Obstetrical Nurses' Perspectives of Pregnant Women Who Use Illicit Substances and Their Provision of Care: A Thematic Analysis.

Abstract

The growing number of pregnant women using illicit substances presents a serious public health concern. The purpose of this study was to explore obstetrical nurses' perspectives toward caring for pregnant women who use illicit substances in a large inner-city hospital in Western Canada. Guided by an interpretivist and social constructivist epistemological approach, I engaged in a thematic content analysis of qualitative semistructured interviews. In total 18 registered nurses from multiple obstetrical units were recruited. Four major themes were identified: (i) services and care were recognized through elements of caring, creating a welcoming environment, and providing client-centered care; (ii) stigma and discrimination impacted nurses preconceptions of care; (iii) coping mechanisms were necessary when struggling professionally; and (iv) recommendations of continuing specialized education were identified. Obstetrical nurses highlighted a number of conflicting views about caring for pregnant women who use illicit substances. Key actions, such as establishing professional support when nurses experience ethical distress or when they are unable to provide meaningful care to patients, were suggested. Strong recommendations for ongoing professional development, as well as increased educational opportunities during prelicensure programs were made in order to support nurses in their role.