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    What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

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    Authors
    Isbell, Linda M.
    Boudreaux, Edwin D
    Chimowitz, Hannah
    Liu, Guanyu
    Cyr, Emma
    Kimball, Ezekiel
    UMass Chan Affiliations
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2020-01-15
    Keywords
    diagnostic errors
    emergency department
    patient safety
    qualitative research
    Emergency Medicine
    Psychiatry and Psychology
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1136/bmjqs-2019-010179
    Abstract
    BACKGROUND: Despite calls to study how healthcare providers' emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers' emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks. METHODS: Employing grounded theory, we conducted 86 semi-structured qualitative interviews with experienced ED providers (45 physicians and 41 nurses) from four academic medical centres and four community hospitals in the Northeastern USA. Constant comparative analysis was used to develop a grounded model of provider emotions and patient safety in the ED. RESULTS: ED providers reported experiencing a wide range of emotions in response to patient, hospital, and system-level factors. Patients triggered both positive and negative emotions; hospital and system-level factors largely triggered negative emotions. Providers expressed awareness of possible adverse effects of negative emotions on clinical decision making, highlighting concerns about patient safety. Providers described strategies they employ to regulate their emotions, including emotional suppression, distraction, and cognitive reappraisal. Many providers believed that these strategies effectively guarded against the risk of emotions negatively influencing their clinical decision making. CONCLUSION: The role of emotions in patient safety is in its early stages and many opportunities exist for researchers, educators, and clinicians to further address this important issue. Our findings highlight the need for future work to (1) determine whether providers' emotion regulation strategies are effective at mitigating patient safety risk, (2) incorporate emotional intelligence training into healthcare education, and (3) shift the cultural norms in medicine to support meaningful discourse around emotions. permissions.
    Source

    BMJ Qual Saf. 2020 Jan 15. pii: bmjqs-2019-010179. doi: 10.1136/bmjqs-2019-010179. Link to article on publisher's site

    DOI
    10.1136/bmjqs-2019-010179
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/28503
    PubMed ID
    31941799
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjqs-2019-010179
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    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

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