Ulmer, Deborah - IUPUI

Obstacles that made it difficult to
decide to volunteer
Issues that prevented nurses from
being able to fully participate

• The aim of this transcendental phenomenological
study was to explore how nurses experienced the
decision to volunteer to provide humanitarian aid
in the immediate aftermath of hurricane Katrina in
fall, 2005.
• Research questions:
• What made you decide to volunteer?
• How did you decide to go?
• What was it like to be there?
• What did you expect it to be like?
• How was it when you came home?
• How did the experience affect you?

• This method is about seeking meaning from
appearances
• It arrives at essences through intuition and reflection
that lead to:
• Ideas, concepts, judgments and understandings.
• Committed to the rich descriptions of those
experiences and refrains from analyzing and
explaining.
• The essences described emerge into one rich, universal
description with elements common to all who
experienced the phenomenon.

• Criteria for inclusion:
• RN at the time. Volunteer. Assigned to hurricane
devastation site. No compensation. Willing to
participate.
• IRB Approval
• Snowball sampling used
• Formal Written Consent
• Recruitment script

• 11 identified.
• All 11 participated
• 9 provided aid in the immediate aftermath
• 2 provided aid five months after the hurricane
• All 11 nurses‟ stories are included.

• As nurses were identified, appointments were made by
phone or email.
• Interviews conducted at site selected by study
participant.
• Epoche written prior to each interview.
• Participants were asked to tell their stories around the
interview questions.
• Interviews tape recorded and written.
• Interviews transcribed verbatim by the researcher.
• Transcription compared to tape for accuracy.
• Saturation occurred with 9 th interview. All interviews
were included.
• Participants given pseudonyms.

• Member checking method used.
• All 11 participants received the composite
textural-structural story and were asked to
verify that they heard their voice somewhere in
the story.
• All 11 responded stating they did hear their
voices and see themselves in the composite.
• NOTE: this is not a required step in the procedure

• Unavoidable wake up call to the inner soul.
• Personal link to the area devastated
• News stories and photos were deeply upsetting.
“we were watching the news and the media, I was just
sitting there completely appalled. I couldn‟t believe
Americans were living in those conditions and
weren‟t getting the help they needed.”
• “Real faces, real people”
• “I felt led spiritually to do something from the pictures
and this is in our own country.”

• Subtheme 1: Thoughts:
• “I think I thought that I needed to do something that was
concrete and decisive.”
• “I could feel something, but I wasn‟t sure what it meant.”
• “I prayed about it and got my answers.”
• Subtheme 2: Reflection:
• “I think back through my life, different times I‟ve gone and
worked and helped people out and how important it‟s been.”
• “You know that „calling‟ they always talk about in nursing
school and everybody goes, „Oh please?‟ Well, there you go, it
does exist, it really does.”
• “I guess it goes back to 9/11 where I didn‟t respond in any
personal way. I wrote checks, but I didn‟t do anything
personal.”

• Subtheme 1: Family
• “Why do you want to go and do that? Why does it
have to be you?”
• “I made sure they had a clear understanding of how
important this was to me and that it was something I
was feeling led to do and they needed to be ok with
that. I don‟t know that they were comfortable with
that, but I needed them to be because I felt like I
should go.”

• Subtheme 2: Work
• “I thought when I said I really want to go down
there and do this and it means I will miss three
days of work it would be like, ok, we will work
around it. Staffing wasn‟t great right then and
there were a lot of people on orientation. They just
said, „you need to cover yourself.‟ So I did. I
needed three 12-hour shifts covered and I got all
but 4 hours. Its two years later and I finally paid
off my debt this Christmas. Although the hospital
agreed it was a good thing to do, I wasn‟t
supported.”

• Subtheme 3: Organizational obstacles.
• State agencies: “We were ready to go but then
we needed permissions and we were stymied.”
• Nursing Education Programs:
• Permissions at multiple levels
• Coordination with other class faculty
• College administration: “we had to jump through a
bunch of hoops. It was an uphill battle. To this day I
feel like my chair and dean hold it against me.”

• Subtheme 1: Conditions
• “It was hot, in the 90‟s. We were working on a black
tar pavement. Seeing a couple hundred patients a
day. We were thirsty. We were hungry.”
• “We stayed in a church and slept on a concrete slab
and I really didn‟t think I was going to survive but I
can tell you there was not a night that I didn‟t lay
down that I didn‟t wake up the next morning and
not even notice the concrete. That‟s how tired we
were.”
• “Some people became so physically exhausted. I
mean they just couldn‟t think anymore and I got to
that place as well. But you know, as a nurse, I just
think you were prepared for that. You land on your
feet.”

• Subtheme 2: Confusion:
• “You could tell there wasn‟t a plan. People were
showing up. Nurses driving in on their own to assist
and then finding out they couldn‟t put a Band Aid
on with a doctor‟s order.”
• “So we thought we would get to Montgomery to
this staging area and they‟d say, „Oh, we‟ve been
waiting for you.‟ We got there and nobody knew
anything.”
• “So, communication and leadership was, there
wasn‟t a clear chain of command. And so we said,
„OK, we will function here within ourselves.‟ We
kind of took direction from the doctor in the group.
Everybody knew that model.”

