Background and significance of Mindfulness-Based Stress among Nurses
Contrary to the conventional beliefs, evidence-based practice and evidence-based protocols should extend well beyond just the care of patients to include a new focus on the health and wellbeing of medical practitioners. Nursing professionals are at risk of developing mindfulness stress because of exposure to long work hours, loss and emotional suffering, dealing with pain, caring for patients of terminal illness and those destined to death, and providing emotional support to their families (Daigle, S., et al., 2018). Nurses are also exposed to complex patients and illnesses, shortages of staff, increased need for knowledge of dynamic technologies, and corporate financial constraints.
Stress impacts on high-level cognitive functions such as memory and attention, which increases the risks of developing mental issues among nurses. Studies have shown that persistent high stress among nurses starts to demonstrate negative outcomes in the workplace such as professional and personal burnout, low productivity, absenteeism, workplace turnover, and low job satisfaction (Daigle, S., et al., 2018). In turn, these outcomes negatively affect patient care, including poor handling of patients, negative emotions towards patients and colleagues, failure to accomplish tasks, and lack of coordination in the workplace. Consequently, patient dissatisfaction may escalate and lead to economic losses on the side of the organization.
Description of the practice change: Adopting MBSR in practice
MBSR is an EBP practice for teaching mindfulness meditation, basic yoga, breath work, and other methods of relaxing the body and the mind. It is a self-directed mind calming and body relaxing practice focusing on the awareness of the present-moment. The new practice is an 8-week program involving training in yoga and mindfulness meditation. Nurses are required to attend the practice once in a week for a period of 2 months (Daigle, S., et al., 2018). Each year, it will run for four times and will take place in the main hall in the evenings.
Summary of the Study: Daigle et al., 2018
The present pilot study aimed at discovering the extent to which mindfulness-based stressed reduction training impacted the nurses’ well-being and subsequently reduced the rates of medical errors (Daigle et al., 2018, p. 2427). With the help of a randomized controlled trial, seventy RNs were divided into the intervention group (N=37) and a control group (N=33). During the pre-intervention study, the chi-square goodness of fit test revealed insignificant differences in terms of medical errors and psychological distress (Daigle et al., 2018, p. 2429). However, during the post-treatment assessment, it has been estimated that nurses in the intervention group reported lower distress rates and fewer medical errors. Hence, it may be concluded that the present study justified the positive implications of mindfulness-based stress reduction training for nurses’ well-being and ability to perform fewer medical errors.
Summary of the Study: Ghawadra et al., 2019
The present systematic review aimed at analyzing the studies related to mindfulness-based stress reduction training and nurses’ well-being and decreasing the rates of psychological distress. The sample of the study included the publications issued between 2002 and 2018 available at PubMed, Science Direct, Springer Link, EBSCO, and Web of Science (Ghawandra et al., 2019, p. 3747). Using the Quality Assessment Tool for Qualitative Studies, the initial sample of 1749 found results were reduced to nine eligible studies (Ghawandra et al., 2019, p. 3749). The selected studies, although obtaining a variety of limitations, resulting in positive MBSR outcomes for the nurses’ well-being (Ghawandra et al., 2019, p. 3753). The outcomes addressed reduced stress, anxiety, depression, burnout, and better job satisfaction rates (Ghawandra et al., 2019, p. 3747).
Summary of the Study: Lin et al., 2019
The present study pursued the goal of defining the effect of the MBRS program on the general hospital nurses’ levels of stress and resilience (Lin et al., 2019, p, 111). The study obtained a design of a randomized control trial, with the sample including 110 Chinese nurses. The sample was randomly assigned to either the intervention or control group, and the intervention group underwent an 8-week MBRS program. In order to efficiently evaluate the outcomes of the study, the intervention group participants were asked to fill in a baseline questionnaire three times: prior to the intervention, immediately after the program, and three months later (Lin et al., 2019, p, 111). The results of the study indicate that the nurses felt less stressed and exhausted, yet no job satisfaction improvement was indicated (Lin et al., 2019, p, 118).
Summary of research literature supporting the practice change
Considering the aforementioned studies, it may be concluded that MBSR obtains a positive impact not only on the level of nurses’ stress or anxiety but enhances their overall health and cognitive abilities (Daigle et al., 2018). For this reason, it is advisable to develop a proper intervention framework for the nurses to undergo MBSR interventions over certain periods of time, as the program itself works best when repeated. Moreover, the work setting of nurses is extremely stressful and exhausting in terms of workload, and it is necessary to define the ways to address burnout promptly to secure tangible results.
Theoretical framework to support the practice change
The theory by Shapiro, Carlson, Astin, and Freedman best fits in the MBSR therapy for stress management. According to this theory, three axioms or principles occur simultaneously to produce the state of mindfulness (Daigle, S., et al., 2018). These axioms or principles are attitude, attention, and intention. When put together, the axioms define mindfulness as “paying attention in a given way on the purpose, in the current moment, and in a non-judgmental way”. (Ghawadr, etal., 2019) Attention is to direct focus of awareness and uses cognitive inhibition, switching, and sustained attention. Intention involves personal vision of the expected gains from the practice (Lin, et al., 2019). Attitude is the evaluative component that goes towards a given activity.
The developers of this theory argue that intention, attention, and attitude underpin all the subsequent effects of the state of mindfulness in humans. The three axioms create a process that makes one realize that the consciousness is different from its contents, which results in improved self-regulation, behavioral, emotional, and cognitive flexibility. In addition, it helps expose a person to previously or existing troubling internal states of the mind (Ghawadr, etal., 2019). However, this theory fails to address the actual underpinnings of the process of changing the state of mindfulness.
In conclusion, nursing professionals are at risk of developing mindfulness stress because of exposure to long work hours, loss and emotional suffering, dealing with pain, caring for patients of terminal illness and those destined to death, and providing emotional support to their families. MBSR is an EBP practice for teaching mindfulness meditation, basic yoga, breath work, and other methods of relaxing the body and the mind. MBSR, once conducted repeatedly, demonstrates positive impacts on the overall health of the participants. Therefore, it will be a compulsory practice for all the nurses in the institution to attend.
Daigle, S., Talbot, F., & French, D. J. (2018). Mindfulness‐based stress reduction training yields improvements in well‐being and rates of perceived nursing errors among hospital nurses. Journal of advanced nursing, 74(10), 2427-2430.
Ghawadra, S. F., Abdullah, K. L., Choo, W. Y., & Phang, C. K. (2019). Mindfulness‐based stress reduction for psychological distress among nurses: A systematic review. Journal of clinical nursing, 28(21-22), 3747-3758. Web.
Lin, L., He, G., Yan, J., Gu, C., & Xie, J. (2019). The effects of a modified mindfulness-based stress reduction program for nurses: A randomized controlled trial. Workplace health & safety, 67(3), 111-122. Web.