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Yehene E, Asherman A, Goldzweig G, Simana H, Brezner A. Secondary traumatic stress among pediatric nurses: Relationship to peer-organizational support and emotional labor strategies. J Pediatr Nurs 2024; 74:92-100. [PMID: 38029691 DOI: 10.1016/j.pedn.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Even though the cost of caring is acknowledged in multiple helping professions, research into secondary traumatic stress in pediatric nursing remains limited. This study aimed to determine the prevalence of secondary traumatic stress among pediatric nurses and examine its correlation with demographics, perceived organizational support, peer support, and emotional labor strategies. DESIGN AND METHODS A total of 186 nurses working in a pediatric hospital completed questionnaires addressing secondary traumatic stress, perceived organizational support, peer support, and emotional labor strategies. Through correlational and mediation analyses, we explored the relationships between the study variables. RESULTS Approximately 77.8% of the pediatric nurses surveyed exhibited moderate to severe secondary traumatic stress. Notably, the level of secondary traumatic stress did not correlate with demographic variables. Increased peer support was significantly associated with a heightened use of all emotional labor strategies (surface acting, deep acting, and natural expression) and with elevated levels of secondary traumatic stress. However, surface acting was the sole mediator of this relationship. Conversely, greater perceived organizational support correlated with decreased levels of surface acting and secondary traumatic stress, with surface acting serving as the mediator. CONCLUSIONS Pediatric nurses are greatly impacted by secondary traumatic stress. Enhancing organizational support and carefully assessing peer support can reduce this, by decreasing nurses' need to suppress or feign genuine emotions. PRACTICE IMPLICATIONS To enhance nurses' psychological well-being, healthcare institutions should raise awareness of secondary traumatization and foster a supportive organizational environment that prioritizes effective team emotional support and evaluates collegial emotional labor.
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Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, the Academic College of Tel Aviv - Yaffo, Israel; Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.
| | - Adi Asherman
- School of Behavioral Sciences, the Academic College of Tel Aviv - Yaffo, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, the Academic College of Tel Aviv - Yaffo, Israel
| | - Hadar Simana
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Amichai Brezner
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
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Bentz JA, Vanderspank-Wright B, Lalonde M, Tyerman J. 'They all stay with me'-An interpretive phenomenological analysis on nurses' experiences resuscitating children in community hospital emergency departments. J Clin Nurs 2023; 32:701-714. [PMID: 35253290 DOI: 10.1111/jocn.16273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/04/2022] [Accepted: 02/17/2022] [Indexed: 12/01/2022]
Abstract
AIM To understand the lived experiences of nurses resuscitating children in community hospital emergency departments. BACKGROUND Emergency department nurses exposed to paediatric resuscitations are at a high risk of developing post-traumatic stress. This may be especially true in community hospital emergency departments, where nurses have less exposure to, knowledge about, and resources for managing these events. Interventions to proactively prevent nurse trauma in these contexts remain largely uninvestigated. To inform such interventions, a detailed understanding of the largely unknown lived experiences of these nurses is necessary. DESIGN AND METHODS In-depth, semi-structured interviews were conducted with four registered nurses that had experienced at least one paediatric resuscitation while working in a community hospital emergency department in Ontario, Canada. Data were analysed using interpretive phenomenological analysis. Reporting follows the COREQ checklist. RESULTS Analysis revealed three superordinate themes (i.e. 'Conceptualising Paediatric Resuscitations', 'Seeing What I See', and 'Making Sense of What I Saw') and nine corresponding subthemes. CONCLUSION This study provides insight into the infrequent, but profound experiences of nurses resuscitating children in community hospital emergency departments. Nurses, who conceptualise these events as unnatural, emotional, and chaotic, are comforted by those who understand their experiences and are distressed by those who cannot see what they see. To reconcile what they have seen, nurses may reflect and ruminate on the event, ultimately restructuring their experiences of themselves, others, and the world to make room for a new reality where the safety of childhood is not certain. RELEVANCE TO CLINICAL PRACTICE Our findings contribute to pragmatic recommendations for interventions to proactively prevent nurse distress in these contexts, including psychoeducation, psychological support and in-situ simulation activities. Nursing leaders should consider staff that have resuscitated children as valuable sources for information on how to improve practice settings.
