First Advisor

Copeland, Darcy A.

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The emergency department is a unique, unstudied, chaotic environment where novice emergency nurses are frequently interrupted. Novice emergency nurses’ impressions, values, beliefs, and attitudes attributed to interruptions were unknown. No prior research has explored the phenomenon of interruptions for the novice emergency nurse. A qualitative, focused ethnographic study was undertaken to understand novice emergency nurses’ impressions, values, beliefs, and attitudes about interruptions within the emergency department. Eleven nurses participated in semi-structured interviews via Zoom. Braun and Clarke’s (2006) six phases of thematic analysis revealed three main themes (Values, Beliefs, and Attitudes) and 11 subthemes. Novice emergency nurses learn within a unique subculture that influences, challenges, and often contradicts previously held values, beliefs, and attitudes. Interruptions in a chaotic environment, coupled with limited experience within it, led to unique expressions of values, beliefs, and attitudes. Interruptions are embraced as normal, expected, and unavoidable. Yet, the resulting increased cognitive workload was overwhelming and elicited feelings of stress and anxiety. The emotional toll, moral dilemma, and cognitive dissonance felt when managing interruptions resulted in construction of meaning and influenced actions of novice emergency nurses. Research, education, and practice leaders must strive to make the unknown subculture and environment of the emergency department known. Education exposing the novice emergency nurse to the culture and emotional component of interruptions within the emergency department and practicing coping strategies in simulation is key to promote emotional well-being and patient safety. Further research is needed to advance nursing knowledge of interruptions and the novice emergency nurse within the emergency department culture.


125 pages

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