The struggle of nurses in initial trauma emergency care in challenging geographic areas of Indonesia: A phenomenology

Background: East Sumba Regency is dominated by hills, mountains, and damaged road conditions, which increases the prevalence of accidents that result in trauma. The initial management of trauma patients by puskesmas nurses has several obstacles that cause delays in the treatment process; consequently, the safety of patients becomes a serious problem. This study is aimed to explore nurses' experience in managing early trauma emergencies. Methods: A qualitative research design was adopted with an interpretive phenomenological approach. In addition, a semi-structured, in-depth interview was used to collect data from 7 nurses who were randomly selected by purposive sampling and further analyzed using IPA. Results: The results show that the struggle is caused by limited equipment and difficult terrain. In addition, the difficulty of circumstances forces innovation and modification of services and tools. Furthermore, the obstacles in service are also caused by the lack of infrastructure, inadequate number of health workers, and difficult geographical factors. Conclusions: A challenging geographic area brings in struggles, but provides a learning experience by being creative, initiative, and independent in handling emergency cases. However, nurses are only one of the components in the health care system. Other components are still needed for better health services.