Liang Ju

Date of Completion

7-6-2020

Document Type

Thesis

Degree Name

Master of Arts in Nursing

Keywords

ER nurses, Lived experiences, Emergency Nursing

Abstract

This study utilized a qualitative research approach to explore the lived experiences of emergency room nurses with secondary trauma. A theoretical sampling method was used in the selection of participants. The participants in the study were all nurses currently working in the emergency departments of government hospitals, who experience the daily scenario of providing emergency care to tragic or suffering patients. They all have at least 1 year of experience as emergency nurses. During the interviews, the researcher used Mandarin as a medium of communication and recorded information and data using audio recorder. Data collection ended after the 10th respondent when data saturation was reached. At the end of each data collection, interviews were transcribed. Colaizzi's method was used for data analysis. A total of 154 meaningful statements were extracted and the researcher used all interpretations from the interview participants. The researcher extracted phrases or sentences that were relevant to the study and then analyzed the meaning behind those statements in depth, and then described them in a more meaningful and in-depth manner. Three themes and ten sub-themes were formed by integrating the findings into a detailed description of the phenomenon being studied. A total of 154 meaningful utterances were extracted from the participants' verbatim experiences, from which three (3) themes and ten (10) sub-themes were formulated. The study concluded that, There were some common opinions captured from the different description of experiences of participants with secondary trauma. First of all, according to the nature of the emergency room environment in Chinese government hospitals, ER nurses usually work in a complex and contradictory environment, which mainly includes two points: a) high-pressure work environments and b) lack of understanding. It is no doubt that, in China, the emergency department in government hospitals receive a large number of clients every day. ER nurses often undertake high intensity nursing work and caring of client's psychological health. They should ensure a high degree of concentration and also maintain good mental health and physical fitness to better cope with stressful work content. However, some people do not show sufficient understanding and respect for the work content and secondary traumatic stress of emergency health workers completely. The normal demands for the mental health of ER nurses were often overlooked. There still existed the common view that ER nurses should not react negatively to the traumatic event of caring for patients, because this is what nurses should do. The major and obvious finding was that the current situation of secondary trauma experiences of Chinese ER nurses was pessimistic. Secondary trauma often occurs at an unconscious level among ER nurses. They were unaware that they were experiencing secondary trauma, or they do not know what secondary trauma is. ER nurses were inevitably and negatively affected. ER nurses who were experiencing secondary trauma have considered and introspected the whole process they are experiencing. When exposed to a traumatic event or death in a critically injured patient, they often develop negative feelings of powerlessness and reflect on where the professional value of a nurse when they failed to reduce patient suffering or saving lives. ER Nurses have feelings of empathy that decreases after repeated exposure to traumatic events from patients and show the avoidance behavior of contacting with anything relative to clients. They also have the behavior of self-blame because they deemed that their current mental state and behaviors were contrary to the professional conduct and values of nurses. Emergency nurses tend to be ashamed of secondary traumatic experiences. They are unwilling and afraid to be labeled as heterogeneous or vulnerable as they are working in the emergency department, while they prefer to relieve stress through chatting with friends, peers or family members about what they have seen and heard in daily work. One of the more meaningful findings to emerge from the study was that secondary traumatic experiences encourage ER nurses to develop the capabilities of self-feedback and adjustments. They desire to explore what can be done to reduce stress and keep psychological health. To a certain extent, introspective behavior and self-feedback have enabled emergency nurses to gain self-growth in terms of health professional ability, resistance capability of psychological pressure, professionalism and values, and attitude towards life. There was still an expectation that attaches importance and assistance to physical and psychological health among ER nurses from society, government, and other support groups. They secondary traumatic experience of ER nurses can be understood and respected completely.

First Advisor

Monina G. Dimas

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