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Affiliation(s)
- Jamie Anne Bentz
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Michelle Lalonde
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jane Tyerman
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Roche N, Darzins S, Oakman J, Stuckey R. Worker Experiences of the Work Health and Safety Impacts of Exposure to Dying and Death in Clinical Settings: A Qualitative Scoping Review. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221117902. [PMID: 36476137 DOI: 10.1177/00302228221117902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Workers employed in clinical healthcare settings often encounter dying and death of patients as a part of their role. This scoping review aimed to explore the physical and psychosocial OHS impacts on health workers exposed to death within their occupational role and their inherent coping strategies. Six electronic databases PsycINFO (Ovid), Medline (Ovid), AMED (EBSCO), CINAHL (EBSCO), and Proquest Social Sciences were searched for peer reviewed research articles published between March 1971 and April 2022. PRISMA-ScR guidelines were followed. Three authors independently assessed articles for inclusion. Fifty-three studies with focus settings in hospitals, hospice, general practice and residential care were identified. Five main themes were developed and organized using and ergonomic systems approach: Cultural Environment, Workplace, Job Demands, Impacts and Coping. The findings demonstrate that caring for dying patients, the dead and their families in clinical settings impacts workers emotionally, physically, behaviorally and spiritually.
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Affiliation(s)
- Natalie Roche
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Susan Darzins
- School of Allied Health, Australian Catholic University, Melbourne, VIC, Australia
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Rwth Stuckey
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
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Jang SG, Min A, Kim S. Experience of Pediatric Patient Death, Moral Distress, and Turnover Intention among Pediatric Nurses at a Tertiary Hospital in South Korea: A Cross-Sectional Study. J Palliat Med 2022; 25:1215-1221. [PMID: 35138941 DOI: 10.1089/jpm.2021.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Pediatric nurses are particularly vulnerable to moral distress and turnover due to frequent experiences with patient death combined with limited pediatric palliative resources and related support. Objective: This study examined pediatric nurses' experiences of pediatric patient death, moral distress, and turnover intention and identified the correlations between them as well as the mediating role of moral distress. Methods: This cross-sectional study conducted an online survey with 161 pediatric nurses working in a tertiary hospital in Seoul, South Korea. The survey comprised questions to assess nurses' experience of pediatric patient death and turnover intention and a validated instrument to measure their moral distress. Logistic regression was used to examine the relationships between study variables, and structural equation modeling was performed to determine the mediating effect of moral distress. Results: Pediatric nurses (N = 161) reported high levels of moral distress with a mean score of 101.06 (standard deviation = 70.528) on the pediatric version of the Moral Distress Scale. Turnover intention increased 1.01 times for every 1 U increase in moral distress. Moral distress fully mediated the relationship between the experience of pediatric patient death and turnover intention. Conclusion: Pediatric patient death had an indirect effect on turnover intention through moral distress among pediatric nurses. Reducing pediatric nurses' moral distress caused from experiencing patient death may help minimize their turnover intention.
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Affiliation(s)
- Seung Gyeong Jang
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Sujeong Kim
- Department of Family Health Nursing, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea.,Research Institute for Hospice/Palliative Care, The Catholic University of Korea, Seoul, Republic of Korea
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A Scoping Review of the Experiences of Adolescents and Young Adults in the ICU, Their Family Members, and Their Health Care Team. Crit Care Nurs Clin North Am 2022; 34:31-55. [DOI: 10.1016/j.cnc.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chew YJM, Ang SLL, Shorey S. Experiences of new nurses dealing with death in a paediatric setting: A descriptive qualitative study. J Adv Nurs 2020; 77:343-354. [PMID: 33074568 DOI: 10.1111/jan.14602] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/30/2020] [Accepted: 09/24/2020] [Indexed: 11/28/2022]
Abstract
AIMS To explore and describe the experiences, challenges and coping strategies of new nurses dealing with paediatric death in a clinical setting. DESIGN A descriptive qualitative study design was used. METHODS Semi-structured interviews were conducted to explore the experiences of 12 new paediatric nurses from a tertiary public hospital in Singapore. Data were collected from September 2019-December 2019. A thematic analysis was performed for data analysis. RESULTS Four themes were generated: (a) a spectrum of emotions; (b) the 'blame' game; (c) getting through the grief; and (d) new nurses' wish list. The new nurses tended to be emotionally affected by their first death experience. They felt anxious and personally responsible for the death but eventually controlled their emotions. Colleagues, religion and self-actualization were key in overcoming grief. CONCLUSION The experiences nurses go through at the early stages of their profession shape future workplace attitudes. Additional training and support should be provided to new nurses to build their confidence in managing end-of-life care. Training should include cultural awareness and communication skills to equip nurses with the necessary skills. IMPACT This research will have an impact on institutions, which develop culturally congruent training and support platforms that prepare new nurses for nursing practice. This research will drive future investigations on the long-term effects of paediatric death on new nurses.
