Support mechanisms that enable emergency nurses to cope with aggression and violence: Perspectives from New Zealand nurses.

Background: Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence.

Methods: A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department.

A qualitative exploration of bereaved family members' experiences of emergency ambulance care at the end of life.

Background: In the context of a sudden or unexpected event, people with a life-limiting illness and their family caregivers may be dependent on emergency ambulance services.

Aim: To explore bereaved family members' experiences of emergency ambulance care at the end of life.

Design: A qualitative study using reflexive thematic analysis of data collected from semi-structured phone interviews.

When resuscitation doesn't work: A qualitative study examining ambulance personnel preparation and support for termination of resuscitation and patient death.

Background: Many ambulance personnel can withhold or terminate resuscitation on-scene, but these decisions are emotionally, ethically and cognitively challenging. Although there is a wealth of research examining training and performance of life-saving resuscitation efforts, there is little published research examining how ambulance personnel are prepared and supported for situations where resuscitation is unsuccessful, unwanted or unwarranted.

Aim: To identify and describe existing preparation and support mechanisms for ambulance personnel enacting decisions to terminate resuscitation and manage patient death in the field.

Paramedic student confidence, concerns, learning and experience with resuscitation decision-making and patient death: A pilot survey.

Background: Around the world, many paramedics are authorised to withhold or terminate resuscitation. Research indicates this can be a challenging part of their role. Little is known about graduating paramedic student confidence, concerns and learning in this area.

Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making.

Background: Clinical decision making is a complex, but important, research area. Decision-making theories have evolved to recognise that, although heuristics and biases can lead to error, expert clinician decision makers can also use intuition to good effect. More research is needed to understand how nurses and other clinicians make sense of complexity and uncertainty.

Beyond prognostication: ambulance personnel's lived experiences of cardiac arrest decision-making.

Introduction: The purpose of this study was to explore ambulance personnel's decisions to commence, continue, withhold or terminate resuscitation efforts for patients with out-of-hospital cardiac arrest.

Method: Semistructured interviews with a purposive sample of 16 demographically diverse ambulance personnel, currently employed in a variety of emergency ambulance response roles, around New Zealand.

Results: Participants sought and integrated numerous factors, beyond established prognostic indicators, when making resuscitation decisions.

Grey areas: New Zealand ambulance personnel's experiences of challenging resuscitation decision-making.

Introduction: When faced with a patient in cardiac arrest, ambulance personnel must rapidly make complex decisions with limited information. Much of the research examining decisions to commence, continue, withhold or terminate resuscitation has used retrospective audits of registry data and clinical documentation. This study offers a provider-perspective which characterises uncertainty and highlights clinical, cognitive, emotional and physical demands associated with decision-making in the cardiac arrest context.

Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death.

Background: Death and dying are inevitable life encounters, but a nurse's first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses.

Nurses' early experiences with patient death: the results of an on-line survey of Registered Nurses in New Zealand.

Background: Death has been identified as a known stressor for nurses and has been extensively researched in nursing populations. However, very little is known about the impact of a specific stressful event; that of the novice nurse's first encounter with patient death. Using a sequential quantitative-qualitative mixed methods design, a study was undertaken to explore the clinical circumstances, impact and challenges and rewards of nurses' early experiences with patient death.