A master's thesis: A narrative inquiry into the experiences of trauma-informed care with nurses working in rural acute care settings
Date
2024
Authors
Wright, Stephanie
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Abstract
Principles of trauma-informed care are strongly aligned with nursing ethics, professional standards, and human rights and provide a framework for safe, compassionate, person-centred care. Additionally, trauma-informed care promotes emotional safety, patient engagement and empowerment, and treatment adherence, leading to improved health outcomes. Trauma-informed care also draws attention to recognizing vicarious trauma. Research suggests that rural nurses’ limited knowledge and education challenge incorporating trauma-informed care into practice in rural healthcare settings. In this narrative inquiry, I explore the experiences of nurses in relation to trauma in rural acute care settings. Narrative inquiry helps to better understand how nurses’ personal, practical, social, and institutional stories impact care delivery related to trauma-informed care, including vicarious trauma. I engaged with two nurses, Veronica and Barb, in three to four 1-hour conversations across 2 to 3 months. The conversations were recorded and transcribed verbatim. Transcriptions and field notes, including personal observations and reflections, formed the narrative accounts and were analyzed for resonant threads. Two threads were made visible: a) Learning to name trauma: the absence of language, turning to metaphor, and attending to embodiment, and b) Disrupting dominant stories of trauma-informed care: balancing personal and professional boundaries, and exploring the complexities of rural environments. This study has the potential to inform organizational policies, resources, and educational efforts to address trauma. It could enhance nurse retention and create innovative ways to support quality in patient-centred care, improve patient outcomes, and empower nurses and patients working with trauma.
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Keywords
Trauma-informed care, Narrative inquiry, Vicarious trauma, Rural nursing