Ulmer, Deborah - IUPUI

Ulmer, Deborah - IUPUI

Ulmer, Deborah - IUPUI


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Obstacles that made it difficult to<br />

decide to volunteer<br />

Issues that prevented nurses from<br />

being able to fully participate

• The aim of this transcendental phenomenological<br />

study was to explore how nurses experienced the<br />

decision to volunteer to provide humanitarian aid<br />

in the immediate aftermath of hurricane Katrina in<br />

fall, 2005.<br />

• Research questions:<br />

• What made you decide to volunteer?<br />

• How did you decide to go?<br />

• What was it like to be there?<br />

• What did you expect it to be like?<br />

• How was it when you came home?<br />

• How did the experience affect you?

• This method is about seeking meaning from<br />

appearances<br />

• It arrives at essences through intuition and reflection<br />

that lead to:<br />

• Ideas, concepts, judgments and understandings.<br />

• Committed to the rich descriptions of those<br />

experiences and refrains from analyzing and<br />

explaining.<br />

• The essences described emerge into one rich, universal<br />

description with elements common to all who<br />

experienced the phenomenon.

• Criteria for inclusion:<br />

• RN at the time. Volunteer. Assigned to hurricane<br />

devastation site. No compensation. Willing to<br />

participate.<br />

• IRB Approval<br />

• Snowball sampling used<br />

• Formal Written Consent<br />

• Recruitment script

• 11 identified.<br />

• All 11 participated<br />

• 9 provided aid in the immediate aftermath<br />

• 2 provided aid five months after the hurricane<br />

• All 11 nurses‟ stories are included.

• As nurses were identified, appointments were made by<br />

phone or email.<br />

• Interviews conducted at site selected by study<br />

participant.<br />

• Epoche written prior to each interview.<br />

• Participants were asked to tell their stories around the<br />

interview questions.<br />

• Interviews tape recorded and written.<br />

• Interviews transcribed verbatim by the researcher.<br />

• Transcription compared to tape for accuracy.<br />

• Saturation occurred with 9 th interview. All interviews<br />

were included.<br />

• Participants given pseudonyms.

• Member checking method used.<br />

• All 11 participants received the composite<br />

textural-structural story and were asked to<br />

verify that they heard their voice somewhere in<br />

the story.<br />

• All 11 responded stating they did hear their<br />

voices and see themselves in the composite.<br />

• NOTE: this is not a required step in the procedure

• Unavoidable wake up call to the inner soul.<br />

• Personal link to the area devastated<br />

• News stories and photos were deeply upsetting.<br />

“we were watching the news and the media, I was just<br />

sitting there completely appalled. I couldn‟t believe<br />

Americans were living in those conditions and<br />

weren‟t getting the help they needed.”<br />

• “Real faces, real people”<br />

• “I felt led spiritually to do something from the pictures<br />

and this is in our own country.”

• Subtheme 1: Thoughts:<br />

• “I think I thought that I needed to do something that was<br />

concrete and decisive.”<br />

• “I could feel something, but I wasn‟t sure what it meant.”<br />

• “I prayed about it and got my answers.”<br />

• Subtheme 2: Reflection:<br />

• “I think back through my life, different times I‟ve gone and<br />

worked and helped people out and how important it‟s been.”<br />

• “You know that „calling‟ they always talk about in nursing<br />

school and everybody goes, „Oh please?‟ Well, there you go, it<br />

does exist, it really does.”<br />

• “I guess it goes back to 9/11 where I didn‟t respond in any<br />

personal way. I wrote checks, but I didn‟t do anything<br />


• Subtheme 1: Family<br />

• “Why do you want to go and do that? Why does it<br />

have to be you?”<br />

• “I made sure they had a clear understanding of how<br />

important this was to me and that it was something I<br />

was feeling led to do and they needed to be ok with<br />

that. I don‟t know that they were comfortable with<br />

that, but I needed them to be because I felt like I<br />

should go.”