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Affiliation(s)
| | | | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Singapore
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Bagnasco A, Aleo G, Timmins F, Catania G, Zanini M, Brady AM, Sasso L. The potential contribution of mixed-method research to critical care nursing. Nurs Crit Care 2020; 24:113-114. [PMID: 31074551 DOI: 10.1111/nicc.12431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Annamaria Bagnasco
- Associate Professor of Nursing, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Research Fellow and Lecturer, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Fiona Timmins
- Associate Professor of Nursing, Director of Post Graduate Teaching and Learning, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Gianluca Catania
- Assistant Professor and Researcher, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Assistant Professor and Researcher, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Anne-Marie Brady
- Professor of Chronic Illness, Head of School, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Loredana Sasso
- Full Professor of Nursing, Department of Health Sciences, University of Genoa, Genoa, Italy
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Barnes S, Jordan Z, Broom M. Health professionals' experiences of grief associated with the death of pediatric patients: a systematic review. JBI Evid Synth 2020; 18:459-515. [PMID: 32197009 DOI: 10.11124/jbisrir-d-19-00156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to synthesize the experiences of health professionals who have experienced grief as a result of a pediatric patient dying. INTRODUCTION There has been some research into health professionals' grief experiences associated with the death of pediatric patients, but there has not been a review that synthesizes the findings of these experiences. Other related reviews have focused on prenatal, perinatal or adult deaths or the coping strategies employed by health professionals. This review highlights the complexities of experiences faced by pediatric health professionals. INCLUSION CRITERIA Qualitative studies involving pediatric health professionals working in any healthcare setting who had experienced grief from the death of a patient were considered for inclusion. Studies were conducted in any country, at any time and published in English. METHODS The search was conducted in PubMed, CINAHL, Embase, PsycINFO, Scopus and ProQuest Dissertations and Theses. The search was completed in January 2019. The review followed principles of meta-aggregation in line with the JBI approach. Methodological quality assessment was based on representation of participants' voices and congruence between research methodology and both research question and analysis of data. RESULTS Meta-aggregation led to three synthesized findings from 12 qualitative studies that met the inclusion and methodological quality criteria. Studies predominantly included nurses working in a hospital, with sample sizes ranging from six to 25 participants. The synthesized findings were physical, behavioral, psychological or spiritual symptoms; compounding grief; and alleviating grief. Physical, behavioral, psychological, or spiritual symptoms highlighted the various characteristics of grief experiences by health professionals. Compounding grief was the largest synthesized finding and incorporated the various factors that contributed to a poorer experience of grief. Alleviating grief showed the limited identified factors that improved the experience of grief. Methodological quality led to synthesized findings receiving a ConQual rating of low or moderate. CONCLUSIONS The synthesized findings from this review highlight the varied reported experiences of grief in health professionals. The methodological quality and reporting of studies, however, led to decreased confidence in the synthesized findings and recommendations arising from this review. Healthcare professionals should be aware of the potential for experiencing grief when a patient dies and the compounding and alleviating factors associated with this. Further research could expand participant and language limitations, and improve methodological quality and reporting.
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Affiliation(s)
- Shannon Barnes
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.,CQUniversity, Noosaville, Australia
| | - Zoe Jordan
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Margaret Broom
- Neonatal Intensive Care Unit, Centenary Hospital for Women and Children, ACT Health, Canberra, Australia.,Australian Catholic University, Canberra, Australia
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Affiliation(s)
- Wendy Walker
- Reader in Acute and Critical Care Nursing, Institute of Health, University of Wolverhampton, UK. Editorial Intern, Nursing in Critical Care
| | - Josef Trapani
- Lecturer in Nursing, Faculty of Health Sciences, University of Malta. Editorial Intern, Nursing in Critical Care
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Temsah MH, Alsohaim F, Al-Eyadhy A, Bashiri FA, Hasan G, Almosned B, Temsah O. Drowning in the desert: family denial of brain death. Sudan J Paediatr 2019; 18:48-52. [PMID: 30799899 DOI: 10.24911/sjp.106-1537437446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Drowning continues to be a cause of childhood mortality that is associated with significant psychological distress to the affected families. The unexpected death due to such preventable injury causes excessive grieving responses in these situations. In the present report, we describe a case of a 3-year-old child who was a victim of drowning in a recreational pool, whose family went through severe denial phase following the establishment of brain death. Single-photon emission computed tomography brain scan showed the absence of tracer uptake within brain parenchyma, while the calvarium showed increased tracer distribution, also known as the "halo sign." She also had electrocerebral inactivity revealed by electroencephalography. We also discuss the magnitude of this family distress that led to total family avoidance of meeting with the treating team, from the time the parents were informed about the established brain death in the drowning child till the patient had cardiopulmonary arrest 2 weeks later.
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Affiliation(s)
- Mohamad-Hani Temsah
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohaim
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad A Bashiri
- Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Bader Almosned
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Walker W, Trapani J. What's in this Issue. Nurs Crit Care 2018; 23:3-5. [PMID: 29388376 DOI: 10.1111/nicc.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wendy Walker
- Reader in Acute and Critical Care Nursing, Intern in Nursing in Critical Care
| | - Josef Trapani
- Lecturer in Nursing, Intern in Nursing in Critical Care
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