Frustration skapar distanstagande : Sjuksköterskors upplevelser av hot eller våld i prehospital vård

Sammanfattning: Introduction: Registered nurses should strive to keep an open and humble approach towards all patients. Registered nurses in the Emergency Medical Services face many different situations that require a broad knowledge to be able to take care of patients in the best possible way. Patients that appear threatening or violent are part of the working situation and threatfull and violent situations tend to become more common in the prehospital emergencycare. It is now seen as a serious problem in ambulance care. Problem area/purpose: The aim is to highlight registered nurses´ experiences in ambulance care of how they themselves and the care to the patient are influenced by threatening or violent situations in their work. Method/design: The study was conducted as a qualitative survey in which 50 questionnaires were answered from three ambulance stations in southern Sweden. Data was analyzed by latent qualitative content analysis. Results/clinical conclusions: A common theme emerged; Frustration creates distance. Five main categories with related sub categories emerged: Verbal threats evokes feelings and reactions; The verbal threat affects work and patient care; Physical violence leads to negative emotions; The physical consequences of violence on patient care; Support trough talking. The results showed that verbal threats or physical violence againstregistered nurses were common in the work. The consequence of this was that the nurses were influenced both personally and in caring for patients. Most registered nurses therefore developed increased safety approach and risk awareness. A majority disassociated themselves from patients due to safety reasons, which led to frustration of not being able to give adequate care. The authors suggest extended safety training by way of self-defense and expansion of safety routines as well as to rise and intensify penalties for violence against officials in deterrence.