PRISM :: Browsing by Author "Raffin Bouchal, Shelley"

Browsing by Author "Raffin Bouchal, Shelley"

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Open Access
A hermeneutic reappraisal of nurse patient relationships on acute mental health units, using Buddhist perspectives
(2012) McCaffrey, Graham; Raffin Bouchal, Shelley
This dissertation is a hermeneutic study of the nurse-patient relationship on acute care, inpatient mental health units, using Buddhist perspectives. At its centre is a research study in the form of interpretive analysis of interview data from nurses with experience of working in acute mental health settings. The work in its entirety functions as a triangulation between the topic of nurse-patient relationship, Buddhist thought, and philosophical hermeneutics as an approach to research. Each of the three elements serves to illumine something about the others in a series of reciprocal discussions. There is necessarily a linear structure to the dissertation, so that one of the three elements is highlighted in a given chapter, but with reference to the other two. The arc of the work thus proceeds through the background to the topic and a discursive literature review; philosophical hermeneutics; Buddhist thought; hermeneutics in a research context; interpretive chapters based on interview data; and implications for practice. This is an intercultural study, in which different traditions of thought and practice are exposed to each other without any intention of subordinating one to another, but of allowing for a shifting of perspective and creation of new understanding. Among the three elements, however, the target is of course nursing practice and the extension of the theoretical, philosophical, and practical vocabularies, which are available to the nursing profession to articulate and develop its therapeutic practice with nurse-patient relationship.
Open Access
A Narrative Inquiry Exploring All-Terrain Vehicle Injury Survivors' Experiences
(2023-06) Grossi, Marissa; dela Cruz, Añiela; Estefan, Andrew; Raffin Bouchal, Shelley
All-terrain vehicle (ATV) use in Canada, has led to significant morbidity and mortality. Children under 18 years old are more prone to ATV injuries. Despite the increasing number of ATV-related injuries and fatalities, there has been limited research about ATV use conducted in Alberta. There is limited academic knowledge about ATV riding behavior. There have been no known qualitative studies that have researched the experiences of ATV injury survivors. Given the unique nature of ATVs as a recreation vehicle and as farming equipment, the increasing rate and severity of injuries, and the perceived lack of protective equipment used while operating an ATV, it is important to research and understand the experiences of people who have sustained ATV injuries during childhood. The purpose of this narrative inquiry was to understand the experiences of emerging adult ATV injury survivors (ages 18 to 29 years old), who sustained childhood ATV-related injuries, and how their experiences with injury survival shaped their self-identity. Clandinin and Connelly’s (2000) form of narrative inquiry methodology was used to explore the experiences of two emerging adults who had childhood ATV-related injuries. Data was generated through field texts which included in-depth conversational interviews with each participant and field journal writing. This study yielded in-depth narratives which described ATV experience as being strongly anchored within the social spaces of family and community. Two narrative threads that resonated across narrative accounts include: ATV use as a shared experience, and stories to live by (narrative forms of identity) - how ATV-related injury shapes emerging adults over time. This thesis concludes with a discussion of the personal, social, and practical significance of this work, with implications for nursing practice, social policy, health education, and future research.
Open Access
A Study of the Interplay between New Graduate Life Experience, Context, and the Experience of Stress in the Workplace: Exploring Factors towards Self-Actualizing as a Novice Nurse
(2018-04-17) Dames, Shannon Suzanne; Groen, Janet; Raffin Bouchal, Shelley; Kawalilak, Colleen A.
Prolonged levels of stress and feelings of insecurity in new graduate registered nurse work environments are an expected part of the transition experience, yet we continue to see high rates of emotional exhaustion leading to burnout. There is a significant amount of literature on the sources of new graduate stress. However, research is lacking regarding what makes one nurse more vulnerable than another within similar work environments. This qualitative study explored the interplay of life experiences that enable and disable eight new graduate nurses from engaging in the process of self-actualization or thriving. Three prominent themes emerged as significant factors that influence the new graduates’ ability to engage in self-actualization. Developmental factors were significant in the capacity to manage workplace stressors and included congruence from their childhood experience or time in their young adult life where they engaged in relationships that provided unconditional positive regard, the habitual practice of self-compassion, and the ability to resolve areas of moral and ethical dissonance. Biological factors also buffered the experience of stress in the field, which included age and having a personality suited to their nursing role. Finally, contextual factors included having a trusted mentor at work, feelings of meaning and purpose within another life role, threats of emotional and physical violence in the workplace, workloads that took novice inefficiencies into account, limiting redeployment, and work schedules that allowed for adequate rest between sets. These insights inform nursing curriculum and transition programs by deepening the understanding of the interplay between previous and current contexts and the experience of stressors that are endemic in the workplace.