• Subtheme 2: Work<br />

• “I thought when I said I really want to go down<br />

there and do this and it means I will miss three<br />

days of work it would be like, ok, we will work<br />

around it. Staffing wasn‟t great right then and<br />

there were a lot of people on orientation. They just<br />

said, „you need to cover yourself.‟ So I did. I<br />

needed three 12-hour shifts covered and I got all<br />

but 4 hours. Its two years later and I finally paid<br />

off my debt this Christmas. Although the hospital<br />

agreed it was a good thing to do, I wasn‟t<br />


• Subtheme 3: Organizational obstacles.<br />

• State agencies: “We were ready to go but then<br />

we needed permissions and we were stymied.”<br />

• Nursing Education Programs:<br />

• Permissions at multiple levels<br />

• Coordination with other class faculty<br />

• College administration: “we had to jump through a<br />

bunch of hoops. It was an uphill battle. To this day I<br />

feel like my chair and dean hold it against me.”

• Subtheme 1: Conditions<br />

• “It was hot, in the 90‟s. We were working on a black<br />

tar pavement. Seeing a couple hundred patients a<br />

day. We were thirsty. We were hungry.”<br />

• “We stayed in a church and slept on a concrete slab<br />

and I really didn‟t think I was going to survive but I<br />

can tell you there was not a night that I didn‟t lay<br />

down that I didn‟t wake up the next morning and<br />

not even notice the concrete. That‟s how tired we<br />

were.”<br />

• “Some people became so physically exhausted. I<br />

mean they just couldn‟t think anymore and I got to<br />

that place as well. But you know, as a nurse, I just<br />

think you were prepared for that. You land on your<br />


• Subtheme 2: Confusion:<br />

• “You could tell there wasn‟t a plan. People were<br />

showing up. Nurses driving in on their own to assist<br />

and then finding out they couldn‟t put a Band Aid<br />

on with a doctor‟s order.”<br />

• “So we thought we would get to Montgomery to<br />

this staging area and they‟d say, „Oh, we‟ve been<br />

waiting for you.‟ We got there and nobody knew<br />

anything.”<br />

• “So, communication and leadership was, there<br />

wasn‟t a clear chain of command. And so we said,<br />

„OK, we will function here within ourselves.‟ We<br />

kind of took direction from the doctor in the group.<br />

Everybody knew that model.”

• Subtheme 3: Relationships<br />

• “ Everyone bonded fast. We‟re all here because we<br />

want to be here because it‟s a disaster. We want to<br />

help and we are all here with the Red Cross and so<br />

quick bonding.”<br />

• The EMT‟s were hilarious and fun. The humor—this<br />

group of EMT‟s—always humorous, throwing out<br />

jokes, teasing. It was great.”<br />

• “there was a lot of bonding around what State you<br />

were from. It was the first time I had the experience<br />

of feeling like I am an American. We are here as<br />

Americans. I didn‟t matter what you believed, or<br />

what your religion was. We were just here to help<br />

and that was the guiding principle.”

• Subtheme 4: People in charge<br />

• “the people who ran our shelter were the most<br />

miserable people in the world and they were the<br />

most autocratic and dictatorial people in the world.<br />

They were nice to the people who were left<br />

homeless, they were horrible to the workers.”<br />

• “I saw people who were there as volunteers trying to<br />

understand their motivations for being there, there<br />

were also a lot of control freaks there including my<br />

nursing supervisor.”<br />

• “The staff was exhausted, irritable. Not in a good<br />

place. Tired of dealing with volunteers even though<br />

they were helping. It was challenging.”

• “We were giving tetanus shots. Our sharps box was a<br />

water bottle.”<br />

• “The best nursing care we provided was in touch, in<br />

listening, in just being there. People would say, „Well,<br />

what did you do as far as nursing?‟ Well, we basically<br />

sat and listened. And that‟s probably the most<br />

important thing you can do.”<br />

• “Our resources were skimpy; we had to be creative. It<br />

was never actually clear what we were supposed to do.<br />

There were no protocols. We made them up as we<br />


• “We came to realize the deepest needs were to<br />

be heard and seen as human beings, for<br />

someone to hear their story.”<br />

• “There was a lot of frustration for people like,<br />

why did we come if we couldn‟t practice. But I<br />

felt like we were allowed to touch people so I<br />

could work.”

