Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chairperson Martha G. Fuller, PhD, PPCNP-BC, Committee Member Eileen K. Fry-Bowers, PhD, JD, RN, CPNP-PC, FAAN, Committee Member Karen "Sue" Hoyt, PhD, RN, FNP-BC, ENP-C, FAEN, FAANP, FAAN, Committee Member


: Nurse practitioner, Human Trafficking, Emergency Department, qualitative narrative inquiry. Moral Distress


Background: Human trafficking (HT) is a global and domestic concern that impacts individuals, families, and communities. Over the last ten years, HT has become a significant public health concern intersecting with the health care community in various settings. HT abuse and oppression have both short- and long-term health consequences. Approximately 50 to 88% of trafficked individuals visit a health care provider, and 63% of those visits are evaluated in the emergency department (ED). Nurse practitioners (NPs) working in the ED interact with HT individuals but have not been represented in recent research scholarship.

Purpose: The purpose of this qualitative narrative inquiry was to explore perceptions of NPs working in the ED, centering on their interaction with individuals who are being trafficked. The study focused on understanding personalized narratives of the NP experiences, constructed memory, and applied meanings of interactions with HT individuals.

Methods: A qualitative narrative inquiry was used to explore individual NP stories. Targeted purposive and network snowball recruitment was obtained through the American Academy of Emergency Nurse Practitioners (AAENP) membership organization. The sample included 17 NP participants in 60–90-minute semi-structured interviews through the Zoom internet platform. The NP narratives were analyzed using Clandinin’s thematic, structural, performative, and storying methods to identify emerging themes.

Findings: Analysis revealed six themes that emerged from the narratives illuminating complex barriers NPs face daily in the ED. The themes included environmental challenges, performance pressures, the bias of presentation, knowledge deficits, lack of trust during encounters, and the overlapping sixth theme of moral distress. Findings support existing research but also reveal a deeper understanding of the complexities of HT identification in the ED.

Implications: NPs can improve the care and identification of potential and/or actual human trafficked individuals in the ED. The findings of NP’s construct themes can assist the health care community with focused education to improve recognition of identification barriers, implement screening strategies, collaborate with policymakers, improve guidelines in the complex ED environment, and decrease moral distress in NP providers.

Document Type

Dissertation: Open Access



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