Operating room nurses involved in the surgical management of patients with critical multiple and combined trauma described substantial technical, collaborative, and psychological demands and reported unmet needs for specialized training, psychological support, standardized procedures, and staffing resources, according to a qualitative study.
In a descriptive phenomenologic study, investigators analyzed semistructured interviews involving 15 operating room nurses at a tertiary trauma center in Hunan, China, to examine their lived experiences managing critical multiple and combined trauma. Using Colaizzi's seven-step analysis method, the investigators identified four major themes: professional challenges and emergency response, value and dilemmas of team collaboration, psychological stress and coping strategies, and professional growth and support needs.
The investigators found that the nurses described trauma surgery as a setting requiring sustained hypervigilance, rapid decision-making, and the management of multiple competing priorities. Nurses reported challenges associated with simultaneous procedures, massive hemorrhage, changing patient conditions, infection-control requirements, and the need to anticipate surgeons' needs during time-sensitive operations.
Emergency response capability emerged as a recurring theme in the participants' interviews. Experienced nurses described preparing instruments and supplies before they were requested, while less experienced nurses reported difficulty adapting to unfamiliar procedures and instruments. They emphasized that maintaining both speed and precision was necessary to support patient safety during emergency interventions.
The investigators also identified team collaboration as a central component of trauma care. The nurses described clear role allocation, mutual support, and coordinated multidisciplinary activity as important contributors to efficient surgical management. In addition, the nurses reported communication conflicts among physicians, anesthesiologists, and nursing staff when multiple urgent priorities competed for attention. The participants also described delayed staffing support, the incomplete transfer of clinical information between departments, and the emotional burden of absorbing colleagues' negative emotions during high-pressure situations.
Psychological stress was another prominent theme. The nurses linked anxiety, tension, fear, emotional exhaustion, and compassion fatigue to repeated exposure to severe injuries and emergency procedures. They reported using preparation, peer support, reflective practice, and physical exercise to manage stress. However, the participants repeatedly expressed a desire for formal psychological counseling services and additional organizational support.
The investigators identified professional growth as a recurring need. The nurses reported that repeated involvement in trauma care strengthened emergency management skills, confidence, teamwork abilities, and professional identity. The participants associated successful patient rescue with a sense of professional meaning and accomplishment.
The participants also identified several opportunities for improvement in trauma operating room practice. These included increased staffing during trauma cases, expanded emergency equipment and supply reserves, written standard operating procedures for trauma coordination, simulation-based multidisciplinary training, and improved information-sharing systems.
The study had several limitations. The sample included 15 nurses from a single tertiary trauma center, which may limit transferability to other institutions or health care systems. As a qualitative study, the findings reflected participant experiences and researcher interpretation rather than quantitative outcome measures. The investigators also noted that experiences were not analyzed according to trauma type or urgency level.
The investigators concluded that operating room nurses occupy a multifaceted role in trauma care that spans technical performance, multidisciplinary collaboration, and psychological adaptation. They suggested that training programs, collaboration processes, and support systems could be tailored to address challenges described by the nurses involved in the study.
One of the participants described the professional meaning associated with trauma care during the interview: "When the patient is safely transferred to ICU and then discharged, a life continues. This makes me feel that my work is extremely meaningful and valuable."
The study was supported by multiple Chinese institutional and governmental grants, including the Natural Science Foundation of Hunan Province, National Key Clinical Construction Specialist Project, and Clinical Medical Technology Demonstration Base for Emergency Treatment of Chest Pain in Hunan Province. The study authors reported no conflicts of interest.
Source: Frontiers in Medicine