• Subtheme 1: New ways of being.<br />

• “I am kind of surprised at myself now because I am<br />

doing Habitat for Humanity and I do soup kitchen<br />

when I can and for Christmas I asked my family to get<br />

an angel from the tree for part of my Christmas gift.<br />

And it‟s just like what? Who are you?‟<br />

• “We raised $6000 that one night. It was important for<br />

me to be part of that, to do something that would<br />

generate joy and to send it to those people. I knew I<br />

was changed forever.”<br />

• “When I went there I found my story. They‟ve asked<br />

me to go to Bosnia in May for health care education<br />

and for women‟s health. I am becoming a globe<br />

trotter…it all makes sense.”

• Subtheme 2: New educational quests<br />

• “the inspiration and driver to keep wanting to<br />

do my PhD stuff. I‟m not doing it because I‟m<br />

going to get a promotion. I‟m doing this for<br />

some real deep-seated internal reasons and so<br />

that I can somehow, I can somehow use it to<br />

make things better for people who really are in<br />


• Subtheme 3: New ways of thinking.<br />

• “The thing that really affected me was this whole<br />

concept of needs and wants. I‟m never going to use<br />

the word „need‟ again. I‟m never going to say I need<br />

again because how dare I say I need something<br />

unless I am as desperate as the people I saw in Africa<br />

and Mississippi. It‟s not an issue of need. It‟s so<br />

much more an issue of want.”<br />

• I vote a little different now. Or the considerations<br />

that I make when I vote are very different.”

• “ It‟s amazing because I hear people who have<br />

no clue, who haven‟t been to visit, who don‟t<br />

know what it‟s like and they say things like,<br />

„don‟t rebuild. Just plow over the whole area.‟<br />

When I hear those conversations they‟re<br />

depersonalized. And they‟re not really looking<br />

at the people who are affected.”

• Subtheme 4: New emotions<br />

• “It was huge in my life and I mean, we weren‟t<br />

even the victims. I knew I was changed forever.”<br />

• “It was amazing. Just amazing. You know, what I<br />

thought I would do was nowhere near the<br />

enormous difference we made. It was incredible.”<br />

• “I was so proud of myself. I don‟t think anything<br />

could dampen the proudness that I have. It was an<br />

experience I will never forget.<br />

• “I think it was, besides my son, the most profound<br />

thing I had ever seen, the most amazing thing I‟ve<br />

ever done.”

• Subtheme 5: New Ways of understanding nursing.<br />

• “we talk about the Sacred Covenant” at my<br />

university, between the nurse and the patient. It<br />

was a clear example of how important that is. And<br />

as far as what‟s nursing‟s role? I guess my<br />

philosophy is nursing‟s role is first, be the<br />

presence. Nursing‟s role is to be a presence and<br />

then explore what their needs are and go from<br />

there.”<br />

• “I think between nursing and that experience it<br />

gave me a deeper understanding of the need for<br />

community service and what we need to do for<br />


• Helps us to understand more about nurses and their<br />

determination in the volunteer role.<br />

• Stories support the literature presented about compassion<br />

and volunteerism.<br />

• Nurses will continue to volunteer in these kinds of events.<br />

• There is work to be done to prepare for those who volunteer<br />

so that their skills can be utilized.<br />

• Nurses can be helped to understand that nursing is more<br />

than scope of practice.<br />

• Nurses who do this are almost always changed as a result of<br />

the experience.<br />

• The relationship between the nurse and the patient,<br />

whomever the patient is and whatever the work of the nurse<br />

is, is significant.<br />

• For these nurses, their response was a calling.

Moustakas, C. (1994). Phenomenological research<br />

methods. Thousand Oaks, CA: Sage.

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