Redefining critical incidents: a preliminary report.

This pilot study was conducted to describe how some traumatic events become "critical incidents" and to generate a new understanding of the term critical incident. The qualitative research design utilized content analysis of structured interviews of six emergency nurses. The nurses were interviewed regarding the ways they think about certain patient care events, the reasons that specific events are remembered and the changes that occurred following the experience of an event they considered to be critical. The definitions of a critical incident as described in the literature--as an event, as a professional's reaction and as a professional's performance--are included in the nurses' comments. None of them, however, offers a comprehensive way of describing a critical incident. The results of this pilot study suggest one, two or all three elements may be present when a traumatic event is experienced. The interaction of these elements helps to produce a fourth "critical" component, the meaning a nurse gives to an event, which can trigger cognitive, affective and/or behavioral changes. This study acknowledges the importance of all the definitions of a critical incident and proposes a more comprehensive definition that results from the interaction among the other components and the generation of personal meaning and change.