How professional nurses’ experiences and explanations of traumatic stress exposure influence nursing practice in the Western Cape

Background: Traumatic stress exposure significantly affects nurses, patients and the provision of safe, ethical and compassionate healthcare, particularly in low- and middle-income settings such as South Africa. Although nurses occupy a frontline caring role and are routinely exposed to traumatic stressors, there is limited research on how these experiences influence their nursing practice. Objective: This study explored and described how professional nurses’ discourse on traumatic stress exposure influences their nursing practice within the City of Cape Town Metropolitan Municipal District, Western Cape. Methodology: An exploratory-descriptive qualitative design was used within an intersectional critical social constructionist paradigm with reflexive thematic analysis. Semi-structured interviews were conducted with purposively sampled professional nurses with direct patient care experience, and who self-identified personal, social or occupational exposure to traumatic stress. The study was aligned to trauma-informed research principles. Findings: Nurses’ discourse described trauma as dynamic, cumulative and endemic in, but not inherent to, nursing. Exposure was seen to be constructed by inequality and epistemic oppression, gendered and hierarchical social relations and exploitative working conditions. The impact of traumatic stress exposure was influenced by negating witnessing environments and entrenched cultural norms of denial within the workplace. Traumatic stress shaped nursing practice through embodied responses, identity shifts, relational-spatial strategies of self-protection as well as forms of resistance to unethical care through practice adaptations and revaluing of the nursing lens. Post-trauma sense-making and insights increased social and self-awareness and re-motivation to practice from a person-centred holistic nursing paradigm. Conclusion: Traumatic stress exposure in nursing requires attention to the structural and sociopolitical conditions of production, not only to individual factors. The study contributes locally generated knowledge on nurses’ practice after trauma exposure highlighting the need to address this to sustain compassionate nursing practice, Future research should contribute to nurses’ capacity to engage structural drivers of trauma, increase compassionate reflexivity and resist the commodification of nursing care.

Grantor dc:publisher

Stellenbosch : Stellenbosch University

Year dc:date.issued

2026

Author dc:creator

• Williams, Catherine Angela Margaret

Advisors dc:contributor.advisor

• Young, Cornelle
• Mayers, Pat

Language dc:language.iso

en

Repository record dc:identifier.uri

https://scholar.sun.ac.za/handle/10019.1/136609

OAI identifier oai:identifier

oai:scholar.sun.ac.za:10019.1/136609