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Delivering ‘bad news' : a key aspect in provision of support in assisted reproductive technology nursing practice
Introduction: Assisted Reproductive Technology (ART) nurses play a pivotal role balancing many aspects of the treatment cycle as they endeavour to optimise outcomes for both patients and ART units. The purpose of this study was firstly to gain an understanding of the ART nursing role within Australia and secondly to develop a theory to explain the role. There is limited research that clarifies the unique nature of the ART nurse role within Australia and internationally, therefore outcomes of this research have the potential to be applicable to the global ART nursing community of practice. Materials and Methods: Grounded theory (GT) methodology was utilised with purposive and theoretical sampling approaches used to recruit Registered Nurses (RNs) who were members of the Fertility Nurses of Australasia professional group. Fifteen in-depth, exploratory, semi-structured interviews were conducted over a 12 month period with RNs actively employed in metropolitan and regional centres around Australia. Data were analysed using the GT approach of constant comparative analysis and NVivo8™ was use to facilitate management of the comprehensive volume of data gained. Results: The research identified the substantive theory ‘Balancing to optimise outcomes for patients and the ART unit’. One significant aspect of this theory that emerged from this study related to the key role that support plays within ART nursing practice. This theme was described as encompassing: provision of support for patients during and after their treatment; support for colleagues as part of daily practice; as well as the ART nurses’ individual needs for support. In particular, an important aspect identified was the notion of patient support associated with delivery of what participants commonly termed ‘bad news’ (example: negative test results). This finding has been rarely articulated in the nursing literature. The delivery of ‘bad news’ more commonly lies within the domain of medical practice, however it was evident that most ART nurses have extended practice roles that see them taking on activities traditionally conducted by doctors and other healthcare professionals. Participants discussed strategies that they use to cope with this at times challenging issue. They also explained that nurses, particularly those who are less experienced in the ART domain, need specific training and support to enable them to undertake this role effectively. Conclusion: Given their comprehensive and pivotal role combined with the extended duration of patient contact, ART nurses are well placed to play a key role in provision of support for patients accessing ART treatment. This is even more critical at times when ‘bad news’ must be given. The findings from this study identify this as an area worthy of further in-depth research. ART units and nursing professional groups should consider strategies to manage this area of support when delivering ‘bad news’. The impact of this issue on nurses who are less experienced in the field warrants further investigation. Importantly findings from this study will inform practice, education and curriculum development for ART nurses and the outcomes of this research are relevant to the ART community of practice.