Author Identifiers

Melanie Buhlmann
ORCID: 0000-0002-3528-3165

Date of Award

2019

Degree Type

Thesis

Degree Name

Master of Nursing (Research)

School

School of Nursing and Midwifery

First Advisor

Dr Beverley Ewens

Second Advisor

Dr Amineh Rashidi

Field of Research Code

1110

Abstract

Aims: The aims of this study were to gain a deeper understanding of the experiences of nurses and midwives who have been involved in a critical incident in a non-critical care area and to explore how they have ‘moved-on’ from the event.

Background: It is irrefutable that health care is intrinsically risk-laden and perceived to be personally and professionally demanding for those who are employed within it. The term ‘second victim’ has been assigned to health care professionals who experienced emotional distress as a result of their involvement in critical incidents. Despite the recognition that critical incidents contribute to workrelated stress, strategies employed by nurses and midwives to move-on from their often traumatic experiences of these events in non-critical care settings were not widely reported.

Research design: An interpretive descriptive design based on the scientific worldview of constructivism guided inductive inquiry to interpret the meaning of moving-on central to nurses and midwives who have lived through the impact of critical incidents.

Methods: Purposive sampling was used to recruit 10 nurses and midwives to participate in the study. Data collection comprised of semi-structured interviews, memos and field notes. Data was concurrently collected and analysed with the data management software NVivo 11, to derive themes and patterns, which enabled the researcher and the study-participants to co-construct knowledge. A thematic analytical method stipulated a coherent analytical framework to evolve the emerging themes and transform the data into credible interpretive description findings.

Findings: The findings revealed five main themes (1) initial emotional and physical response, (2) the aftermath, (3) long-lasting repercussions, (4) workplace support and (5) moving-on. Nurses and midwives experienced intense initial reactions and tumultuous emotions in the aftermath of the event and desired to share their burden. Various unsupportive workplace practices convoluted the reclamation of their professional competence, whilst adaptive strategies to promote physical and mental well-being enabled the participants to rise above the impact of critical incidents.

Discussion: This study highlighted several issues fundamental to withstand and overcome the personally damaging and professionally destructive challenges associated with critical incidents. The discussion of findings revealed new insights into the significance of support and a generally optimistic outlook derived from a well-adjusted work-life balance. Future research is required to explore the perceived effectiveness of workplace practices, as well as the role of education.

Relevance: This study presented an opportunity to shed light on the perceptions of ‘nurse and midwife-second victims’ within a range of non-critical care settings. Through their lens, the strategies they engaged in to move-on from the event were identified and their call for organisational and collegial support received a voice.

Conclusion: This study explored how nurses and midwives moved-on following critical incidents in various clinical areas. The identification of adaptive strategies contributed to the existing body of knowledge surrounding this phenomenon. Findings have the potential to inform health care organisations with the aim to support others who experienced critical incidents in health care, as well as guide nursing and midwifery education programs to raise awareness of the potential effects associated with the impact of critical incidents.

Available for download on Wednesday, June 03, 2020

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