Open Access
An Interpretive Ethnography: Nursing Culture for People with Dementia and Behavioral and Psychological Symptoms of Dementia in the Acute Care Environment
(2018-09-12) Hannaford, Sara Anne Dellarie; Venturato, Lorraine; Fox, Loralee; Holroyd-Leduc, Jayna M.; Raffin Bouchal, Shelley
Objectives: Acute care nurses care for people with dementia (PWD) who suffer from behavioral and psychological symptoms of dementia (BPSD) in care environments that may worsen BPSD. The purpose of this study is to understand the nursing culture of care that exists for PWD with BPSD, and align this culture of care with the theory of person-centered dementia care (PCC). Methods: An interpretive ethnography approach was used, and data was collected on a general medicine unit at one acute hospital through 75 hours of participant observation and five semi-structured interviews with registered nurses and licensed practical nurses. Data was thematically analyzed. Results: A number of facilitators (teamwork, creativity, knowing the person, care plans, flexibility) and barriers (time constraints, safety, restraint use) for prevision of PCC to PWD and BPSD were identified. The culture of care for PWD with BPSD is shaped by formal protocols, informal protocols or unwritten rules, and beliefs about PWD and the nurses’ role in acute care. Nurses’ ability to provide PCC is limited by the incompatibility between the needs of the PWD and the acute care environment, and risk-averse safety culture that promotes physical safety over the needs and wants of the PWD. Conclusion: PWD with BPSD should be supported outside of the acute care environment when possible. The acute care environment needs to become more dementia friendly, and nurses need support and permission on a systems and individual level to re-conceptualize the meaning of risk for PWD with BPSD.
Open Access
Are We Failing FAmILy?: A Situational Analysis of Family Perspectives on Functioning While in Out-of-home Care
(2022-07-19) Westelmajer, Chloe; St. George, Sally; Wulff, Daniel; Ewashen, Carol; Archer-Kuhn, Beth; Raffin Bouchal, Shelley
Despite Canada having the highest rate of children living in out-of-home care throughout the world (Brownell & McMurtry, 2015; Gilbert et al., 2012; Thoburn, 2007) there is scant Canadian data or research pertaining to these children and their families. Research has shown that a child’s family functioning level is highly correlated with successful out-of-home mental health care treatment outcomes, discharge, behavioural improvement, and stability (Sunseri, 2004, 2019). Family functioning models and assessments that have not been normed upon Canadian families, or that organise family functioning related to task accomplishment, are being utilised to make life-changing decisions within out-of-home care settings. Harnessing my experiences as a front-line counsellor, family therapist, manager, administrator, and passionate out-of-home care advocate I set about asking the research question “What aspects of functioning as a family unit are most important and most immediate to families with a child in out-of-home mental health care?” in order to create theory that could provide better comprehension of what functioning means for these families. I utilised Adele Clarke’s (Clarke, 2005, 2007, 2009; Clarke et al., 2015, 2018) methodological extension of Situational Analysis, Kathy Charmaz’s (2014) Constructivist Grounded Theory Coding structure, and Nora Bateson’s (2016) concept of “warm” and contextualised data to get as close as possible to the situated knowledge of family functioning with a child in out-of-home care. Following maximum variation theoretical sampling, 13 semi-structured interviews were conducted with 12 families and 42 individual family members engaging in out-of-home mental health care. Through my analysis 72 family functioning tasks, or core competencies, practiced by families arose and were categorised within five core areas: coping with disconnected systems, managing stigma and blame, attending to the emotional needs of the whole family, living through and living with mental health issues, and creating togetherness through separation. The resulting theory is that families, as the unacknowledged and silenced front-line workers, have to function with, and within, the many elements that surround the reality of living with a family member in out-of-home mental health care.
