Perinatal nursing in uncertain times: the Katrina effect

To make explicit the perinatal nurses' shared meanings of their lived experience while providing nursing care in the New Orleans area during the disaster of Hurricane Katrina.

Interpretative phenomenology.

Semi-structured, in-depth interviews were conducted with 16 perinatal nurses 9 to 18 months after they worked in obstetrical and newborn hospital settings in the Greater New Orleans area during the Hurricane Katrina disaster. Van Manen's process of reflective thematic analysis-guided data analysis was used.

Themes and subthemes included (1) duty to care (back to the basics, empathy, and advocacy in action); (2) conflicts in duty; (3) uncertain times: chaos after the storm (evacuation: routes through uncertainty, hopelessness, abandonment, and/or fear); (4) strength to endure; (5) grief: loss of relationships, identity, and place; (6) anger; and (7) feeling right again.

Nurses who work during disasters must live through the uncertainty of the situation and be prepared to adapt to the needs that arise in patient care situations and self-preservation. Excellent basic nursing skills, intuitive problem solving, and a sense of staff unity are primary resources. Nurses and other caregivers need ongoing supportive interventions to rebound from the experience and cope with symptoms associated with trauma exposure.