# A Narrative Inquiry into Junior Nurses’ Psychological Recovery After Adverse Events in China

## TL;DR

Junior nurses in China face intense emotional distress after adverse events and need timely support and a blame-free culture to recover.

## Contribution

The study provides insights into the psychological recovery trajectory of junior nurses in China and emphasizes the role of organizational culture.

## Key findings

- Junior nurses experience intense distress immediately after adverse events, highlighting the need for timely emotional support.
- Organizational support can help nurses bypass certain recovery stages, but it remains limited in practice.
- A just, blame-free culture is essential for promoting psychological recovery among junior nurses.

## Abstract

What are the main findings?
Junior nurses experience their most intense distress immediately after an adverse event, underscoring the importance of timely emotional support.Nurse managers are well-positioned to create supportive environments where early-career nurses feel valued and understood.

Junior nurses experience their most intense distress immediately after an adverse event, underscoring the importance of timely emotional support.

Nurse managers are well-positioned to create supportive environments where early-career nurses feel valued and understood.

What are the implications of the main findings?
Although the concept of a “no-blame” culture is increasingly recognized within China’s healthcare system, a fully realized just culture that balances accountability and fairness remains limited.Building a genuine, just culture requires visible leadership commitment, targeted education, and transparent communication.

Although the concept of a “no-blame” culture is increasingly recognized within China’s healthcare system, a fully realized just culture that balances accountability and fairness remains limited.

Building a genuine, just culture requires visible leadership commitment, targeted education, and transparent communication.

Background: Junior nurses—who are most prone to errors and emotional distress as “second victims”—often experience underreported adverse events and psychological challenges. This study aimed to explore how junior nurses in China psychologically recover after adverse events and how they navigate their recovery experiences. Methods: Guided by Scott’s Second Victim Recovery Trajectory Model, a qualitative study was conducted from September to November 2023. Purposive sampling was used to recruit junior nurses from hospitals across China who had experienced adverse events in their clinical practice. Informed by themes emerging from the initial nurse interviews, the study subsequently included nurse managers to provide additional organizational and managerial perspectives. In-depth semi-structured interviews were conducted with nine junior nurses and four managers. Data were analyzed thematically within a narrative inquiry framework and reported following the Standards for Reporting Qualitative Research (SRQR). Results: Two main themes emerged: (1) the trajectory of adverse events: A nonlinear psychological response, and (2) final outcomes of adverse events: reflection and adjustment. Psychological recovery broadly followed the Second Victim Recovery Trajectory, with only two outcomes observed—dropout and thriving. Organizational support sometimes enabled nurses to bypass certain recovery stages, but such support was limited. Conclusions: Junior nurses experience notable emotional distress following adverse events. The post-event recovery is strengthened by supportive interpersonal environments but limited by insufficient organizational attention. The study findings highlight the need to foster a just, blame-free culture to promote recovery.