Open Access
Breastfeeding Practices among Arab Mothers in Calgary with a Focus on Exclusive Breastfeeding: A Qualitative Inquiry
(2018-11-15) Dorri, Roqaia Ahmad; Donnelly, Tam Truong; Premji, Shahirose Sadrudin J. E.; McKiel, Elaine; Raffin Bouchal, Shelley
Breastfeeding is university acknowledged as providing health benefits for the child, for breastfeeding mothers, and for the community. The World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of an infant’s life. However, the rates of exclusive breastfeeding practices among immigrant mothers, including Arab mothers residing in Calgary, are lower when compared with rates for non-immigrant Canadian mothers and mothers in the immigrants’ countries of origin. Using critical ethnography, the purpose of this study was to explore the contextual factors that influence initiation and exclusive breastfeeding practices by Arab immigrant mothers. Ten Arab mothers residing in Calgary were interviewed. Three of these mothers were interviewed twice for member checking. An analysis of the qualitative narrative data indicated that knowledge, family, religion, and infant feeding practices influence Arab immigrant mothers’ initiation and exclusive breastfeeding practices. The findings from this study can be used to facilitate supportive culturally safe and sensitive interventions that are tailored to address Arab mothers’ breastfeeding concerns and needs, so that exclusive breastfeeding might be promoted within this population in Canada. Further, the research will provide information needed for addressing key challenges relating to culture, religion, and the healthcare system with the practice of exclusive breastfeeding.
Open Access
Coming Alongside a Patient Throughout their Cancer Journey: A Constructivist Grounded Theory of Cancer Patient Navigation from the Perspective of Registered Nurses in the Navigator Role
(2017) Vimy, Kristina; Raffin Bouchal, Shelley; Watson, Linda; Sinclair, Shane
Cancer patient navigation has become an important aspect of cancer care to support and guide patients through the health care system. In Canada, registered nurses commonly take on this role. The purpose of this study was to gain a better understanding of the process of cancer patient navigation from the perspective of registered nurses who work in the navigator role. Using constructivist grounded theory methodology, I interviewed nine cancer patient navigators in the province of Alberta, to examine their experiences and perspectives of their role. I analyzed the data using constant comparison and six interrelated categories emerged. This analysis led to the co-construction of the theory of Coming Alongside a Patient Throughout Their Cancer Journey. Findings from this study bring a new understanding of navigation as a process and highlight a different conceptualization of time, which sets this study apart from other research.
Open Access
Connecting in Crisis: Family Presence in Resuscitation
(2014-01-30) Schmidt, Rosemary; White, Deborah; Raffin Bouchal, Shelley; MacLeod, Bruce
Family presence during resuscitation, while discussed and championed by numerous health care organizations remains an inconsistent practice in many emergency departments, including the one examined in this study. Nurses who participated in this grounded theory study reported support and advocacy for family presence. Family members were regarded a valuable resources for the patient and health care team. The nurses discussed the importance of families being together and working together with the health care team in the resuscitation effort. The social process that emerged from the study was connecting in crisis. Facilitating family presence via policy development was not palatable to the participants. Rather, an overarching belief in the importance of family presence and a situational assessment of resuscitation, patient, family, and team was deemed as necessary prior to family inclusion.
Open Access
Consequence Delimiting: A Grounded Theory of Healthcare Leader Decision Making in the Context of Adverse Events
(2018-05-22) McRae, Leonard Glenn; White, Deborah Elizabeth; Estefan, Andrew; Raffin Bouchal, Shelley; Reilly, Sandra Muir; Sheps, Samuel Barry
Adverse events (AEs) remain a central focus of North American healthcare leaders (HLs) since the release of the Institute of Medicine’s (IOM) report: “To Err is Human” in 1999 (Institute of Medicine, 1999). The IOM reported that as many as 98,000 people died from preventable deaths every year in the United States as a result of errors in the delivery of healthcare. Studies in other healthcare systems report comparable rates of harm (Baker et al., 2004; Thomas et al., 2000; Vincent, Neale, & Woloshynowych, 2001). The high incidence of AEs coupled with healthcare leaders’ fiduciary and regulatory responsibilities to manage these events result in its central import for healthcare leaders. The aim of this study was to discover a general substantive theory on how HLs approach accountability in the context of adverse events (AEs). The research findings were that the main concern of HLs was determining how to respond to each AE. Consequence Delimiting emerged as the core category of this classic grounded theory (CGT). The theory was conceptualized as a stage theory where multiple phases proceed sequentially and each produces a product that is built upon by subsequent stages to ultimately produce an outcome. Consequence Delimiting begins at the time that the HL accountable for managing the AE; the accountable leader (AL) becomes aware of the AE and proceeds through the interrelated categories of apprehending, story constructing, expectation navigating and truth promoting to an event disposition. The emergent theory takes particular cognizance of the role that context and discretion play in determining the disposition of an AE. It highlights the influence of organizational and leadership culture, constraints and the role of pathways in influencing the disposition. Consequence Delimiting has implications for regulators and healthcare leaders interested in better understanding and improving patient safety in their organizations.
