Date of Completion

9-26-2018

Embargo Period

9-25-2020

Keywords

pediatric, behavioral health, emergency department, children, experiences

Major Advisor

Cheryl Beck

Associate Advisor

E. Carol Polifroni

Associate Advisor

Thomas Van Hoof

Field of Study

Nursing

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

Obtaining behavioral health evaluation and care for the pediatric population is particularly difficult. In recent years, emergency departments (EDs) have become a customary location for patients to seek behavioral health treatment. This spike has created unforeseen problems and caring for this vulnerable population presents ED nurses with many challenges. The purpose of the study was to understand the lived experience of nurses caring for pediatric behavioral health patients in the ED. A qualitative, descriptive phenomenological research design was utilized. Participants (N = 15) engaged in semi-structured interviews and Colaizzi’s (1978) method was used to identify themes. The data analysis resulted in 355 significant statements, which formed five overarching themes: (a) Caring on Empty: The Result of Negative Emotions and Feelings, (b) A Fraying Rope: Does Anyone Care About Us?, (c) Children in Purgatory: Waiting in Limbo, (d) Mirroring a Prison: Are We Doing More Harm Than Good, and (e) Creating a Larger Tool Belt: Incorporating Behavioral Health Into the ED. Nurses often expressed frustration, anger, sadness, hopelessness, and feelings of being overwhelmed. Many either experienced or witnessed physical violence and feared working with this population. The physical and emotional abuse led nurses to wonder if hospital organizations cared about their well-being. Nurses discussed excessive utilization of the ED, excessive lengths of stay, and the lack of resources in the ED. Caring for pediatric behavioral health patients in the ED was described as “working on a sinking ship.” Nurses can utilize the results of this study to provide safe, therapeutic care to pediatric behavioral health patients in the ED. The results make clear the importance of putting pediatric behavioral health at the forefront of ED care in order to increase patient outcomes as well as to increase nurse satisfaction.

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