Doctoral Dissertations

Date of Award

12-2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Mary Gunther

Committee Members

Ralph G. Brockett, Marian W. Roman, Sandra P. Thomas, Mary Gunther

Abstract

The frequency of errors in the healthcare environment is staggering, and nurses are often responsible for potentially or actually inflicting unintentional harm on patients. The patient and family are the first victims of a nursing error, but the incident can be a traumatic experience for the nurse as well, establishing him or her as a second victim. The purpose of this phenomenological research study is to describe the lived experience of nurses as a second victim following involvement in an unanticipated nursing error. The study is grounded in the existential phenomenological philosophy of Merleau-Ponty and guided by research procedures developed by Thomas and Pollio (2002). The study answers the question: How do nurses involved in an unintentional nursing error perceive and describe their response to the experience as a second victim? The research design methodology included a purposeful networking approach to recruit participants. In-depth, unstructured phenomenological interviews were conducted with 12 nurses willing to be interviewed about their personal, direct involvement in an unanticipated nursing error, with or without patient injury. Participants ranged in age from 24 to 64 years, and length of nursing experience at time of the error ranged from one month to 30 years. Data analysis included reading and analyzing all transcripts for meaning units and global themes to develop the thematic structure. The researcher, Interpretive Research Group, and willing participants agreed upon the final thematic structure. An encompassing central theme of “it’s a little scar” was woven throughout the interviews as participants described their experience. Four figural themes manifested within this central theme: (1) “That was a traumatic experience”; (2) “My god, am I still competent?”; (3) “They did not treat me bad” – “I am being thrown under the bus”; and (4) “I still think about it.” Study rigor was maintained through bracketing, data saturation, peer debriefing, member checking, and the use of direct quotes to support findings. This research offers an intensified awareness of what it is truly like to live as a nurse following involvement in a nursing error. Findings add to the nursing literature and have implications for nursing education, practice, and policy.

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