Cunningham Tim, Ducar Dallas M
From the University of Virginia School of Nursing, Charlottesville.
South Med J. 2019 Sep;112(9):469-474. doi: 10.14423/SMJ.0000000000001012.
The Pause is a short-term, microbreak created by an emergency nurse in 2009. It provides care team members a few seconds of silence to honor a patient who has died while also honoring the efforts of the team. It is used now on four continents as a standard of care. We investigated how it is being used and why.
We used a modified Delphi methodology with purposive sampling and a descriptive approach. During the three-round Delphi, we created a data display using open, then axial coding to develop a thematic analysis. Member checking and reflexivity exercises were used to build reliability and trustworthiness of findings.
We analyzed 21 transcripts. The Pause is reported to be an ongoing practice in at least 23 health systems globally. Key themes such as Benefits, Self-Care, and Support of other Patients were most pertinent in our analysis.
The Pause is a low-risk, grassroots intervention that can be led by any member of a care team in emergency settings. It offers self-care for the individual and team. It helps emergency providers feel grounded after a death before going to treat another patient. According to our sample, The Pause helps reduce caregiver stress, which may decrease the risk for burnout. Although further research is recommended, we assert that The Pause be used as a standard of care in emergency departments across the United States.
“暂停片刻”是急诊护士在2009年创设的一项短期微休息活动。它为护理团队成员提供几秒的默哀时间，以缅怀逝去的患者，同时也认可团队的努力。目前它在四大洲被用作一项护理标准。我们调查了它的使用方式及原因。
我们采用了改良的德尔菲法，运用目的抽样和描述性方法。在三轮德尔菲过程中，我们先使用开放式编码，然后进行轴心编码来创建数据展示，以开展主题分析。通过成员核对和反思练习来建立研究结果的可靠性和可信度。
我们分析了21份文字记录。据报告，“暂停片刻”在全球至少23个医疗系统中是一项持续开展的活动。在我们的分析中，诸如益处、自我关怀和对其他患者的支持等关键主题最为相关。
“暂停片刻”是一种低风险的基层干预措施，可由急诊环境中护理团队的任何成员发起。它为个人和团队提供自我关怀。它有助于急诊医护人员在经历患者死亡后在去治疗另一位患者之前保持沉稳。根据我们的样本，“暂停片刻”有助于减轻护理人员的压力，这可能会降低职业倦怠的风险。尽管建议进一步开展研究，但我们主张将“暂停片刻”用作美国各急诊科的护理标准。
