The Lived Experience of Male Medical-Surgical Registered Nurses With a Cardiopulmonary Resuscitation Inpatient Death: A Phenomenological Study

Abstract

Nurses are frequently exposed to the phenomenon of post–cardiopulmonary resuscitation (CPR) deaths of inpatients, which has a stress-related influence that negatively impacts nurses’ well-being and subsequently, patient safety. The extant literature does not separate male nurses’ experiences from those of female nurses regarding the stress caused by a CPR event that results in patient death, but such stress may present differently based on gender. Using a descriptive phenomenological design, this study explored the lived experience of male medical-surgical registered nurses (MS RNs) with a CPR inpatient death. This qualitative approach centered on the reality of the phenomenon experienced and aided in exploring a topic about which little is known. A purposive sample of 6 male MS RNs who had experienced a patient death with a CPR attempt were recruited from a large urban academic hospital in the midwestern United States, where nurses actively participate in CPR events in the inpatient setting. In-depth interviews were conducted with a semistructured interview guide to explore the research question: “What is the lived experience of the male MS RN with a CPR inpatient death?” Bevan’s phenomenological approach to interviewing was used to inform the structure of the interview questions. Additionally, Ahern’s recommendations for phenomenological bracketing and reflexive journaling were applied. The data analysis, conducted with Colaizzi’s (1978) seven-step method, resulted in identification of 10 emergent themes. The use of theory was excluded from the study design; however, a theory became relevant after the data analysis was initiated. The findings of this study supported Lazarus and Folkman’s (1984) stress and coping theory. Six of the 10 emergent themes aligned with Folkman et al.’s (1986) established coping strategies. The coping strategy definitions were expanded to encompass the participants’ full descriptions. The 6 themes related to coping strategies were as follows: (a) when I know better; I do better (planful problem solving); (b) was it me (accepting responsibility); (c) my patient needs me to control emotions (self-controlling); (d) finding my support (seeking social support); (e) doing my best and learning (positive reappraisal); and (f) I use distancing, but what’s that (distancing). Four additional themes were identified: (a) being an MS RN – to lead or to follow; (b) with this patient it’s different; (c) my experience with emotions; and (d) male nurse – it’s just nurse. Practice recommendations involve implementing evidence-based interventions known to be effective learning and coping strategies with nurses, including in-situ simulation, structured operational debriefing, resilience and emotional intelligence training, and peer support programs. Recommendations for further research include mentor-based observational learning of real-life CPR events for less experienced MS RNs who desire guided CPR learning exposure and supplements to CPR training programs, such as setting realistic expectations for patient death, discussing appropriate distancing, establishing professional-patient boundaries, and normalizing the use of humor. Furthermore, interventions such as contextualized CPR training, resilience training, and support programs that meet the needs of male MS RNs must be developed and tested to assess their effectiveness in terms of CPR-related preparedness and well-being.