Open Access
Defining the needs and improving the wellbeing of healthy brca1 and brca2 mutation carriers
(2008) Mor, Pnina; Oberle, Kathleen; Raffin Bouchal, Shelley
Open Access
Designing and Implementing an Ambulatory Oncology Nursing Peer Preceptorship Program: Using Grounded Theory Research to Guide Program Development
(Hindawi Publishing Corporation, 2012-02-03) Watson, Linda C.; Raffin Bouchal, Shelley; Melnick, Amy; Whyte, Darlene
Open Access
Developing a Faculty-Librarian Community of Inquiry: A Blended Learning Approach to Facilitate Information Literacy Education
(2018-06-21) Melgosa, Annette Alyce; Jacobsen, Michele; Hayden, Katharine Alix; Kim, Beaumie; Raffin Bouchal, Shelley; Hughes, Janette; Burns, Amy M.
The purpose of the study was to explore how disciplinary understanding around Information Literacy (IL) might be achieved between faculty members and librarians through the design and implementation of a blended Community of Inquiry (CoI) (Garrison, 2011) Faculty-Librarians CoI Workshop (FacLibCoI) within a social constructivist epistemology. A mixed methods, design-based research (DBR) approach was used to build and test the FacLibCoI prototype and was based on Pool and Laubscher’s (2016) micro/meso iterative-cycle approach to McKenney and Reeves’ (2012) Generic Model for Educational Design Research. An environmental scan of the literature and the university where the study took place comprised phase one of the study. In addition to the review of literature, university reports were reviewed, and focus group interviews were conducted with university faculty members and students. Analysis revealed that faculty viewed research as discovery while students equated it with term papers. Students who had learned IL in general studies writing courses demonstrated good conceptual knowledge but poor implementation skills. Phase Two comprised the design phase. The FacLibCoI was designed to last two months and include three in-person sessions with accompanying asynchronous online discussions. The FacLibCoI workshop was implemented and analyzed in phase three. The design changed to four in-person sessions and two asynchronous discussions. Data included before-and-after participant interviews, transcripts, CoI questionnaires, and group artifacts. All CoI presences and metacognition were achieved in the FacLibCoI. Participants demonstrated group cohesion and disciplinary-based, shared understanding of IL, producing a disciplinary IL Model, IL learning goals mapped to disciplinary and IL standards, and an action plan for IL implementation. A CoI was established in less time than in studies reported in the literature and holds promise for scaling up. The online portion of the design proved unsustainable, and technology platforms and busy schedules were negative factors. Online collaboration between librarians and faculty may prove successful during a later departmental IL implementation phase. This phase should be considered in future iterations. Consulting participants on selection of a technological platform is advised.
Open Access
Engaging in the "How to Care, What to Say" Grief and Loss Workshop: A Constructivist Grounded Theory Study
(2018-04-20) Leteta, Barbara Ann; Raffin Bouchal, Shelley; Sinclair, Shane; Berg, Beverly
The purpose of this study was to evaluate an Alberta Health Services grief education workshop offered to health care providers through the Grief Support Program titled, “How to Care, What to Say.” The goal of the workshop was to improve delivery of care for dying and deceased persons by providing holistic care to the family before, during, and after the death of a loved one. This was the only ongoing grief support workshop offered within the Calgary Zone to provide theory and practical information for health care providers caring for grieving patients and families at the end of life. Written evaluations of the grief workshop were reviewed and illuminated the need to understand how learning of grief theory and intervention occurred in practice. Therefore, a qualitative research study was conducted using Constructivist Grounded Theory to interview past participants of “How to Care, What to Say” workshop and who cared for grieving individuals/families. Individual interviews and a focus group revealed how participants perceived the learnings from the workshop and transferred their knowledge from the workshop to practice. Data analysis uncovered themes which led to the overarching theory for implementation of the workshop into practice: A relational process of understanding knowledge, self-awareness, advancing grief competencies, and moral responsibilities of providing holistic grief support. Research findings included the usefulness and meaningfulness of the grief program, effective teaching and learning processes, a need for increased application based exercises, and ideas for development of advanced grief workshops to improve health care providers’ comfort and competence to provide grief support.
