Psychological impact of traumatic events in rural nursing practice: An Integrative review


Background: Rural and remote nurses who practice in acute care often deal with traumatic injury and death in isolated practice with limited psychosocial support. The majority of research in this area has been conducted within urban nursing populations or non-nursing disciplines. Caring for others who have experienced a traumatic event may place rural and remote nurses at a greater risk of negative psychological effects over time.

Purpose: This integrative review will explore the evidence related to the potential negative psychological impact of caring for those who have experienced a traumatic event in the context of rural nursing practice.

Method: An integrative review of four health and social science databases was conducted using the framework by Whittemore and Knafl (2005). Main search terms included rural and remote nursing, vicarious trauma, secondary traumatic stress, post-traumatic stress disorder, compassion fatigue, trauma, and burnout. Articles published between 2006 and 2017 were identified and critiqued based on their scientific merit and applicability to rural nursing practice.

Results: Nine publications were found regarding rural and remote nurses’ exposure to traumatic events, and the potential personal and professional impact of exposure. While occupational stress was evident within rural and remote practice, there is a lack of clarity on the traumatic stressors of greatest concern. Most notable was the limited application of a rural and remote nursing lens to explore specific events linked to trauma, and the diversity of concepts used to describe the impact of these experiences.

Conclusion: There are few rural or remote studies that have explored the psychological impact of caring for others who have experienced traumatic events. Further research is necessary to explore the specific psychological impact experienced by rural and remote nurses being exposed to traumatic events over time and types of programs necessary to better support them to continue in their practice.

 Keywords: rural, remote, nurses, trauma, vicarious trauma, secondary traumatic stress, post-traumatic stress disorder, compassion fatigue, burnout


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