The Characteristics of Traumatic Events Experienced by Nurses on the Accident and Emergency Ward 

Abstract
Nurses who work in high-risk areas, such as emergency wards, are susceptible to traumatic stress.  The present study is an exploratory one, which attempts to describe and interpret some event characteristics of traumatic incidents identified by nurses.  Nine nurses from the Accident and Emergency wards of two New Zealand hospitals were interviewed using the repertory grid technique.  Qualitative analysis was used to compare event characteristics across participants and four underlying themes were identified:  personal issues, contextual issues, control issues, or organisational issues.  Comparison of these results with previous work with high stress occupations suggests that although event characteristics from all groups can be broadly grouped under four themes, there are some distinct differences in the traumatic impact of some event characteristics for nurses.  The results have implications in the development of measures of traumatic stress for nurses and have immediate implications for organisational practice.

Keywords
nurses, emergency work, psychological trauma, work stress

Introduction
Nursing is understood as a high stress occupation (Gray-Toft & Anderson, 1981; Marshall, 1980; Monro, 1985).  One source of stress is the work environment, which may include aversive stimuli, such as vo,mit, blood, noxious smells, emotional expression by patients and their families, death, and dying.  One consequence of working in such an environment is the possiblity of traumatic stress(Garbin, 1982).  The experience of traumatic events at work can generate sugnificant personal and organisational loss as traumatic stress may be manifested as somatic complaints, intra-staff bickering, scape-goating (Garbin, 1982), and psychiatric disturbances, such as anziety disorder, major depression, substance abuse, and post-traumatic stress disorder (Paton & Smith, 1995).  Continued...