Concealing emotions: nurses' experiences with induced abortion care (original) (raw)
Related papers
The concept of ‘nursing’ in the abortion services
Journal of Advanced Nursing, 2010
Title. The concept of 'nursing' in the abortion services. Aim. This paper is a report of a study of the perceptions of nurses who work in abortion services. Background. International debate surrounds abortion. In England and Wales the Abortion Act which was introduced in 1967 recently came under public review in relation to its legal limit of 24 weeks gestation. The review did not extend to those working within abortion services, and these nurses' views remained unknown. Investigating the perceptions of nurses who work in abortion services adds a dimension to the debate from a professional perspective which has hitherto been absent. Methods. Qualitative semi-structured interviews were conducted in 2007 with nine nurses working in three different abortion clinics in the United Kingdom. NVivo was used to manage the interview data and thematic analysis identified patterns of nursing concepts and attitudes. Findings. Two global themes of 'Attitudes Towards' and 'Coping With' abortion were identified. Six organizational themes detailed these: 'society', 'nurses' and 'reasoning' in 'Attitudes Towards' and 'role', 'clients' and 'late gestation abortion' in 'Coping With'. Eleven basic themes further described the organizational themes. Kim's theory of Human Living was used to clarify and provide a rationale for the nursing approach to care in this setting. Conclusion. The ability of participants to care for their clients as individuals illustrates the nature of empowerment of the nurses to attain the goals of the client. Making this support explicit through defined roles for nurses would potentially enable nurses in abortion services to perform their role more effectively at all gestation times.
Self-preservation in abortion care: a grounded theory study
Journal of Clinical Nursing, 2011
Aim. To seek an explanation as to why nurses concede and conceal their judgements towards women having an abortion. Background. Recent advances in abortion techniques and pharmacology have resulted in a greater proportion of medical abortions occurring at a lower gestation than previously. As this technique demands more of nurses, it becomes important to ask whether they are equipped to deal with this greater involvement. Design. A grounded theory approach using a recognised framework was used. Theoretical sampling was used in this study to increase the depth of focus from a previous study of nurses who were found to concede and conceal their judgement in abortion care. Findings. Several important aspects of abortion care were elucidated as to why nurses concealed and conceded their judgements. Lower gestation of abortions was central in determining greater involvement of nurses in the abortion process. It was found that some nurses treated women the same and some treated women differently, but all strived for equitable care. Self-preservation in the form of 'switching off' or 'getting on with it' was employed by nurses when they encountered the foetus or women who were blasé. Self-preservation was found to be a key phenomenon and a major reason why nurses conceded and then concealed their judgement. Conclusions. In rapidly advancing abortion care, there needs to be positive ways of ensuring self-preservation in nurses without compromising care. Relevance to clinical practice. Abortion care demands specific skills of nurses, and this is likely to increase in the near future. Self-preservation needs to be embedded into nurses' professional development by the use of positive strategies such as guided reflection in providing a productive woman-centred service.
Nursing Care for Mothers with Incomplete Abortions: Case Study
Journal of Vocational Nursing, 2022
Incomplete abortion is bleeding in pregnancy before 20 weeks, where some of the products of conception have come out of the uterine cavity through the cervical canal left in the decidua or placenta. Methods: This research uses a case study design. Data collection from assessment to nursing evaluation was carried out in the jasmine room of Dr Soegiri Lamongan Hospital in February 2019. Participant care at the hospital for three days-data collection techniques using interviews, observation, and documentation. Data analysis uses narrative analysis based on the analysis of relevant facts and theories. Results: The assessment of the two participants was the first and second pregnancies, with gestational ages of 12 and 16 weeks, experiencing vaginal bleeding and abdominal pain. There is abdominal tenderness, a pain scale of 5, and uterine contractions on examination. The nursing diagnosis was acute pain associated with uterine contractions and fluid volume deficit related to bleeding (abortion). The evaluation was carried out for 72 hours of reduced pain. The discussion is expected that nurses provide health education about pain and incomplete abortion. Conclusions: The pain and anxiety were reduced after implementing nursing for 72 hours. The reference from this study is for nurses to provide health education related to pain in incomplete abortion.
The experience of Italian nurses and midwives in the termination of pregnancy: a qualitative study
The European Journal of Contraception & Reproductive Health Care, 2017
Objectives: The aim of the study was to provide insight into the experiences of nurses and midwives working in the Italian abortion service. Methods: Study participants were recruited through purposive sampling. Semi-structured interviews were conducted between July and September 2016, among 22 nurses and two midwives working in five abortion services in Milan, Italy. Transcripts of interviews were analysed using a phenomenological approach to data analysis. Results: Five main themes emerged from the analysis: (a) coping with caring for women undergoing a termination of pregnancy; (b) improving professional training; (c) approaching work in a mechanistic way as a means of overcoming difficulties; (4) performing medical abortions; (d) recounting an experience. Conclusions: This first study about assisting with pregnancy termination in Italy may enable critical comparison with studies carried out in other countries. Both nurses and midwives suggested strategies, which may improve the provision of care: collaboration between primary and tertiary care, continuous training, multidisciplinary collaboration, increase of staff turnover and being kept abreast of new pharmaceutical products. Our findings are applicable to wider medical practice.
