Steps During the Interventions Phase

This intervention plan is based on the idea of the importance of a mindfulness meditation program for nurses who have to work with high mortality patients during a pandemic. It is expected to work for eight weeks; however, two additional weeks have to be considered as an opportunity for the researcher to clarify a situation with participants, analyze available data, and cooperate with stakeholders. Weekly monitoring plays a crucial role in this project because it contributes to better evaluation, observation, feedback, and communication.

Week 1: During the first week, it is necessary to check all processes and preparations. A proposal is offered to the ethics committee and an administrative team of a hospital in terms of which the main idea of the intervention is explained, and the rights and responsibilities of participants are discussed. Observations of nurses, their working conditions, cooperation, and practices are necessary this week to make sure that a mindfulness program can be properly introduced and accepted in the facility.

Week 2: It is the period of the first direct contact with the participants. If the researcher has already gathered some information about potential participants, their duties, and roles, nurses know nothing about this research and their contributions to this intervention. During this week, nurses are informed about their participation in order to make a decision either to agree or to neglect the offer. The final step of this week is signing informed consent that is an agreement between a research team and nurses as direct participants and sources of information.

Week 3: This week aims at educating nurses and providing them with all theoretical aspects of the intervention. Now, it is high time for nurses to understand the importance of a mindfulness meditation program. With the help of PowerPoint presentations, specially developed handouts, and a professional educator, nurses take several lessons in a conference room. Information about nurse burnout, stress, and obligations are properly introduced to nurses during 1-2 hour lectures three times per week. Nurses have to visit these meetings to improve their awareness of the relationship between work stress and meditation. Formative evaluation and feedback should end the week to clarify the importance of education for nurses before the intervention.

Week 4: There are several questionnaires that have to be offered to nurses in order to evaluate their stress level and readiness to cooperate. The pre-test stage contains three surveys to be sent to every participant: the Expanded Nursing Stress Scale, the SF-12 Questionnaire, and a self-administrated questionnaire. If nurses do not have personal computers or other devices where they can answer these questions in an electronic form, the researcher has to provide them with the same tools in a written format during a face-to-face meeting.

Week 5: It is the first week of a mindfulness meditation program actually begins. There is a special room for nurses to spend two hours three times per week. Participants have an educator who guides their activities and shows how each step must be taken. There has to be a special device for background music. The room is clean, and fresh air reaches it regularly. It is also recommended to turn off cell phones in order to spend enough time to complete a meditation course successfully.

Week 6: During this week, the intervention is combined with formative evaluation and observation. The researcher gathers the first factual data about nurses’ behaviors and reactions to the offered intervention. Nurses, in their turn, spend two hours in a meditation room where they are involved in four different activities: sitting, walking, stretching, and watching. To make their participation comfortable, the room should have an interesting surrounding, including several pictures, calm walls, and clean windows from which it is possible to observe weather changes.

Week 7: More attention has to be paid to formal evaluation this week. Nurses continue participating in a meditation program and spend two hours outside their working place and focusing on their wellbeing. The researcher has to prepare post-test questionnaires and assess behavioral changes among nurses: their readiness to go to work after meditation, their mood before the meditation course, and their common feedback about what is offered to them. Personal observations and direct contact with participants may not be obligatory, but they will help to analyze statistical data during the next weeks.

Week 8: The same way pre-test surveys were sent to participants is used during this week to gather post-intervention information about participants’ wellbeing. Nurses have to continue meditating regularly but also ask the questions in order to evaluate their stress levels. One-to-one conversations are recommended if there is enough time, which creates additional opportunities to understand nurses’ needs, emotions, and attitudes toward the relation between mindfulness meditation, stress, and overall wellbeing.

In general, cooperation with participants is one of the most important steps in this project. During the intervention phase, nurses have to learn the main aspects of wellbeing at work and their responsibility for patient health and personal stability. If a nurse is not able to cope with stress or other negative factors, the quality of care can be challenged. The success of a mindfulness meditation program depends not only on the qualities gained by nursed but also on their knowledge and the abilities to find and exchange information. This intervention plan focuses particularly on the activities for nurses and the outcomes of their participation in a program to improve their wellbeing and reduce stress.

Appendix

Plan for Educational Offering

OBJECTIVES CONTENT (Topics) TEACHING METHODS TIMEFRAME EVALUATION METHOD
1. Improve awareness of personal wellbeing at work Nurse wellbeing is introduced as a critical element of care in a hospital. Learners share their experiences and listen to the lecturer about why nurses should focus on their wellbeing as well as the health conditions of their patients. Despite the intention to predict nurse burnout, there are situations when their wellbeing is challenged because of unpredictable situations. Wellbeing of patients is crucial and turns out to be one of the primary goals for nurses. However, it should never be achieved at the expense of personal health and behavioral changes. PowerPoint presentation and discussions 30 minutes Simple questions are posed by a lecturer for nurses to identify their strengths and weaknesses in the chosen topic.
2. Analyze the impact of a pandemic on nursing care A pandemic situation is hard to predict and prevent, and its impact can influence different spheres of work. Nurses should understand why a pandemic determines their responsibilities. PowerPoint Presentation and statistics 10 minutes Brief notes (three points) to prove that the offered theme is worth analysis.
3. Understand the basics of a meditation program It is important to review meditation as an intervention for consideration. There are several purposes, as well as causes of why meditation is necessary for nurses during their work with high mortality patients. PowerPoint presentation, simulation 20 minutes Not measurable, but it is possible to ask nurses to share the cases when meditation is a helpful tool either for nurses or other care providers.
4. Evaluate personal levels of stress Nurses have to recognize their needs and promote changes as soon as stress levels are increased. There are many methods to evaluate personal wellbeing, and stress tests are among them. Written handouts and cards with tests 10 minutes The Expanded Nursing Stress Scale (all questions) can be used to show if nurses are challenged by stress. The Health Survery SF-12 is used to analyze the quality of work nurses demonstrate before education and after the meditation program.
5. Take meditation steps appropriately There are several tasks for nurses to complete during their meditation program, and each of them has a specific impact on nurses. Sitting activities help to relax and focus on problems and concerns that bother a nurse at the moment. Physical exercises are used to make the body work and predict muscle-related problems. Mindful stretching helps to reduce the number of negative substances in the body, and simple watching completes the meditation program by an overall evaluation of the offered idea. PowerPoint presentation – to explain each step of the meditation program;
Individual cards – to provide nurses with simple guides on how to succeed in mindfulness meditation personally.
20 minutes Not measurable, but it is possible to ask nurses to repeat the steps and check their awareness of the intervention before and after its implementation.
6. Complete professional duties and responsibilities at a high level Nurses underline their roles in a setting in regard to patients and their families, doctors, and other medical staff, and themselves as direct doers. On the one hand, nurses have to predict the development of disease and check patients regularly. On the other hand, they are responsible for personal health and should know how to help people but never due to personal losses. PowerPoint presentation and role play 10 minutes A self-administrative survey is used to gather personal information about nurses and their vision of tasks and responsibilities during a pandemic period.