Exploring The Lived Experience Of Trauma Among Obstetric Registered Nurses

Objective:  Trauma is the emotional or psychological state of discomfort or stress resulting from an overwhelming event or series of events while providing direct care. Exposure to trauma has negative consequences for nurses including mental, physical, and/or emotional health issues leading to problems such as post-traumatic stress disorder (PTSD), burnout, poor nursing care, and patient safety risk. Very few studies have explored trauma among obstetric nurses despite their repeated exposure to trauma. The purpose of this study was to describe and analyze the lived experiences of obstetric registered nurses encountering trauma while providing direct care.

Design: Hermeneutic phenomenology

Setting: New York City

Sample: Ten eligible obstetric nurses were recruited in New York City using convenient, purposive, and snowball sampling. Other data such as the etymological history of the words and idiomatic phrases related to the phenomenon, and experiential descriptions in literature, biographies, diaries, art, and phenomenological literature were also collected.

Methods: Approval was obtained from UIC IRB prior to collecting data in addition to a Certificate of Confidentiality from the National Institute of Nursing Research. Interviews were recorded, transcribed, and analyzed based on van Manen’s stages of reflective analysis in order to arrive at the essential meaning of the phenomenon.

Results:  Although experiences with trauma varied, the most common experiences were with maternal deaths, intrauterine fetal demises (IUFDs), and emergency Cesarean sections. Seven essential themes were uncovered: (a) An internal process; (b) Being faced with the unexpected; (c) Going through the motions; (d) Feeling helpless; (e) Engaging others; (f) A visceral imprint, and (g) A damaged person.

Conclusion/Implications for nursing practice: Trauma was an unforgettable, deeply personal, and complex experience for these nurses. It is important that obstetric registered nurses themselves, as well as outsiders, recognize that trauma is ever present and real in obstetrics even if it is a specialty that is more commonly associated with the beginning of life and joyful memories. The critical insight gained from this study provides valuable information to enrich our awareness about the vulnerability of obstetric nurses to trauma, to begin a conversation about how to improve the work environment for nurses, and to enhance the care they provide to their patients. Recommendations for practice, education, and research are discussed.

Keywords:  birth, trauma, nursing, experience