Open Access
The Experiences of End-of-Life In-home Caregiving by Immigrant Family Caregivers
(2022-01) Gana, Rhodric; Raffin Bouchal, Shelley; Wallis, Mary; Dela-Cruz, Añiela
The de-institutionalization of healthcare systems around the world has led to the rise of home care services as a preferred option. Many people with life limiting illnesses have expressed their wish to stay at home during End-of-Life (EOL) care. The ability to die at home is made possible partly by significant levels of informal caregiving from family members and friends. In-home caregiving presents many positive and negative experiences that are common among Canadian family caregivers and their loved ones. However, cultural values and norms for immigrant family caregivers may shape the experience of in-home caregiving in unexpected ways. The purpose of this research is to understand the immigrant family caregiver’s experience of End-of-Life in-home caregiving. Using a Constructivist Grounded Theory methodology, I interviewed immigrant family caregivers who described their experience of taking care of a loved one dying at home. Semi-structured interviews with guided questions were the means by which seven immigrant family caregivers described their experience of EOL in-home caregiving. I analyzed the data using coding, memo-writing, theoretical sampling, and constant-comparative processes. This analysis led to the co-construction of the theory Immigrant family caregiver experience of EOL in-home caregiving: A Relational Process of Maintaining Dignity in Dying. Encompassed within this theory are three interrelated categories and nine sub-categories.
Open Access
Exploring Awareness of a Palliative Approach: A Constructivist Grounded Theory Study
(2018-09-17) Tellier, Leah; Raffin Bouchal, Shelley; Reay, Gudrun; Shantz, Heather Davison
Chronic diseases are the leading cause of death in Canada. Advanced cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, and advanced dementia are life-limiting conditions that would benefit from a palliative approach to care. There is minimal Canadian literature that explores healthcare providers’ knowledge and awareness of introducing a palliative approach for patients living with chronic disease. This thesis outlines a qualitative study using grounded theory methodology, to explore the knowledge, perspectives, and beliefs of healthcare professionals who care for individuals with chronic life-limiting illness. In this study, interviews were conducted to explore healthcare professionals’ understanding of a palliative approach to care, available resources, and their beliefs about introducing a palliative approach earlier in the illness trajectory for patients living with chronic disease. Data was collected and analyzed using constructivist grounded theory methodology. Findings from this study have determined the need for increased awareness of a palliative approach for patients living with chronic disease as well as the resources available for physicians and nurses to make appropriate referrals for patients who would benefit from early palliative care initiatives. In addition, the long-term objective is to decrease the amount of Emergency Department visits and acute care admissions as well as improve quality of life for patients living with chronic disease by increasing access to community palliative care resources through early referral.
Open Access
Exploring Intensive Care Unit Nurses’ Decision Making in Alarm Management
(2023-07) Krakova, Nikola; King-Shier, Kathryn; Banner-Lukaris, Davina; Raffin Bouchal, Shelley
Alarm fatigue, which occurs when the exposure to an increased amount of false or nonactionable alarms leads to alarm desensitization and reduced clinical response by the healthcare provider, can pose a significant risk to patient safety. With the increasing advances in technology and frequency of alarms in our healthcare system, alarm fatigue is an important and growing safety concern that needs to be addressed. Exploring alarm-related decision making is key to reducing alarm fatigue, as it is important to the development of alarm management related initiatives, education, and policies. To examine this, I used Interpretive Description methodology to explore factors that influence Intensive Care Unit nurses’ decision making regarding alarm management, specifically how they triage and respond to various alarms. This study included 12 participants, comprised of nurses with varying levels of experience, working at three different Intensive Care Units. The results of the interviews suggest that the nurses’ decision making consists of three steps that capture their alarm management response: awareness, triage, and response. Based on these results, a positive alarm management culture, standardized alarm-related education, and mentorship should be evaluated to implement an effective alarm management response and reduce alarm fatigue.
