The Operating Room (OR) is a clinical context in which interprofessional teams surgically intervene with the intention of improving the health of the patients they care for. Despite this, surgery is high risk, invasive and often volatile. The reality is that some patients die in the OR, an outcome which violates the care intention of the clinicians who work there. Using the narrative paradigm, this study explores the stories interprofessional team members shared about caring for patients who died intraoperatively. To appreciate the cultural climate in which these stories were rooted, a literature review of OR culture and theoretical analysis of master narratives was conducted. Using individual interviews, six perioperative clinicians were invited to share their stories: two Registered Nurses, one Registered Practical Nurse, two Surgeons and one Anesthetist. Two analytic approaches were used to authentically capture participant narratives: a narrative thematic approach and structural analysis. The structural analysis revealed the types of stories told—tragedies, romances, comedies and satires—while the thematic perspective elucidated participants’ experiences of intraoperative death and their interpretation of the impact of these experiences. These findings illustrated unique perspectives of intraoperative death, illuminating features which enhanced or deteriorated the experiences for clinicians and their teams. Examining results in tandem with master narratives highlighted prevalent cultural discourses which are held in tension by the clinicians who perpetuate them. Exploring these intersecting elements provides insight into implications for nursing practice, research, education and policy, with particular attention to interprofessional dynamics, staff support, and promoting a culture of resilience.

The purpose of the project is to evaluate various pastoral care methods which are employed to assist parents whose child has died in traumatic circumstances. In the light of this evaluation, then to propose an alternative approach which the pastor can exercise to support and help bereaved parents. This thesis considered the variety of pastoral care methods by means of a literature review. A questionnaire was then sent to pastors from different denominations. The information gleaned from completed questionnaires was used to prepare a review of pastoral care at “ground level”, that is to form an idea of how the general run of pastors dealt with such cases. In addition, a number of parents were interviewed with regard to their experience of the pastoral care which they received when their child had died in traumatic circumstances. The outcome of the thesis suggests that the perceptions of pastors and parents differed widely as to what constituted appropriate pastoral care. This study seeks to address this discrepancy and to formulate a proposed pastoral care method which can be used by any pastor in the event of the traumatic death of a child. The applicability of this thesis is somewhat limited by the fact that the sample used is relatively small. As a consequence other areas and communities might produce a different result. / Dissertation (MA (Theology) : Practical Theology)--University of Pretoria, 2008. / Practical Theology / unrestricted

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Traumatic death survivors are an at-risk population that could benefit from social work interventions. This action research study explored social work perspectives on crisis practice with traumatic death survivors in acute medical settings. The research questions focused on whether early crisis interventions by social workers would benefit traumatic death survivors, which interventions were recommended in crisis practice with this population, the potential effects of repeated trauma exposure on the social workers providing the crisis interventions, and recommendations to manage this professional exposure to trauma. The purpose of the study was to explore social work perspectives on potential benefits of crisis interventions with traumatic death survivors and potential effects of crisis practice on the social workers providing the services. Crisis theory and family systems theory informed the study. Participants were selected from a convenience sample of licensed social workers, and data were collected in 1 focus group and 3 in-depth interviews. Data were analyzed using descriptive and thematic analysis. Findings supported the benefits of social work crisis interventions for traumatic death survivors and the need for self-care, self-awareness, and support to reduce the risks of negative effects of crisis practice on social workers. Specific crisis interventions recommended for practice include the roles of advocate and guide, grief support, viewing of the body, and explanation of next steps. An increase in knowledge and recommendations for future practice based on study findings might promote positive social change by raising awareness about the problem and improving social work practice with traumatic death survivors.

People all over the world do experience some kind of trauma during their lives. Some may experience more than one trauma, and some may experience more intense trauma, but sooner or later we all experience trauma. Sadly, our children are not excluded. The first aim of this study, was to investigate the influence of trauma on the lives of children in their mid childhood years. The following questions were asked: · What are the specific developmental tasks for middle childhood, regarding their physical, cognitive, affective, social, religious, moral and esthetical development? · What about trauma is so traumatic? · Are there any recognisable and predicted effects, present in children who experienced trauma? · And last, but not least, how do children understand and experience a traumatic death? The second aim of this study was to develop a trauma counselling program for children who experienced a trauma. The program had to focus on the specific needs of children in their mid childhood years. In order to do this, the following points were looked at: · What is the current understanding of trauma? Are there any counselling programs for children available, and how do they work? · There are a vast majority of intervention techniques available, the most popular techniques – playtherapy, bibliotherapy, grouptherapy, arttherapy and narrative therapy, were briefly discussed. · Finally a graphic presentation of a new trauma counselling program was included. To see whether this trauma counselling program could help children to overcome posttraumatic symptoms and prevent posttraumatic stress-disorder, it was implemented during two case studies. · The first case study was a girl that had been bitten by dogs twice. As a result of this trauma, she developed an unnatural fear of dogs. The trauma counselling program was implemented, and after a few weeks the girl was able to conquer and control her fear of dogs. · The second case study was a boy who needed to accept his father’s suicide. The trauma counselling program was adapted to suit his specific needs, and once again the program helped the boy to understand and accept his father’s suicide. The success of these two case studies, lead to the acceptance of this study’s hypothesis, namely, that if one developed a trauma counselling program that are compatible with the needs of children in their mid childhood years, it will help children to accept and overcome trauma. Therefore posttraumatic stress symptoms will be reduced and post-traumatic disorder will be prevented. / Dissertation (MEd (Learning Support, Guidance and Counselling))--University of Pretoria, 2006. / Educational Psychology / unrestricted