Exploring the meaning of critical incident stress experienced by undergraduate nursing students: A hermeneutic study.

AIM: To better understand the meaning of clinical related critical incident stress experienced by undergraduate nursing students. BACKGROUND: Undergraduate nursing students who engage in learning in the clinical practice setting may experience critical incidents. DESIGN: Gadamer's philosophical hermeneutics (1960/2013) was used to explore the meaning of clinical related critical incident stress experienced by undergraduate nursing students. METHODS: A purposive sample was used to recruit 11 students who were enrolled in a Canadian university baccalaureate nursing program. Data collection involved conducting semi-structured interviews over 10 months in 2020-2021. The interviews were recorded and transcribed verbatim and the data were analyzed using the interpretive method of hermeneutics. RESULTS: Findings from this research revealed that the student-teacher relationship was influenced by students' experiences of critical incident stress. Students' navigating uncertainty and the need to maintain the optic of perfection had a potential impact on the response to critical incidents. CONCLUSION: This study highlighted that critical incident stress may lead to distress associated with students' altered perception of nursing as a discipline and profession as well as created opportunity for new insights and possibilities.

Clinical related critical incidents in undergraduate nursing students: A scoping review.

AIM: The purpose of this scoping review was to map clinical-related critical incidents and their implications on undergraduate nursing students. BACKGROUND: The unpredictability inherent in the clinical learning environment places nursing students at risk of a critical incident that may lead to long-term consequences. DESIGN: A scoping review was conducted using the Joanna Briggs Institute framework. METHOD: A search for primary research sources and dissertations was conducted using the CINAHL, PubMed, Dissertation and Thesis Global, and MEDLINE databases. Eligibility criteria included primary research related to undergraduate nursing students who had experienced critical incidents in the clinical setting. RESULTS: From a total of 66 identified articles, only one met the inclusion criteria. Overall, it was identified that the term "stress" was inconsistently defined. Researchers have primarily focused on general stress from academic and experiential learning rather than sudden and unexpected critical incidents underpinned by clinical experiences. CONCLUSION: The scoping review results identify a significant gap in the research relative to clinical-related critical incidents and the associated implications experienced by undergraduate nursing students. RELEVANCE TO CLINICAL PRACTICE: Further research is needed so that crisis interventions can be prioritized and strategies to enhance resilience can be addressed before graduation.

Collaboration with Rural and Remote Communities to Improve Sexual Assault Services.

After a recent sexual assault, clients in rural and remote communities do not typically receive comprehensive services. They experience delays with staff shortages and unfamiliarity with procedures, negative responses to disclosure such as disbelief, and may be turned away or required to travel elsewhere away from their support systems. These experiences increase their risks for mental health disorders and chronic diseases, placing a significant burden on the client's health and on the community. A participatory action approach was used in five Canadian communities to find collaborative solutions to their challenges. Mixed methods were used to collect data on the impact of community identified interventions on knowledge, service quality and comfort in providing services. Interventions included support for multidisciplinary advisory teams, resource development, and education sessions for service providers. The Enhanced Emergency Sexual Assault Services (EESAS) education selected by communities provided trauma informed knowledge of collaborative and comprehensive services in their community. Both focus group and survey data demonstrated increased collaboration and shared knowledge, enhanced communication, and improved services such as provision of increased privacy for clients. Knowledge increased in all key areas of services and service quality. Limited data suggests the changes are sustained for at least 6 months post-training. The combined findings of qualitative and quantitative data support the effectiveness of a multidisciplinary community development program. The increased knowledge, comfort and teamwork have potential to improve services clients receive and therefore the health of both the individuals and the community.

Identificación de las fortalezas, preocupaciones y necesidades educativas del Servicio Rural de Agresión sexual en las comunidades rurales y aborígenes de Alberta (Canadá) / Identifying rural sexual assault service strengths, concerns and educational needs in rural and aboriginal communities Alberta, Canada

Las mujeres en las comunidades rurales no reciben regularmente la atención integral de salud debida después de haber sufrido agresiones sexuales, lo que resulta en un aumento de las tasas de enfermedad mental, abuso de sustancias, revictimización, y problemas de salud crónicos. Además, las mujeres corren el riesgo de una victimización secundaria, de una estigmatización y de una revictimización derivada de las respuestas de los otros a la agesión. La victimización secundaria aumenta cuando las víctimas deben ser transportadas fuera de la comunidad rural para su tratamiento, debido a las demoras en los servicios, cuando los profesionales reaccionan de forma negativa hacia ellas, o sencillamente prestan unos servicios incompletos. Un estudio de investigación se hace necesario para abordar estos riesgos y comprender la necesidad de recursos educativos para los trabajadores que están a cargo de la crisis en las comunidades rurales y de aborígenes. Los hallazgos de las entrevistas de grupo con profesionales interdisciplinarios en las zonas rurales de Alberta, Canadá, identificaron algunas fortalezas, pero también revelan desafíos y la prioridad de una educación necesaria para aquellas personas que cuidan de las víctimas de agresión sexual(AU)

Women in rural communities do not regularly receive comprehensive health care following sexual assaults, resulting in increased rates of mental illness, substance abuse, re-victimization, and chronic health problems. Additionally, women are at risk for secondary victimization, the stigmatization and re-victimization that results from the responses of others to the assault. Secondary victimization is amplified when victims must be transported out of a rural community for treatment, receive delays in services, when professionals react negatively towards them, or provide incomplete services. A research study sought to find ways of addressing these risks and understanding the educational resources needed for crisis care workers in rural and Aboriginal communities. The findings from focus group interviews with interdisciplinary professionals in rural Alberta, Canada, identified strengths, challenges and priority educational needs for those caring for sexual assault victims(AU)