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UBC Theses and Dissertations

Staff nurses' appraisals and coping strategies in a critical incident Appleton, Leanne Andrea


Although there was extensive literature pertaining to how nurses reacted to and coped with stressful encounters, there was little information about a specific kind of stress: critical incident stress (CIS). The purpose of this study was to describe how medical/surgical general duty nurses appraised, reacted to, and coped with critical incidents (CI)s. Lazarus and Folkman's (1984) theoretical framework was used to guide this study. A descriptive research design was used to gain knowledge related to the following four research questions: 1) What events did medical/surgical staff nurses appraise as CIs? 2) What were the nurses' reactions to CIs? 3) How did the nurses cope with the CIs? 4) How had the CIs impacted on the nurses' professional and personal lives? The investigator recruited 50 nurses and each participant completed four instruments. Quantitative data were coded and descriptive statistics were calculated. Open-ended questions were subjected to content analysis. The staff nurses did experience CIs within their daily practice. Using content analysis the nurses' CIs were assigned to one of six categories: moral distress, lack of responsiveness by a health care professional, violence toward nurses, emergency situations, death, and contact with infectious disease (hepatitis, acquired immunodeficiency syndrome). The majority of the nurses recalled CIs that occurred early in their nursing careers and some included student experiences. In addition, a large majority of nurses reported that the CIs occurred on evening and night shifts. Nurses primarily reported negative emotions one to two days following experiencing the CIs (fear, anxiety, worry, anger, disappointment, frustration, and disgust). Nurses also used a variety of strategies to cope with the CIs. However, four coping strategies were used most often: seeking out social support, self-controlling, positive reappraisal, and planful problem-solving. Despite nurses use of a variety of coping strategies, a large majority of nurses identified debriefing as one resource that would have been helpful following the CIs. Lastly, at least 18% of the nurses reported that CIs did have an impact on their professional or personal lives. The implications of the findings for nursing education, administration, and research are discussed.

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