Pushing through: A grounded theory of undergraduate nursing students making meaning of clinical related critical incidents

Background: Undergraduate nursing students are at risk of exposure to clinical related critical incidents. The impact on nursing students and the use of coping mechanisms and processes to make meaning of these distressing experiences are poorly understood. Purpose: The aim of this study was to provide a theoretical understanding of the processes that undergraduate nursing students use to make meaning of clinical related critical incidents. Method: Following the constructivist grounded theory method, a purposive sample was used to recruit 15 students enrolled in a Canadian university baccalaureate nursing program. Data were collected using semi- structured interviews over 12 months. Interviews were transcribed and analyzed using constant comparison and concurrent data collection and coding. Results: Three theoretical categories emerged from the data to explain the processes used by nursing students to make meaning of their critical incidents: distress, identity shift, and moving forward. The processes described were characterized by an overarching category of "Pushing Through." Conclusion: The resulting theory of "Pushing Through" can be used as a lens for students and nurse educators to navigate making meaning of clinical related critical incidents. This theory highlights the significance of students' self-understanding as they explore and assemble individualized strategies and coping skills. Educators who teach in the clinical setting should prioritize the development of a trauma-informed learning environment by establishing connections and transparent expectations with learners.