The Experiences of Emergency Department Nurses After Unexpected Patient Death in a Community-Based Hospital: A Focused Ethnography

Abstract

Abstract Background: Unexpected patient death is an unmodifiable event faced by emergency department (ED) nurses. Previous studies have reported how ED nurses cope with, and the consequences of, an unexpected patient death. Purpose: This study explored the experiences of ED nurses after unexpected patient death in a community-based hospital setting, as previous research focused on experiences of ED nurses in urban, or teaching, hospitals. Design and Methods: Focused ethnography allowed for the collection of thick rich data through ED site observation and the semi-structured interviews of six participants. Data were analyzed using thematic analysis where four themes and six sub-themes were construed. Results: Although ED nurses have varying ways of characterizing whether a patient death is unexpected, ED nurses experience unexpected patient death in a chaotic environment where there is an ongoing exchange of support between those around them. Complexity theory unveiled the emerging changes of what defines, and the roles of, junior and senior ED nurses. Implications: Implications for practice, policy, and research include the routine use of formal debriefing, working with local emergency medical services (EMS) for adjacent opportunities of support, and exploring the experiences of junior ED nurses, specifically.