Perinatal Nursing in Uncertain Times

PURPOSE: To make explicit the perinatal nurses' shared meanings of their lived experience while providing nursing care in the New Orleans area during the disaster of Hurricane Katrina. STUDY DESIGN: Interpretative phenomenology. METHODS: Semi-structured, in-depth interviews were conducted with 16 perinatal nurses 9 to 18 months after they worked in obstetrical and newborn hospital settings in the Greater New Orleans area during the Hurricane Katrina disaster. Van Manen's process of reflective thematic analysis-guided data analysis was used. RESULTS: Themes and subthemes included (1) duty to care (back to the basics, empathy, and advocacy in action); (2) conflicts in duty; (3) uncertain times: chaos after the storm (evacuation: routes through uncertainty, hopelessness, abandonment, and/or fear); (4) strength to endure; (5) grief: loss of relationships, identity, and place; (6) anger; and (7) feeling right again. CLINICAL IMPLICATIONS: Nurses who work during disasters must live through the uncertainty of the situation and be prepared to adapt to the needs that arise in patient care situations and self-preservation. Excellent basic nursing skills, intuitive problem solving, and a sense of staff unity are primary resources. Nurses and other caregivers need ongoing supportive interventions to rebound from the experience and cope with symptoms associated with trauma exposure.