• Subtheme 3: Relationships
• “ Everyone bonded fast. We‟re all here because we
want to be here because it‟s a disaster. We want to
help and we are all here with the Red Cross and so
quick bonding.”
• The EMT‟s were hilarious and fun. The humor—this
group of EMT‟s—always humorous, throwing out
jokes, teasing. It was great.”
• “there was a lot of bonding around what State you
were from. It was the first time I had the experience
of feeling like I am an American. We are here as
Americans. I didn‟t matter what you believed, or
what your religion was. We were just here to help
and that was the guiding principle.”

• Subtheme 4: People in charge
• “the people who ran our shelter were the most
miserable people in the world and they were the
most autocratic and dictatorial people in the world.
They were nice to the people who were left
homeless, they were horrible to the workers.”
• “I saw people who were there as volunteers trying to
understand their motivations for being there, there
were also a lot of control freaks there including my
nursing supervisor.”
• “The staff was exhausted, irritable. Not in a good
place. Tired of dealing with volunteers even though
they were helping. It was challenging.”

• “We were giving tetanus shots. Our sharps box was a
water bottle.”
• “The best nursing care we provided was in touch, in
listening, in just being there. People would say, „Well,
what did you do as far as nursing?‟ Well, we basically
sat and listened. And that‟s probably the most
important thing you can do.”
• “Our resources were skimpy; we had to be creative. It
was never actually clear what we were supposed to do.
There were no protocols. We made them up as we
went.”

• “We came to realize the deepest needs were to
be heard and seen as human beings, for
someone to hear their story.”
• “There was a lot of frustration for people like,
why did we come if we couldn‟t practice. But I
felt like we were allowed to touch people so I
could work.”

• Subtheme 1: New ways of being.
• “I am kind of surprised at myself now because I am
doing Habitat for Humanity and I do soup kitchen
when I can and for Christmas I asked my family to get
an angel from the tree for part of my Christmas gift.
And it‟s just like what? Who are you?‟
• “We raised $6000 that one night. It was important for
me to be part of that, to do something that would
generate joy and to send it to those people. I knew I
was changed forever.”
• “When I went there I found my story. They‟ve asked
me to go to Bosnia in May for health care education
and for women‟s health. I am becoming a globe
trotter…it all makes sense.”

• Subtheme 2: New educational quests
• “the inspiration and driver to keep wanting to
do my PhD stuff. I‟m not doing it because I‟m
going to get a promotion. I‟m doing this for
some real deep-seated internal reasons and so
that I can somehow, I can somehow use it to
make things better for people who really are in
desperation.”

• Subtheme 3: New ways of thinking.
• “The thing that really affected me was this whole
concept of needs and wants. I‟m never going to use
the word „need‟ again. I‟m never going to say I need
again because how dare I say I need something
unless I am as desperate as the people I saw in Africa
and Mississippi. It‟s not an issue of need. It‟s so
much more an issue of want.”
• I vote a little different now. Or the considerations
that I make when I vote are very different.”

• “ It‟s amazing because I hear people who have
no clue, who haven‟t been to visit, who don‟t
know what it‟s like and they say things like,
„don‟t rebuild. Just plow over the whole area.‟
When I hear those conversations they‟re
depersonalized. And they‟re not really looking
at the people who are affected.”

• Subtheme 4: New emotions
• “It was huge in my life and I mean, we weren‟t
even the victims. I knew I was changed forever.”
• “It was amazing. Just amazing. You know, what I
thought I would do was nowhere near the
enormous difference we made. It was incredible.”
• “I was so proud of myself. I don‟t think anything
could dampen the proudness that I have. It was an
experience I will never forget.
• “I think it was, besides my son, the most profound
thing I had ever seen, the most amazing thing I‟ve
ever done.”

• Subtheme 5: New Ways of understanding nursing.
• “we talk about the Sacred Covenant” at my
university, between the nurse and the patient. It
was a clear example of how important that is. And
as far as what‟s nursing‟s role? I guess my
philosophy is nursing‟s role is first, be the
presence. Nursing‟s role is to be a presence and
then explore what their needs are and go from
there.”
• “I think between nursing and that experience it
gave me a deeper understanding of the need for
community service and what we need to do for
people.”

• Helps us to understand more about nurses and their
determination in the volunteer role.
• Stories support the literature presented about compassion
and volunteerism.
• Nurses will continue to volunteer in these kinds of events.
• There is work to be done to prepare for those who volunteer
so that their skills can be utilized.
• Nurses can be helped to understand that nursing is more
than scope of practice.
• Nurses who do this are almost always changed as a result of
the experience.
• The relationship between the nurse and the patient,
whomever the patient is and whatever the work of the nurse
is, is significant.
• For these nurses, their response was a calling.

Moustakas, C. (1994). Phenomenological research
methods. Thousand Oaks, CA: Sage.