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W. Travis McCall

TravisW. Travis McCall, MSN, RN, AGACNP-BC, FNP-BC, CEN, CCEMT-P

Flight Nurse/RN-3
LifeFlight

Title of Project: Caring for Patients from a School Shooting: A Qualitative Case Study in Emergency Nursing

Description of Project:

The adult emergency department received five patients after a school shooting event. Emergency nurses who participated in the trauma resuscitations or assisted with the transition of these patients from the receiving helipad to the emergency department were identified and invited by email to participate in interviews. The semi-structured interview questions and analysis of the data were informed by processes from a theory of secondary traumatic stress. Interviews were transcribed verbatim by the researcher or a transcriptionist who completed a confidentiality agreement. Key phrases and meaning units from the interview transcriptions were coded using NVivo 12 software. The categorization of codes generated themes that represented what the participants shared.

Why You Chose This Project:
Emergency nurses are frequently exposed to traumatic events in the delivery of care to injured patients. Those events identified as being most distressing to nurses are those that involve sudden death, children, or adolescents. Providing care to school shootings is therefore likely to be particularly stressful, and the frequency of multiple-victim school shootings has increased in a recent nine-year period. The presence of secondary traumatic stress in emergency nurses can have negative effects on their resilience, which may ultimately contribute to burnout and departure from the nursing profession.

Implications/Recommendations from the Study:
• Encourage positive coping skills and self-care routines to mitigate the incidence of secondary traumatic stress.
• Comprehensive peer-focused debriefings that encourage open discussion and reflections.
• Active involvement of peer support and employee assistance services following these events.
• Paid administrative leave for clinicians immediately following these events.
• Notification of patient outcomes to facilitate closure among those clinicians who provide care to these patients in the emergency department.
• Continued multidisciplinary and multispecialty research efforts to further identify those clinicians who are most at risk for secondary traumatic stress.
• Education and outreach into communities to promote training and readiness for mass-casualty events as well as wellness and selfcare resources to lessen secondary traumatic stress.
• Elevation of research efforts to evaluate the effectiveness of interventions aimed at alleviating symptoms associated with secondary traumatic stress.