Zhang Cuiling, Yang Ziyan, Liang Yali, Feng Yong, Zhang Xiaohong
Department of Digestive Oncology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
College of Nursing, Shanxi Medical University, Taiyuan, China.
BMC Nurs. 2024 Aug 26;23(1):592. doi: 10.1186/s12912-024-02255-7.
In patient safety accidents, nurse managers are indirectly victimized by the pressures from many aspects and become the second victim. This study delves into the experiences of nurse managers in China, aiming to uncover their cognition and provide reference for relevant managers.
A descriptive phenomenological approach was used to gain insight into the inner reality of nurse leaders' experiences and management perceptions of experiencing patient safety incidents. The data of 15 nurse leaders who experienced patient safety incidents in Bethune Hospital, Shanxi Province, China, were collected via face‒to‒face semi-structured interviews, and the data were analyzed via the 7-step analysis method of Colaizzi.
On the basis of the content of the interviews, three themes were identified, the emotional experience of experiencing patient safety events, role dilemmas, the obstruction and conceptual reshaping of nursing management. Eight subthemes as follows: physical and mental health-related symptoms due to passive coping and life and work disorder, self-relief, playing multiple roles with lack of role adjustment ability, blurred role positioning and initial signs of job burnout, event replay is impeded, Inaccurate analysis of safety incidents, subversion and remolding of the nursing management concept. Finally, it can be abstracted as "forced growth in patient safety events".
Patient safety incidents can lead to negative impacts, role dilemmas, and management confusion for head nurses, but they also promote purposeful rumination, meditation, and growth. Medical institutions should pay attention to special groups that are second victims of head nurses and construct a safety event support system for nurse leaders to improve the post-training and education system for nurse leaders, help them better adapt to their roles, break through their role dilemmas, improve their post-competence, and construct an effective safety event management system.
在患者安全事故中,护理管理者受到来自多方面压力的间接伤害,成为第二受害者。本研究深入探讨中国护理管理者的经历,旨在揭示其认知,为相关管理者提供参考。
采用描述性现象学方法,深入了解护理领导者在经历患者安全事件时的内心体验和管理认知。通过面对面半结构化访谈,收集了中国山西省白求恩医院15名经历过患者安全事件的护理领导者的数据,并采用Colaizzi的七步分析法对数据进行分析。
根据访谈内容,确定了三个主题,即经历患者安全事件的情感体验、角色困境、护理管理的阻碍与观念重塑。八个子主题如下:因被动应对导致的身心健康相关症状及生活和工作紊乱、自我排解、角色多重但缺乏角色调适能力、角色定位模糊及职业倦怠初现、事件重演受阻、安全事件分析不准确、护理管理观念的颠覆与重塑。最后可提炼为“患者安全事件中的被迫成长”。
患者安全事件会给护士长带来负面影响、角色困境和管理混乱,但也促使其进行有目的的反思、沉思和成长。医疗机构应关注护士长这一第二受害者特殊群体,构建针对护理领导者的安全事件支持体系,完善护理领导者岗位培训教育体系,帮助其更好地适应角色,突破角色困境,提升岗位胜任力,构建有效的安全事件管理体系。