Operating room nurses’ lived experiences in the management of critical multiple and combined trauma: a qualitative study

Background: Critical multiple and combined trauma is severe, complex and rapidly progressive, posing great challenges in trauma care. Patient outcomes rely on prompt, efficient operating room teamwork. As key team members, nurses provide precise instrument support and emergency management while under heavy physical and psychological stress. Existing studies focus on clinical protocols, with little qualitative research on their real experiences, practical difficulties and needs. This study explores their lived experiences to optimize trauma care, relieve occupational stress, and improve multidisciplinary teamwork. Methods: This descriptive phenomenological study recruited 15 operating room nurses with ≥3 years of trauma nursing experience from a tertiary hospital in Hunan using purposive sampling with maximum variation. Semi-structured interviews were analyzed using Colaizzi's seven-step method. Trustworthiness was ensured through investigator triangulation, member checking with five participants, maintenance of a detailed audit trail, reflexive journaling, and external expert review. Results: Four key themes emerged: professional challenges and emergency response, dual effects of teamwork, psychological stress and coping, and career development needs. Nurses managing critical multiple and combined traumas bear heavy technical and psychological burdens, seeking better critical care support and emergency decision-making skills. Despite efficient interdisciplinary collaboration being recognized as essential, communication conflicts, delayed staff support, and the emotional labor of absorbing others' negative emotions were identified as persistent dilemmas. Nurses experienced anxiety and compassion fatigue, relieved by self-regulation and peer support, yet explicitly expressed unmet needs for professional psychological counseling, scenario-based simulation training, standardized procedures, and optimized staffing and emergency supplies. Conclusion: Enhancing trauma nursing for critical multiple and combined injuries requires targeted training, structured psychological support, optimized multidisciplinary collaboration, and systematic career development attention. These strategies, derived from nurses' lived experiences, aim to improve both patient outcomes and professional wellbeing. Readers should assess transferability to their own settings.