Academic journal article Canadian Journal of Counselling and Psychotherapy (Online)

The Experience of Witnessing Patients' Trauma and Suffering among Acute Care Nurses/L'expérience De Témoin Des Traumatismes et De la Souffrance Des Patients Chez Les Professionnels En Soins Infirmiers Actifs

Academic journal article Canadian Journal of Counselling and Psychotherapy (Online)

The Experience of Witnessing Patients' Trauma and Suffering among Acute Care Nurses/L'expérience De Témoin Des Traumatismes et De la Souffrance Des Patients Chez Les Professionnels En Soins Infirmiers Actifs

Article excerpt

It is well known that nursing is a profession that poses a variety of risks. Exposure to infectious diseases, violence, and physical injury are among the common factors that place nurses at risk for work-related injuries (Abendroth & Flannery, 2006; Chen, Chen,Tsai, & Lo, 2007). However, the psychological and emotional effects of nurses' work are not as well known (Frank & Karioth, 2006; Hallin & Danielson, 2007). Using personal observations within acute care hospital settings, the investigators of" this study noticed changes over time in the way nurses related to their work and their patients. Nurses were at times distant and detached, which appeared to be away of coping with the frequently intense emotional situations they were experiencing.

Observations on acute care hospital wards also revealed a common occurrence of hearing nurses talk about trouble sleeping and feeling unable to leave the experiences of their shift in the hospital when they went home. Large numbers of sick calls were also witnessed, and acute care nurses would often claim they could just not do another shift. These observations led the researchers to wonder about the effects upon nurses who experience patients' trauma and suffering.

Various labels have been used to describe the relatively new body of knowledge related to workplace stress in the nursing profession. Tliey include compassion fatigue (Abendroth & Flannery, 2006; Benoit, Veach, & LeRoy, 2007; Figley, 1 995; Frank & Karioth, 2006; Maytum, Heiman, & Garwick, 2004), generalized stress (Hallin & Danielson, 2007), and burnout (Chen et ai., 2007; Ericson-Lidman & Strandberg, 2007; Poncet et al., 2007).

A review of the literature revealed that three constructs could provide a theoretical understanding of the stress experienced by acute care nurses: generalized stress (Lazarus & Folkman, 1984), workplace burnout (Maslach, Schaufeli, & Leiter, 2001), and compassion fatigue (Figley, 1995, 2002). In this article we review these three psychological constructs but acknowledge that there could be other theoretical underpinnings that describe acute care nurses' experiences.

The purpose of this study was to understand acute care nurses' experiences of job-related stress. The study's primary focus was to provide a rich description of nurses' experiences of witnessing patients' trauma and suffering on an acute care ward. The following phenom enologica! question guided the research: What is the lived experience of witnessing patients' trauma and suffering among acute care nurses?

In the following review of the literature, the authors discuss the three main theoretical constructs that have relevance to our understanding of the current study on acute care nurses' experiences of witnessing the trauma and suffering of their patients. However, the researchers were open to the possibility, before commencing the study, that the phenomenon under investigation may or may not reveal whether these constructs had relevance in the participants' experiences as acute care nurses.

REVIEW OF THE LITERATURE

Stress

In Lazarus and Folkman's (1984) Transactional Theory of Stress and Coping, the authors proposed that individuals are constantly appraising the environment in an attempt to discern the meaning and significance of events in order to categorize interactions within their environment related to their well-being. According to Lazarus and Folkman, the amount of stress felt is a result of a two-part cognitive appraisal. The first, a primary appraisal, is the evaluation of whether a situation is irrelevant (has no implications for well-being), benign-positive (preserves or enhances well-being), or stressful (could lead to harm/loss, threat, or challenge). The secondary appraisal is one's evaluation of coping abilities and available options.

Stress has been linked to a number of illnesses (Lazarus be. Folkman, 1984) and can have a wide variety of psychological effects. …

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