Exploring Nurses' Experiences of Older Adult Care: A Mixed Methods Study

We have a global nursing shortage and inadequate provisions to care for our ageing population. To ensure sustainability it is vital to understand predictors of nurse wellbeing. This project began with a systematic literature review determining key concepts for understanding nurses' experiences, revealing growing evidence for secondary trauma in nurses. This is a specific form of distress resulting from witnessing pain or vulnerability in a third party. However, current understanding is limited; and nurses providing older adult care have received little research scrutiny. Mixed methodology was employed, exploring nurses' experiences using qualitative interviews, and measuring prevalence and severity of distress by quantative survey. Interview transcripts from three senior nurses were analysed systematically according to principles of Interpretative Phenomenological Analysis (IPA). In summary, emotional engagement with patients was not only intrinsically rewarding, but often yielded useful information which could improve patient outcomes. However this patient-centred approach may also be associated with burnout, as nurses reported feeling exhausted, especially when interactions were emotionally intense or lacked reciprocity. A quantitative survey investigated the impact further. Nurses across three NHS Trusts completed standardised measures of general health (assessed as anxiety and depression), distress from intense emotional engagement (burnout and secondary trauma) and intrinsic reward (compassion satisfaction). Multiple regression models suggested that compassion satisfaction and perceptions of the organisation as innovative predicted burnout. Therefore in this time of NHS restructure, policy makers need to be aware that staff can benefit from belonging to an organisation perceived as dynamic and entrepreneurial.