International Journal of Multidisciplinary Education and Research, 2018
Background: To be effective in preventing post-abortion mortality and morbidity, emergency post-abortion care must widely accessible throughout the health systems to all women. The health care facilities and trained medical providers, in order to the accessibility of post-abortion care, health services and providing post-abortion family planning services that includes contraceptive methods which are essential in preventing unwanted pregnancies. Objectives 1. To assess the effectiveness of the self-instructional module on post-abortion care among staff nurses. 2. To determine the association between posttest knowledge scores of staff nurses and their demographic variables. Methods and Materials: A pre-experimental one-group pretest-posttest research design was used for this study. The sample consisted of 40 staff nurses working maternity wards, they were chosen by a convenient sampling technique. In the pretest majority of the staff nurses, 36(90%) had inadequate knowledge on post-abortion care whereas in the posttest majority of the staff nurses37 (92.5%) had adequate knowledge and only 3(7.5%) of staff nurses had moderately adequate knowledge. The study findings revealed that the self-instructional module on post-abortion care was highly effective in improving the knowledge of staff nurses.
Women and Birth, 2018
Termination of pregnancy (TOP), in the late second and third trimester, is planned fetal loss that is medically and socially complex, and has lasting consequences for women. In New Zealand TOP after 20 weeks gestation may be performed to save a woman's life or to preserve her physical or mental health, which might be at risk of permanent damage due to fetal abnormality or severe intrauterine growth restriction. Core midwives in New Zealand are the main caregivers for women who face this procedure after 20 weeks gestation. A small number of international studies have demonstrated the ethical, moral and professional challenges midwives face when providing TOP care; however, the New Zealand maternity system, as well as its legal framework, cannot be compared to countries overseas. This hermeneutic phenomenological study aims to uncover the lifeworld of New Zealand midwives in the context of TOP and seeks to establish what enables midwives in their role, the effects of TOP care, if any, and the shortcomings in support networks that midwives would benefit from. Eight midwives from two District Health Boards in the North Island of New Zealand were interviewed about their experiences of caring for women who underwent TOP in the late second and third trimester. Data from the interviews were analysed using Max van Manen's methodological framework. The midwives' experience is described in three themes that emerged through reflection and writing: 'a different kind of midwife'; 'staying true to oneself'; and 'melting an iceberg'. The findings of this thesis suggest that TOP care is a different, specialised role within midwifery. Midwives facilitate death within the space of birth, not daily, yet on a regular basis. Addressing the mother-baby dyad the midwives support women in their decision, provide a positive childbirth experience, and address women's complex needs by meeting them in their emotional space. Midwives enable memory making, honour the life and death of the baby and provide the baby with dignity. Yet, the findings suggest that midwives are unprepared for Philosophical Traditions Shaping van Manen's Thinking .
Journal of Clinical Nursing, 2008
A review of termination of pregnancy: prevalent health care professional attitudes and ways of influencing them Aim. To review the literature on attitudes of health care professionals to termination of pregnancy and draw out underlying themes. Background. The controversy surrounding therapeutic abortion is unremitting with public opinion often polemic and unyielding. Nurses and midwives are at the centre of this turmoil, and as more termination of pregnancies are being performed using pharmacological agents, they are becoming ever more involved in direct care and treatment. Attitudes towards termination of pregnancy have been found to vary depending on the nationality of those asked, the professionals involved, experience in abortion care, as well as personal attributes of those asked such as their obstetric history and religious beliefs. The reasons for women undergoing abortion were also found to influence attitudes to a greater or lesser extent. Conclusion. This paper explores research studies undertaken into attitudes of health care professionals towards termination of pregnancy, to appreciate the complexity of the debate. It is possible that the increased involvement of nurses in termination of pregnancy, that current methods demand, may lead to change in attitudes. Consideration is given to a number of remedies to create an optimum environment for women undergoing termination of pregnancy. Relevance to clinical practice. This paper establishes via a literature review that attitudes in those working in this area of care depend upon a variety of influences. Suggestions are made for measures to be put into place to foster appropriate attitudes in those working in termination of pregnancy services.
Patient Education and Emotional Support Practices in Abortion Care Facilities in the United States
Women's Health Issues, 2012
Purpose: Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. Methods: We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. Main Findings: The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eightytwo percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. Conclusions: All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. Practice Implications: This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices.
Termination of pregnancy services: experiences of gynaecological nurses
Journal of Advanced Nursing, 2010
nicholson j., slade p. & fletcher j. (2010) Termination of pregnancy services: experiences of gynaecological nurses. Journal of Advanced Nursing 66(10), 2245–2256.Aim. This paper is a report of a study to identify the experience of gynaecological nurses involved with termination of pregnancy.Background. Staff involved with termination of pregnancy have been found to experience both positive and negative views. Varying processes and experiences for staff have been identified, from termination of pregnancy work being emotionally draining and stressful to there being a process of care that evolves with greater experience.Methods. A purposive sample of seven gynaecological nurses currently working in a termination of pregnancy service was recruited. Data were collected between October 2007 and January 2008 using interviews and standardized questionnaires. Transcripts of the interviews were analysed using Interpretive Phenomenological Analysis.Results. Eight superordinate themes emer...