PICOT
The following PICOT question will serve as the basis for the proposed DNP project: “Among nurses who care for high morbidity/mortality patients during periods of pandemics (P), would a mindfulness meditation program (I) compared to no intervention (C) reduce the level of work stress (O) in two months (T)?”
Purpose
In this project, an overarching aim is to evaluate the effectiveness of a mindfulness meditation program that can be offered to nurses who work with a specific group of patients. During the period of pandemics, the medical staff is challenged by the necessity to work under restricted conditions and with limited resources. Many people are not ready for new requirements and poorly understand existing threats and opportunities. To achieve the already mentioned aim, several specific objectives have to guide the researcher and other stakeholders of the intervention. At this moment, there are four critical goals to support the main aim:
- To gather information about the current state of affairs in medical facilities and employees’ awareness of their tasks;
- To analyze the impact of pandemics on nurses and patients who are at high morbidity/mortality risk;
- To investigate the characteristics of mindfulness meditation within healthcare units;
- To describe the steps of implementing a mindfulness meditation program among nurses who have to work during a pandemic period.
Evidence-Based Intervention
In this DNP project, the implementation of a mindfulness meditation program for nurses will be discussed and analyzed. The profession of a nurse is never easy and characterized by several responsibilities and duties. On the one hand, nurses have to work in teams and share their obligations regarding their positions, areas of care, and background knowledge. On the other hand, nurses take care directly of patients and communicate with their families and doctors. Stress, anxiety, and depression can hardly be eradicated, but, according to Van der Riet et al. (2018), emotional regulations help to improve their emotional well-being. Therefore, this EBP change is considered as a protective strategy for nurses to contribute to the promotion of high-quality care and support either for nurses (as direct participants) or patients (as indirect observers).
Nurses, as well as other medical employees, have to demonstrate their best skills and experience under different conditions. It is expected that nurses function at their highest psychological and physical levels, and their health is as important as one of their patients (Penque, 2019). The development of mindfulness is critical to reducing the risks of job burnout, turnover, and other problems that could provoke unwanted outcomes in nursing practice. In many countries, this practice has already been successfully implemented during 8, 16, and 24 weeks, and such results as stress reduction, emotional stability, and focus on work were observed (Van der Riet et al., 2018). Some interventions were brief and took several minutes per day due to workload, and some programs were 2.5 hour-long per week, with an additional full-day retreat (Penque, 2019). Despite the conditions under which nurses got an opportunity to meditate at work, the impact of this intervention was proved as positive (Sanko et al., 2016). Therefore, the decision to investigate the same technique for nurses who work with a particular group of patients during the epidemic period is made.
In this project, the idea of the intervention is as follows: a team of nurses is chosen and provided with a discipline about the importance of emotional stability in their personal and professional lives. As soon as the instructor explains the main elements of the procedure and its purposes, nurses are invited to be involved in several physical activities. It is planned to spend about two hours per training three times per week. The first 30 minutes are devoted to sitting activities when the instructor promotes awareness mindfulness. The next 30 minutes are devoted to physical exercises that include healthy breathing and fresh-air walking. Then, 30 minutes are given for mindful stretching, both active (shoulder rolls or overhead reach) and passive (warming up activities and simple exercises). The final 30 minutes are used to complete simple watching, when nurses sit still, think about their lives, and relax. The goal of all these tasks is to underline the necessity to focus on the present moment and let the mind open its boundaries.
Meditation should not be considered as another task that nurses have to complete. It is a means for developing mindfulness and removing all judgments that are related to work for a moment (Van der Riet et al., 2018). In addition to the possibility to decrease stress and anxiety, this tool is effective for enhancing decision-making, problem-solving, and communication skills (Sanko et al., 2016). One should remember that not all invited nurses are eager to spend much time doing all those mindfulness practices because of the already established duties and expectations. Some patients may need additional attention, and some families want to receive high-quality care for a long period. Therefore, it is important to plan each meditation session concerning all participants, their patients, and plans. The idea of the intervention is to change human relationships within a particular context, and high mortality ratings are not always easy to predict or prevent. People’s illnesses may be developed in a variety of forms and lead to different outcomes, but this mindfulness program aims not at understanding the health of patients but at promoting nurses’ well-being under the period of a pandemic.
References
- Penque, S. (2019). Mindfulness to promote nurses’ well-being. Nursing Management, 50(5), 38-44. doi: 10.1097/01.NUMA.0000557621.42684.c4
- Sanko, J., Mckay, M., & Rogers, S. (2016). Exploring the impact of mindfulness meditation training in pre-licensure and post graduate nurses. Nurse Education Today, 45, 142–147. doi:10.1016/j.nedt.2016.07.006
- Van der Riet, P., Levett-Jones, T., & Aquino-Russell, C. (2018). The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review. Nurse Education Today, 65, 201–211. Web.