Emotional touchpoints; the feelings nurses have about explaining multi-resistant organisms to colonised patients

Background: Nurses face challenges when providing information about multi-resistant organisms (MROs), and related hospital policies, to patients found to be colonised, and may be concerned for their own safety when caring for MRO-colonised people. Resultant emotional responses may influence behaviours of staff caring for these patients. This study aimed to identify the feelings experienced by nurses when talking about MROs with patients. Secondary objectives were to learn about staff behaviours towards MRO-colonised patients, and to explore the utility of Emotional Touchpoints methodology in this context.

Methods: A qualitative study using an adapted Emotional Touchpoints method delivered as a paper survey tool for data collection. Content analysis and inductive coding of responses was used to identify key themes.

Results: 53 nurses participated. ‘Nervous’, ‘Concerned’ and ‘Knowledgeable’ were the most commonly selected adjectives chosen to describe their feelings. Reasons for these choices were themed as ‘Empowerment through knowledge’, ‘Performance anxiety’, ‘Concern for the patient’ and ‘Concern for professional reputation’. Social or temporal distancing, and the need for staff and other patients to be protected from contagion were key themes for the behaviours these nurses had witnessed towards patients.

Conclusion: Talking about MROs with patients can elicit strong emotional responses in nurses, and MRO-colonised patients may be treated and spoken about in a discriminatory fashion. Infection prevention and control teams should recognise this and focus on the person rather than the pathogen when educating and supporting nurses. Recommendations for practice are made to support improved wellbeing of nurses as well as MRO colonised patients.