title: Separation of conjoined twins: experiences of perioperative nurses and their recommendations.
abstract: BACKGROUND
  Within an 8-month period, an unprecedented and historical first in Queensland, Australia, the perioperative nurses were members of teams involved in the surgical separation of two sets of conjoined twins. Little is known about the (dis)stress that some of these perioperative nurses experienced nor how best to support them during such experiences.
  
  
  OBJECTIVE
  The aim of this paper is to report on the qualitative study that explored the experiences of those perioperative nurses involved in the surgical separation of cojoined twins and from their stories propose recommendations to support perioperative nurses who are confronted with such workplace experiences.
  
  
  METHODS
  Using a narrative methodology, nine perioperative nurses shared their stories of being involved in the surgical separation of conjoined twins in Australia. Narrative and thematic analyses were conducted and recommendations to support perioperative nurses through workplace (dis)stress were identified. Participants validated the findings and recommendations.
  
  
  RESULTS
  The analyses revealed the themes of professionalism, teamwork, 'them vs. us' and emotional loads.
  
  
  CONCLUSIONS
  The sensationalism around the rarity of conjoined twins brought an intensive intrusiveness from the world media. As a result, secrecy within the hospital about the conjoined twin cases created divisions between those perioperative nurses on the teams and those not. The processes and outcomes of the two surgical cases were in contrast to each other. For some perioperative nurses this caused distress. It is essential that professional support is offered in a way in which the perioperative nurse can take it up without fear of negative judgement.
authors.affiliation: Department of Nursing, University of Southern Queensland, Toowoomba, Queensland, Australia. kmartinm@usq.edu.au
authors.forename: K
authors.initials: K
authors.lastname: Martin-McDonald
authors.forename: P
authors.initials: P
authors.lastname: McIntyre
authors.forename: D
authors.initials: D
authors.lastname: Hegney
mesh_terms: D001315:Australia; D004644:Emotions; D006801:Humans; D007407:Interviews as Topic; D009726:Nurses / Q000523:psychology*; D010348:Patient Care Team; D013527:Perioperative Nursing; D013315:Stress, Psychological; D014428:Twins, Conjoined / Q000601:surgery*