse check” to notice what is present, recognize early signs of strain, and reconnect with what supports steadiness before reactive responses take hold. Developed as a core practice within Replenish at Work™, it has also served as a personal anchor, offering a way to pause, widen perspective, and respond with intention. Take a Moment supports a return toward internal homeostasis by creating space to notice and respond with intention.

We are navigating personal and professional stress in a world that feels increasingly unstable. Attending early to instability, restoring what is depleted, and supporting quality of life remain some of the most meaningful ways we care well for others and ourselves.

- Pam

This space will continue to offer reflection and practical resources in support of that care….

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