University of North Carolina at Chapel Hill Graduate School
Doi
Abstract
ABSTRACT Catherine Crawford: Labor and Delivery Nurses’ Experiences of Traumatic Events and Institutional Support: A Multimethod Study(Under the direction of Jessica Williams) Introduction: This study explored how labor and delivery (L&D) nurses define and experience traumatic events in the workplace, if institutional supports meet desired needs of L&D nurses, and how psychological distress and institutional support affect absenteeism, turnover intention, and resilience. Background: Traumatic experiences in healthcare are associated with negative outcomes including absenteeism, turnover intention, burnout, and secondary traumatic stress. Although well studied in some high exposure areas, the traumatic event experiences of L&D nurses have received less attention in published literature. Methods: A multimethod study examined L&D nurses’ workplace traumatic event experiences. Nurses (N=171) recruited from the Association of Women’s Health, Obstetric and Neonatal Nurses organization completed a survey utilizing the Second Victim Experience and Support Tool – Revised and the Second Victim Support Desirability survey. Descriptive analyses compared available to desired support options. Multiple regression analysis examined levels of psychological distress and lack of institutional support associations with L&D nurse turnover intention, absenteeism, and resilience. Additionally, 13 nurses participated in semi-structured interviews about their experiences. Directed content analysis was used to compare nurses’ traumatic experiences to the Core Beliefs and Second Victim Recovery Trajectory models. Results: Participants described various experiences deemed traumatic in the L&D workplace including neonatal and maternal death, complicated deliveries, workplace violence among others, and indicated that support services offered did not meet their desired needs. Psychological distress, overall distress and lack of institutional support were associated with absenteeism and turnover intention, while only institutional support was associated with resilience. Revisions to the Second Victim Recovery Trajectory were made to reflect the post-trauma experience of L&D nurses, and L&D nurses described many instances in which their core beliefs were shaken by their traumatic experiences. Conclusion: L&D nurses face various traumatic events in the workplace and support offerings provided after traumatic events are not meeting desired needs of L&D nurses. Additional research is needed to understand the scope of the problem and investigate best practices to assist L&D nurses following traumatic events.Doctor of Philosoph
