Prehospital Emergency Nurses' coping strategies associated to traumatic experiences.

BACKGROUND: Prehospital care constitutes a work environment in which Prehospital Emergency Nurses (PENs) are exposed to traumatic situations that can lead to stress and increase their vulnerability to stress reactions. PENs' coping strategies after traumatic experiences have been little explored, which suggests that an investigation leading to a deeper understanding of their coping strategies is needed. AIM: To investigate and describe PENs' coping strategies after traumatic experiences. METHOD: A descriptive, inductive design with a qualitative research approach was used. Semi-structured interviews were analysed using Graneheim and Lundman's method of content analysis. Twelve PENs were interviewed. RESULTS: The main theme that emerged was: "a professional approach supports coping strategies for traumatic experiences". Being unprepared increases the feeling of vulnerability when facing a traumatic event, even though PENs acknowledge that traumatic events are unavoidable in their profession. Previous experiences and mental preparation help PENs to keep focused. To be able to act professionally, PENs distance themselves, thus acquiring a sense of control. Inter-professional teamwork can reduce the sense of aloneness. CONCLUSION: PENs' coping involves several strategies. Their own processing and understanding of an experience are crucial for the management of their own feelings, also affecting the care that PENs can offer the next patient. This study emphasises that a professional approach is the strongest coping strategy after traumatic events.

Bladder irrigation with Chlorhexidine reduces bacteriuria in persons with spinal cord injury.

OBJECTIVE: To explore whether bladder irrigation with chlorhexidine: (i) can reduce bacteriuria, and (ii) is a practically feasible option in subjects with spinal cord injury practicing intermittent self-catheterization. DESIGN: A prospective, non-controlled, open, multi-centre study. METHODS: Fifty patients with spinal cord injury, practicing intermittent self-catheterization, with a history of recurrent urinary tract infections were screened for bacteriuria at follow-up visits to 4 spinal cord injury centres in Sweden. Twenty-three patients had a positive urine culture (> 105 CFU/ml of > 1 bacterial species), of which 19 completed the study. Subjects proceeded with bladder irrigation, using 120 ml of 0.2% chlorhexidine solution twice daily for up to 7 days. Urine samples were taken twice daily. Response to treatment was defined as reduction in bacterial counts to < 103 CFU/ml. RESULTS: Fourteen of 19 subjects reduced their bacterial counts to or below the set limit. Subsequent return of above-endpoint bacteriuria was seen in most of the subjects. However, there were significantly fewer subjects with bacteriuria after treatment (p <0.005). CONCLUSION: Bladder irrigation with chlorhexidine, using intermittent self-catheterization, reduced bacteriuria in the majority of subjects with spinal cord injury and bacteriuria. The addition of bladder irrigation was practically feasible in the short time-frame of this study.