Rene Michael

Work-Related trauma the experiences of perioperative nurses

Traumatic experiences in the workplace are an integral part of the role of the perioperative nurse. The atypical nature and characteristics of these experiences is such that perioperative nurses may suddenly encounter reactions and feelings that are very different and more intense than anything they will have encountered previously. Furthermore, these events may increase the risk of them experiencing subsequent trauma stress reactions and place them at risk of profound distress and significantly impaired functioning. A survey of 233 nurses working in rural and metropolitan operating theatres assessed the range and types of traumatic work experiences. Results showed that exposure to traumatic events was reported by 161 (69%) of all respondents and a wide range of traumatic experiences were reported to have affected their well-being. The findings have implications for the formulation of trauma management strategies, both at individual and organisational levels and suggest new directions for education and research in promoting a recovery environment in which perioperative nurses can work.

Recovery From Work-Related Trauma by Perioperative Nurses: The effects of social and personal resources

The complexities of the recovery process following a traumatic event suggest a need to provide support resources that sustain or promote positive perceptions of the events. The availability and effectiveness of social support is a function of both its content and its capability of responding appropriately to the influence of the recovery dynamics in a contingent manner. Further, the quality of recovery from work-related trauma is suggested to be a function of the interactive processes of the individuals, the organisational environment they work in, and the social support provided. Using methodological triangulaton, 213 nurses working in rural and metropolitan operating suites were surveyed to assess the types, amount and effectiveness of social and personal resources that were used following exposure to traumatic work experiences. The findings demonstrate the significance of personal and social support resources in assisting perioperative nurses to recover from traumatic experiences. A personal sense of coherence and emotional support received through disclosure to work colleagues and supervisors were the most salutary aspects of support following trauma. The results suggest that opportunities should be made available through peer support programs, educational programs and professional meetings to better prepare nurses for traumatic situations and their aftermath. Furthermore, the work organisation needs to be educated in the need for and process of creating sanctuary and providing a holistic approach to management. This will then allow individuals, such as perioperative nurses, to continue to function at an acceptable level during the mitigation of the traumatic incident.

The impact of work-related trauma on the well-being of Perioperative Nurses

Perioperative nurses are confronted daily with the reality of trauma, of experiencing abuse and conflict in the workplace, dealing with practice issues such as gruesome motor vehicle accidents, as well as the heartbreaking tragedy of death (Michael 1999, Michael & Jenkins 2000). This study explored the reported impact of traumatic events upon the well-being of perioperative nurses, using both qualitative and quantitative methods of inquiry. Of the 233 respondents in this study, 161 (69%) reported being exposed to traumatic events. The types of described reactions following trauma were predominantly negative and included negative feelings, negative team member relationship issues, negative behaviour from others, physical concerns and negative working conditions. Intrusion and avoidance behaviour was reported to a significant degree. Performance distress, somatic distress, general feelings of distress and self-related health were significantly poorer in perioperative nurses who had experienced trauma, than their colleagues without such experiences. Conversely, some respondents were able to construe positive outcomes from trauma and grow from the experience. Positive outcomes included gains from the experience, team building, positive feelings and action taken. The current study contributes to understanding of the role of environmental factors, associated work-related trauma and recovery following such events. The outcomes have implications for effective trauma stress management interventions and continuing education of nurses.

Educational innovation for infection control in Tanzania: Bridging the policy to practice gap

The incidence of hospital acquired infection in developing countries is between two to 20 times higher than in developed countries and is attributable to multiple causes. Evidence-based international policies and guidelines developed to improve infection prevention and control are often not used in practice in these countries. To combat this challenge, this article presents an innovative educational framework used to bridge the gap between policy written by global health agencies and the realities of practice in Tanzania.