Open Access
A Grounded Theory of South Asian Older Men Who Have Hypertension
(2019-07-26) Singh, Shaminder; Hirst, Sandra; Raffin Bouchal, Shelley; Mather, Charles; Venturato, Lorrraine; Hunter, Kathleen
Hypertension is a widespread but rarely symptomatic chronic condition characterized by raised blood pressure over a lengthy period of time that causes serious vascular damage. South Asians are nearly three times more susceptible to hypertension than European Whites. As compared to South Asian women, men are more prone to hypertension risk factors such as alcohol and tobacco consumption, remain less compliant with antihypertensive medications, and experience more cardiovascular events and mortality. Age is also a known risk factor of hypertension. How South Asian older men managed their hypertension was a knowledge gap. The current grounded theory revealed the four-stage processes of Savvy the Self for hypertension management in South Asian men aged 55 years and older in a Canadian context: (1) self-care, (2) self-protection, (3) making sense, and (4) equipping self. Findings exposed the links between South Asian men’s masculine identity, cultural beliefs, and disequilibrium in their self-care and developmental needs that emerged with a diagnosis of hypertension. The disequilibrium eventually evoked awakening for South Asian men that mobilized the processes of Savvy the Self leading to their hypertension management. This grounded theory provided insights into South Asian culture and revealed new nursing knowledge to assess, plan, and deliver nursing care for older South Asian men with hypertension. Findings may be useful for health education and services, cultural and faith-based community organizational services, and future research related to professionals’ cultural competency for serving a diverse group of people.
Open Access
How Undergraduate Nursing Students Cope with Stress during the COVID-19 Pandemic: An Interpretive Description
(2021-11) Park, Glennis Laurel; McCaffrey, Graham; Raffin Bouchal, Shelley; Smith, Jacqueline
Stress is a critical issue globally in undergraduate nursing education with studies showing stress among undergraduate nursing students as a decades-old concern. The COVID-19 pandemic is a new stressor which has created changes and disruptions in undergraduate nursing educational programs. The purpose of this qualitative, Interpretive Description research study was to gain an understanding of the lived experiences of undergraduate nursing students during the exceptional context of the COVID-19 including their perceptions of stress and their identified coping strategies to manage stress amid their nursing program. Lazarus and Folkman’s (1984) Transactional Model of Stress and Coping was used as the theoretical foundation to guide this study. The setting for this study was the Faculty of Nursing at the University of Calgary, in Calgary, Alberta, Canada. Convenience and purposive sampling were used with voluntary participation from the undergraduate nursing students. Semi-structured, individual interviews were conducted to gather participant data. All data was transcribed verbatim, analyzed for themes, and reported in aggregate form. The perception of a stressor is unique to each individual, however, broad categories of stressors were found to be common amongst nursing students, along with new stressors associated with the COVID-19 pandemic. The findings indicated that the participants exhibited a common characteristic of strong personal motivation with a focused desire to succeed in the nursing program.
Open Access
"It's Just Worse": The Experience of Emergency Nurses Three Years Into the COVID-19 Pandemic
(2024-08-19) Alphonsus, Lisa; Raffin Bouchal, Shelley; Moules, Nancy; Laing, Catherine
The COVID-19 pandemic has profoundly impacted healthcare professionals. Prior to the pandemic, emergency nurses were already susceptible to psychological distress and being at the frontline of the pandemic, they have experienced increased rates of depression, anxiety, post-traumatic stress, moral distress, and burnout. There is limited qualitative research on emergency nurses’ experience that spans the entirety of the pandemic, particularly in the third year. Using qualitative description, the aim of this research was to understand the experience of emergency nurses during the COVID-19 pandemic. Semi-structured interviews with five experienced emergency nurses were conducted and analysed using Braun and Clark’s (2006) framework of reflexive thematic analysis. Four themes emerged and were described: fear and anxiety of the unknown, a ton of sadness, it’s just nice to get our side of the story out, and it’s just worse. This research allows us to see the long-term effects of the pandemic, demonstrating that emergency nurses experienced the pandemic as getting worse over time. Emergency nurses have demonstrated profound courage, compassion, resilience, strength, and determination throughout the pandemic, however, it has resulted in them experiencing a heavy toll. The pandemic has left emergency nurses heartbroken, hopeless, exhausted, and feeling helpless with nurses leaving the emergency department as well as the nursing profession. Urgent support, resources, and advocacy is needed to help mitigate the toll of the pandemic and the effect it has had on emergency nurses. Understanding their experience is the first step in this essential process.
Open Access
Living in the in-between: a hermaneutic study of families caring for a child with a progressive neurodegenerative illness at home
(2009) Rallison, Lillian Beatrice; Raffin Bouchal, Shelley