Staff Registered Nurses On the Blood and Marrow Transplant Unit: Their Practice and Self-Care Needs

Background

Registered nurse (RN) turnover represents a significant cost to the institution, as well as a burden in training and replacing that RN. Bone marrow transplant (BMT) staff are constantly engaged in providing support to families and meeting their needs throughout the transplant process.  This process is intense and complex medically, emotionally, socially and spiritually for the families and the staff that care for them.  Work-related stress on the BMT unit impacts nurse retention, job satisfaction, and quality of care.

 

Purpose

The purpose of this study is to discover, describe, and analyze all experiences of Registered Nurses (RNs) on the BMT unit at Cincinnati Children’s Hospital Medical Center (CCHMC). Aims include: 1.) discover knowledge through documenting and interpreting staff RN’s beliefs, meanings, expectations and expressions of care, 2.) authenticating beliefs about staff RNs professional role and practice of caring for pediatric BMT patients.

Methods

Leininger’s theory of Culture Care Diversity and Universality guided this qualitative study.  Ethnonursing methodology with a focus group approach was used for data collection.  Hour long focus groups were held at CCHMC until saturation reached.  Additional study sessions with caregivers and managers provide enrichment.  Groups were recorded and transcribed with personal identifiers removed for confidentiality.  Code words are identified from raw data and categorized into patterns with NVivo Software.  Themes that emerge are being analyzed. Evaluation criteria include credibility, confirmability, meaning-in-context, recurrent patterning, saturation, and transferability. 

Results

Preliminary results indicate stress as a theme.  Less experienced staff experience stress with time management and task completion.  More experienced staff experienced stress with responsibility of being resource, complexity of care, and maintaining a positive environment.

Conclusions

Interventions aimed at stress management and reduction could be beneficial for this population.