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Theoretical Framework/Change Model
The Neuman Systems Model will be applied as the theoretical framework. Betty Neuman described her work as a unique perspective to approach a variety of concerns in a healthcare setting (Gonzalo, 2019). There is a properly developed client system, with stressors and the environment being investigated. An individual has to be viewed holistically, considering physiological, psychological, sociocultural, developmental, and spiritual variables (Gonzalo, 2019). Stressors penetrate the life of a human and can be of different types, including intrapersonal, interpersonal, and extrapersonal (Gonzalo, 2019). The prevention of stressors is one of the best interventions to stabilize human well-being, and lifestyle change is one of the primary recommendations. Regarding the nature of the Neuman Systems Model, the application of Lewin’s theory of change is a reasonable alternative.
The purpose of this paper is to understand how the use of a mindfulness meditation program helps nurses who work with high morbidity/mortality patients reduce work stress during a pandemic. The chosen model is based on the evaluation of individual factors about the environmental stressors and nurses’ reactions. This type of relationship plays a crucial role in understanding human behaviors under specific conditions (Gonzalo, 2019). This model explains how the pandemic and a group of patients contribute to increased stress among nurses (extrapersonal and interpersonal stressors). Its application shows the attitudes of nurses toward their responsibilities and their well-being (intrapersonal stressors). The Neuman Systems Model proves the importance of the environment and personal judgments to improve the quality of care and the effectiveness of services.
Change Model
To support the Neuman Systems Model, Lewin’s change theory is used. Change is a common process in any organization, regardless of its size or industry (Deborah, 2018). Attention to Lewin’s model, as one of the core organizational management approaches, helps people understand the importance of change and initial steps. If there is no plan for implementing intervention and promoting change, people face challenges because of chaos (Deborah, 2018). Lewin offered a three-step guide to support stability and avoid misunderstandings. A mindfulness meditation program is an organizational change when two-hour training for nurses is implemented three times per week. The outcomes include the reduction of stress, the improvement of care services, and well-being among the nursing staff.
- Step 1:Unfreeze. It is not always easy to change the already accepted rules and standards. The goal of the first stage is to prepare nurses for new activities and enhance their driving powers (Deborah, 2018). It is planned to start with a one-hour lecture during which the instructor explains the importance of mindfulness meditation and its potential impact on work stress reduction. Nurses have to recognize their weaknesses when they cooperate with a specific group of patients. Their health-related challenges influence their work, well-being, and further attitudes toward their duties.
- Step 2: Change. As soon as the priorities are established, and the characteristics of changes are understood, the next stage occurs. It includes the period when people start believing in the offered changes and resolve their ambiguity (Deborah, 2018). Instead of talking about their problems and thinking about new job opportunities, a two-hour meditation program is developed to make them less dependent on the work and organize their thoughts. Nurses can combine communication, physical activities, and lifestyle changes without leaving their work.
- Step 3: Refreeze. The last stage of this change process is focused on the evaluation of the intrapersonal stressors and the possibility to manage them. It is necessary to ensure that the change can be sustained (Deborah, 2018). Mindfulness stress-based reduction is the goal that determines the effectiveness of the whole intervention. Nurses face new feelings and emotions and learn how to deal with them. At this last phase, all the unclear points are clarified, and nurses become confident if mindfulness meditation has to be promoted further.
Organizational Setting
The setting of this project is a postoperative unit in a local hospital where care is offered to chronic patients (diabetes, Alzheimer’s, or hypertension) or disabled people who cannot perform their basic functions. In this facility, the nursing staff helps patients receive medical treatment and occupational therapy and use custodial care like eating or bathing for some period. Usually, the diagnoses of patients in such a facility are mental health disorders, somatic problems, cardiovascular diseases, and musculoskeletal system changes. At this moment, there are 20 residents, but the number of patients is determined by their conditions. Usually, more than 500 patients are seen annually: some of them live several months here, some patients die in a week or a month, and some people go home.
Population Description
The population for this study is nurses who work with high mortality patients in a postoperative unit of a local hospital. It is planned to invite 20 nurses who meet the inclusion criteria. As soon as a hospital administrator approves the study, a face-to-face meeting occurs with potential participants where general rules, statistics, and goals are explained. Informed consent is signed after personal communication with each nurse. Their primary characteristics are compassion, communicativeness, and desire to change their working conditions.
Inclusion criteria:
- a one-year nursing experience;
- work with high mortality patients during a pandemic;
- English-speaking.
Excluding criteria:
- vacation/sick leaves;
- chronic disorders or acute diseases (except stress).
The only variable that could influence the project outcomes is the nature of the pandemic. If unknown and rapid changes are caused by the situation, nurses and researchers are not able to control the development of the events. Therefore, the conditions of nurses and patients have to be regularly checked to prevent the development of serious illnesses. If urgent measures are required, there could be no time for mindfulness mediation in a setting.
References
- Deborah, O. K. (2018). Lewin’s theory of change: Applicability of its principles in a contemporary organization.Journal of Strategic Management, 2(5), 1-12. Web.
- Gonzalo, A. (2019). Betty Neuman: Neuman systems model. Nurseslabs. Web.
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