A Grounded Theory on the Process Emergency Department Nurses Utilize When Managing Adult Patients' Pain

2.50
Hdl Handle:
http://hdl.handle.net/10755/162507
Type:
Presentation
Title:
A Grounded Theory on the Process Emergency Department Nurses Utilize When Managing Adult Patients' Pain
Abstract:
A Grounded Theory on the Process Emergency Department Nurses Utilize When Managing Adult Patients' Pain



Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Bergman, Cheryl, PhD, ARNP, CEN
P.I. Institution Name:Jacksonville University
Contact Address:2800 University Blvd. North, Jacksonville, FL, 32211, USA
Contact Telephone:904-256-7282
[Annual Conference Research Poster]
Purpose: Pain is the most common emergency department (ED) complaint and the primary reason patients seek care. Improving inadequate pain control has been identified as a critical goal in emergency healthcare. The nursing role is crucial to correcting this problem as the nurse has the most direct interaction with the patient, and is the patients' most important healthcare advocate. The purpose of this study was to improve the understanding and to develop a theory of the process ED nurses use when managing adult patients' pain.

Design: Grounded theory assumes that individuals sharing common circumstances experience similar meanings, thoughts, and behaviors. The philosophical underpinning of grounded theory is symbolic interactionism and served as the source of foundational assumptions of this qualitative study.

Setting: Participants were recruited from the membership of the local emergency nurses association (ENA) of which the researcher is a member, and hospital-based ED's in several counties in Northeast Florida.

Sample: The criteria for inclusion in the study was: (a) licensed registered nurses (b) English-speaking (c) currently working full or part time (a minimum of 24 hours a week) in an ED setting in Northeast (NE) Florida (d) a minimum of one year ED experience (e) responsible for direct care of patients 18 years of age or older. Exclusion criteria included: (a) non English-speaking nurses who worked less than an average of 24 hours a week (b) had less than one year experience in ED nursing (c) and do not provide direct care to patients 18 years of age or older. Institutional Review Board (IRB) approval from Barry University was obtained prior to the commencement of data collection. Interviews were begun in September 2008 and were complete in January, 2009. Saturation was met after 12 nurse participants were interviewed, as no new information was generated that further defined the emerging themes. Three more interviews were conducted following these 12 to ensure saturation had been reached, resulting in a final sample of 15 nurse participants for this study.

Methodology: Utilizing grounded theory methodology, data analysis commenced upon completion of the initial interview and its transcription. Initially, "in vivo" coding was used as a part of the open coding process. In vivo, a term meaning from life or nature, involves the identification of exact words or phrases used by the participants themselves that help to establish the initial concepts and their properties. By way of axial coding, a central category or phenomenon was identified and became the core variable for the theory regarding ED nurses and adult patients' pain management. The last phase of the analysis was selective coding whereby hypotheses and the overall theory was established and formulated. Member checks and peer debriefing were utilized to establish credibility of the data interpretation.

Results: The central core category that emerged highlighted ED environments as inconducive to demonstrating caring when relating to adult patients with pain. Three broad categories supported this central core category: (a) feeling overwhelmed, (b) perceived non-cohesiveness of the health care team, and (c) frustration. Each broad category was supported by three subcategories. Feeling Overwhelmed included constant prioritizing, lack of staff, and lack of control. Perceived non-cohesiveness of the health care team included nurses, administrators and ED doctors. Frustration involved abuse of EDs, pain complexity, and unrealistic patient expectations.

Conclusions: Interventions and solutions need to be explored to improve ED nurses' ability to manage adult ED patients' pain adequately and to demonstrate caring while doing so. Implications for accomplishing this goal clearly exist in nursing education, practice, research, and public policy.



Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Grounded Theory on the Process Emergency Department Nurses Utilize When Managing Adult Patients' Painen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162507-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Grounded Theory on the Process Emergency Department Nurses Utilize When Managing Adult Patients' Pain<br/><br/><br/><br/></td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bergman, Cheryl, PhD, ARNP, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Jacksonville University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2800 University Blvd. North, Jacksonville, FL, 32211, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">904-256-7282</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">cbergma@ju.edu</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference Research Poster] <br/>Purpose: Pain is the most common emergency department (ED) complaint and the primary reason patients seek care. Improving inadequate pain control has been identified as a critical goal in emergency healthcare. The nursing role is crucial to correcting this problem as the nurse has the most direct interaction with the patient, and is the patients' most important healthcare advocate. The purpose of this study was to improve the understanding and to develop a theory of the process ED nurses use when managing adult patients' pain.<br/><br/>Design: Grounded theory assumes that individuals sharing common circumstances experience similar meanings, thoughts, and behaviors. The philosophical underpinning of grounded theory is symbolic interactionism and served as the source of foundational assumptions of this qualitative study.<br/><br/>Setting: Participants were recruited from the membership of the local emergency nurses association (ENA) of which the researcher is a member, and hospital-based ED's in several counties in Northeast Florida.<br/><br/>Sample: The criteria for inclusion in the study was: (a) licensed registered nurses (b) English-speaking (c) currently working full or part time (a minimum of 24 hours a week) in an ED setting in Northeast (NE) Florida (d) a minimum of one year ED experience (e) responsible for direct care of patients 18 years of age or older. Exclusion criteria included: (a) non English-speaking nurses who worked less than an average of 24 hours a week (b) had less than one year experience in ED nursing (c) and do not provide direct care to patients 18 years of age or older. Institutional Review Board (IRB) approval from Barry University was obtained prior to the commencement of data collection. Interviews were begun in September 2008 and were complete in January, 2009. Saturation was met after 12 nurse participants were interviewed, as no new information was generated that further defined the emerging themes. Three more interviews were conducted following these 12 to ensure saturation had been reached, resulting in a final sample of 15 nurse participants for this study. <br/><br/>Methodology: Utilizing grounded theory methodology, data analysis commenced upon completion of the initial interview and its transcription. Initially, &quot;in vivo&quot; coding was used as a part of the open coding process. In vivo, a term meaning from life or nature, involves the identification of exact words or phrases used by the participants themselves that help to establish the initial concepts and their properties. By way of axial coding, a central category or phenomenon was identified and became the core variable for the theory regarding ED nurses and adult patients' pain management. The last phase of the analysis was selective coding whereby hypotheses and the overall theory was established and formulated. Member checks and peer debriefing were utilized to establish credibility of the data interpretation. <br/><br/>Results: The central core category that emerged highlighted ED environments as inconducive to demonstrating caring when relating to adult patients with pain. Three broad categories supported this central core category: (a) feeling overwhelmed, (b) perceived non-cohesiveness of the health care team, and (c) frustration. Each broad category was supported by three subcategories. Feeling Overwhelmed included constant prioritizing, lack of staff, and lack of control. Perceived non-cohesiveness of the health care team included nurses, administrators and ED doctors. Frustration involved abuse of EDs, pain complexity, and unrealistic patient expectations. <br/><br/>Conclusions: Interventions and solutions need to be explored to improve ED nurses' ability to manage adult ED patients' pain adequately and to demonstrate caring while doing so. Implications for accomplishing this goal clearly exist in nursing education, practice, research, and public policy. <br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:22Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:22Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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