2.50
Hdl Handle:
http://hdl.handle.net/10755/198295
Title:
The Stress Reaction in Emergency Nurses Following Trauma Care
Abstract:
[ENA Annual Conference 2011 - Research Presentation]The Stress Reaction in Emergency Nurses Following Trauma Care

Purpose: Trauma care is linked to stress in emergency nurses. Symptoms of stress are related to intrusive thoughts, hyperarousal, and avoidance which may lead to withdrawal and job changes. The purpose of this study was to explore the stress and resilience experienced by emergency nurses following trauma care.

Design: An exploratory qualitative design.

Setting: Study settings were three urban emergency departments verified as trauma centers by the American College of Surgeons and situated in the Midwest United States. The settings were verified as Level I pediatric trauma center, Level III adult trauma center, and Level I adult and pediatric trauma center.

Participants/Subjects: Institutional Review Board approval was secured at all sites. Participants were recruited using convenience sampling (16 per site). Eligibility was restricted to nurses providing direct care to traumatically injured patients and working full or part time hours at the study site. Participants were female (n=48), primarily Caucasian (n=46, 95.8%), and worked day shift hours (n=32, 66.7%). The sample’s mean age was 39.6 years (SD 10.3, range 24-62) and years of emergency nursing experience was 8.8 years (SD 6.6, range 1-28).

Methods: Seven 1-hour focus groups were held. A focus group guide was used to facilitate the sessions. Questions were based on the study’s conceptual framework: the Cognitive Activation Theory of Stress. The framework concepts are stress situations, stress experience and arousal, and stress reaction. Sessions were audio recorded and transcribed verbatim. Data were analyzed using a modified constant comparative analysis method described by Lincoln and Guba (1985). Qualitative rigor was addressed through credibility (equivalent to internal validity) using data source triangulation, investigator triangulation, and debriefings. In addition, dependability (equivalent to reliability) was conducted using investigator triangulation and the generation of an audit trail.

Results/Outcomes: Qualitative data analysis is still in process. Preliminary findings indicate that the stress situations experienced by emergency nurses yielding the greatest distress were traumatically injured children, victims of violence, patients known socially to the emergency nurse, or patients resembling a close friend or family member. Stress situations reported as least distressful were those situations when trauma care was provided to patients injured as a result of substance use. Participant symptoms of the stress experience and stress arousal varied. Most participants reported feeling hot, flushed, anxious, and for a few participants—depressed; however, some participants reported a sense of eustress or exhilaration. Participant stress reactions also varied. While several participants called home to speak with their children or went out as a group for breakfast to debrief at the end of their shift, a few participants used alcohol and isolated themselves from others as a coping mechanism following trauma care that was perceived as particularly distressful.

Implications: Trauma care can be both a positive and negative experience for emergency nurses. It’s important for emergency nursing leadership to implement or promote the use of proactive coping strategies that may reduce the distress experienced by emergency nurses. Strategies that may be beneficial include formal and informal debriefings such as the “breakfast club” described by the participants.


Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleThe Stress Reaction in Emergency Nurses Following Trauma Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198295-
dc.description.abstract[ENA Annual Conference 2011 - Research Presentation]The Stress Reaction in Emergency Nurses Following Trauma Care<br/><br/>Purpose: Trauma care is linked to stress in emergency nurses. Symptoms of stress are related to intrusive thoughts, hyperarousal, and avoidance which may lead to withdrawal and job changes. The purpose of this study was to explore the stress and resilience experienced by emergency nurses following trauma care. <br/><br/>Design: An exploratory qualitative design. <br/><br/>Setting: Study settings were three urban emergency departments verified as trauma centers by the American College of Surgeons and situated in the Midwest United States. The settings were verified as Level I pediatric trauma center, Level III adult trauma center, and Level I adult and pediatric trauma center. <br/><br/>Participants/Subjects: Institutional Review Board approval was secured at all sites. Participants were recruited using convenience sampling (16 per site). Eligibility was restricted to nurses providing direct care to traumatically injured patients and working full or part time hours at the study site. Participants were female (n=48), primarily Caucasian (n=46, 95.8%), and worked day shift hours (n=32, 66.7%). The sample’s mean age was 39.6 years (SD 10.3, range 24-62) and years of emergency nursing experience was 8.8 years (SD 6.6, range 1-28). <br/><br/>Methods: Seven 1-hour focus groups were held. A focus group guide was used to facilitate the sessions. Questions were based on the study’s conceptual framework: the Cognitive Activation Theory of Stress. The framework concepts are stress situations, stress experience and arousal, and stress reaction. Sessions were audio recorded and transcribed verbatim. Data were analyzed using a modified constant comparative analysis method described by Lincoln and Guba (1985). Qualitative rigor was addressed through credibility (equivalent to internal validity) using data source triangulation, investigator triangulation, and debriefings. In addition, dependability (equivalent to reliability) was conducted using investigator triangulation and the generation of an audit trail. <br/><br/>Results/Outcomes: Qualitative data analysis is still in process. Preliminary findings indicate that the stress situations experienced by emergency nurses yielding the greatest distress were traumatically injured children, victims of violence, patients known socially to the emergency nurse, or patients resembling a close friend or family member. Stress situations reported as least distressful were those situations when trauma care was provided to patients injured as a result of substance use. Participant symptoms of the stress experience and stress arousal varied. Most participants reported feeling hot, flushed, anxious, and for a few participants—depressed; however, some participants reported a sense of eustress or exhilaration. Participant stress reactions also varied. While several participants called home to speak with their children or went out as a group for breakfast to debrief at the end of their shift, a few participants used alcohol and isolated themselves from others as a coping mechanism following trauma care that was perceived as particularly distressful. <br/><br/>Implications: Trauma care can be both a positive and negative experience for emergency nurses. It’s important for emergency nursing leadership to implement or promote the use of proactive coping strategies that may reduce the distress experienced by emergency nurses. Strategies that may be beneficial include formal and informal debriefings such as the “breakfast club” described by the participants. <br/><br/><br/>en_GB
dc.date.available2011-12-21T12:45:05Z-
dc.date.issued2011-12-21T12:45:05Z-
dc.date.accessioned2011-12-21T12:45:05Z-
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