| Summary: | The purpose of this study was to examine maternity nurses’ experiences of
caring for pregnant women involved in abusive relationships. A conceptual
framework composed of the relevant concepts of maternity nursing care and
domestic violence was used. The research methodology of phenomenology was
chosen as it allows for the development of a special understanding of the
phenomenon in question by talking to participants who have firsthand experience.
Data were collected using semi-structured, audiotaped interviews that encouraged
the participants to describe the phenomenon in their own words. The study
sample consisted of eleven maternity nurses employed in an acute care maternity
nursing hospital who were interviewed once from one to three times.
Data were simultaneously collected and analyzed over a period of several
months. After transcription of the interviews was completed, data was examined
for common themes according to Colaizzi’s (1978) structure for qualitative data
analysis.
Maternity nurses’ experience was presented in three central, related themes.
The first theme, gaining understanding of patients in abusive relationships was
comprised of the sub-themes: (a) discovering the abuse, (b) reacting to discovery
of abuse, and (c) developing relationships. It was found that many of the patients’
abusive relationships were discovered through nurses’ use of intuition. As a result,
nurses experienced feelings of uncertainty which were reflected in the development
of nurse-patient relationships and subsequent nursing care.
The second theme, facing the realities: the health care context, emerged
from the health care environment in which the nurses provided care. This theme was composed of the following sub-themes: (a) identifying the gaps, (b) working
with others, and (c) providing nursing care. The nurses often felt frustrated at the
perceived lack of support for their abused patients, and the lack of support for the
nurses’ emotions.
The third theme, struggling within the realities: the subjective context,
describes the participants’ personal experiences of caring for abused pregnant
women. Many of the nurses based their own understanding of abuse of their past
personal experiences. This theme was comprised of the following sub-themes; (a)
nurses’ conceptualization of abuse, (b) feeling fear, and (c) connecting with the
patients.
This study has several implications for nursing. In clinical nursing practice,
all nurses need to become comfortable with caring for abused women. The goal
for maternity nurses must be for all childbearing women to be assessed for the
presence of abuse. In order to achieve these changes to clinical practice, nursing
administrators must support all front-line nurses to provide effective health care to
abused patients. This support should be offered through interactive dialogue and
the provision of counselling services for those nurses experiencing personal
difficulties. Furthermore, nurse educators must strive to educate present and
future nurses on the issues of domestic violence. Finally, the need for further
research involves examining groups of nurses from other clinical areas in order to
determine the transferability of this present study’s findings, and to explore the
similarities and differences of nurses’ experiences.
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