Invulnerability in healthcare is an emerging concept. Perceptions of invulnerability in the healthcare setting can result in harm to self and others. Clinical observation, a review of the literature, and Carper's ways of knowing guided this researcher's development of a beginning practice theory of invulnerability in clinical healthcare. Education, prior exposure, and habit are the antecedents of invulnerability that were investigated. The primary purpose of this study was to explore invulnerability among nurses in the clinical healthcare setting, using activation of needle-protective devices as the clinical exemplar. The secondary purpose was to explore the relationships of various nurse characteristics and invulnerability.

A descriptive correlational design was used. Data were collected from 162 registered nurses who gave subcutaneous and/or intramuscular injections with an active needle-protective device. Data were collected using the Subject Demographic Questionnaire (SDQ) and the Clinical Healthcare Invulnerability Questionnaire-Needlestick Injury (CHIQ-NSI), a newly developed valid and reliable tool to measure invulnerability. The SDQ and the CHIQ-NSI were accessed via a link to SurveyMonkey™ and distributed to subjects through email. Two subject recruitment strategies were used. First, email addresses for nurses in the Pennsylvania/New Jersey/Delaware tri-state area were purchased from a national nursing organization. The second recruitment strategy utilized was snowballing; 75 participants known to this researcher were contacted via email, and asked to forward the invitation to participate in the study to other nurses.

Data were analyzed using Pearson correlations, eta, and one-way analysis of variance. The research questions and additional analyses were discussed. The discussion of the findings, implication for nursing, conclusions, and recommendations for future research were presented. The study of invulnerability applied to the clinical exemplar of use of needle-protective devices further informed the development of the beginning theory of invulnerability in clinical healthcare. This understanding is essential as individuals' perceptions of invulnerability may cause harm to self and others.