{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:34:39Z","timestamp":1792564479171,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp; Health"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Emergency departments (EDs) frequently serve individuals who have experienced acute or cumulative trauma. While trauma\u2010informed care (TIC) offers a framework to support healing and psychological safety, little is known about how nurses implement these principles in high\u2010acuity emergency settings. This study explored how emergency nurses understand, deliver, and emotionally navigate trauma\u2010informed care in the context of a tertiary hospital in Saudi Arabia. A qualitative phenomenological design was employed. Seventeen registered nurses from the emergency department of King Faisal university Hospital participated in in\u2010depth, semi\u2010structured interviews. Data were analyzed thematically using Braun and Clarke's six\u2010phase framework and managed with NVivo 14 software. Four interrelated themes were identified: (1)\n                    <jats:italic>Holding Emotional Space in Clinical Chaos<\/jats:italic>\n                    \u2014nurses created micro\u2010moments of psychological safety amid trauma and time pressure; (2)\n                    <jats:italic>Systemic Misalignment with Trauma\u2010Informed Values<\/jats:italic>\n                    \u2014organizational structures constrained relational care; (3)\n                    <jats:italic>Protective Empathy and Adaptive Strategies<\/jats:italic>\n                    \u2014nurses developed emotional boundaries and grounding rituals to sustain compassion; and (4)\n                    <jats:italic>The Accumulated Emotional Toll<\/jats:italic>\n                    \u2014ongoing exposure to trauma resulted in moral injury and emotional exhaustion, countered by reflection and peer support. Trauma\u2010informed care in emergency settings is relational, emotionally taxing, and often constrained by systemic factors. Institutions must invest in trauma\u2010informed systems, staff supports, and educational infrastructure to sustain ethical, emotionally attuned care in acute environments. Patients were not directly involved in this study, which focused on healthcare provider perspectives. Findings may inform institutional strategies to enhance patient\u2010centered, trauma\u2010informed practice.\n                  <\/jats:p>","DOI":"10.1002\/nur.70042","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T13:35:21Z","timestamp":1765632921000},"page":"379-389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["\u201cHolding Space in Chaos\u201d: Nurses' Experiences Delivering Trauma\u2010Informed Care in Emergency Departments"],"prefix":"10.1002","volume":"49","author":[{"given":"Abdulrhman Khaled Al","family":"Abdulqader","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine King Faisal University Al\u2010Ahsa Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayed Ibrahim","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine King Faisal University Al Hofuf Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samah Anwar","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Nursing, Faculty of Nursing Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7822-1653","authenticated-orcid":false,"given":"Mostafa","family":"Shaban","sequence":"additional","affiliation":[{"name":"Community Nursing Department, College of Nursing Jouf University Sakaka Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14030120"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12245-023-00509-w"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.51271\/JNCR-0014"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/qup0000196"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","unstructured":"Chakraborty A. andV.Jain.2022. Leveraging Digital Marketing and Integrated Marketing Communications for Brand Building in Emerging Markets (281\u2013305).https:\/\/doi.org\/10.1007\/978-3-030-88678-3_13.","DOI":"10.1007\/978-3-030-88678-3_13"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11813-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-024-01151-8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.70090"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/23.127"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-016-0141-y"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2025.01.002"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-04342-1_2"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/10400419.2021.1922197"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14040242"},{"key":"e_1_2_10_16_1","unstructured":"Lincoln Y. S. andE. G.Guba1985.Naturalistic Inquiry. Newberry Park."},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","unstructured":"van Manen M.2017. But Is It Phenomenology? InQualitative Health Research Vol. 27 Issue 6 775\u2013779. Sage Publications.","DOI":"10.1177\/1049732317699570"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.84652"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7748\/en.2020.e1990"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/S40037-019-0509-2"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-12568-1"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10091625"},{"key":"e_1_2_10_23_1","unstructured":"Substance Abuse and Mental Health Service Administration (SAMHSA).2014.SAMHSA's Concept of Trauma and Guidance for a Trauma\u2010Informed Approach. SAMSHA."}],"container-title":["Research in Nursing &amp; Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nur.70042","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nur.70042","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nur.70042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:11:18Z","timestamp":1784301078000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nur.70042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,13]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/nur.70042"],"URL":"https:\/\/doi.org\/10.1002\/nur.70042","archive":["Portico"],"relation":{},"ISSN":["0160-6891","1098-240X"],"issn-type":[{"value":"0160-6891","type":"print"},{"value":"1098-240X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,13]]},"assertion":[{"value":"2025-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}