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Intensive Care Nurses' Experience of Caring in Greece; A Qualitative Study. Healthcare (Basel) 2023; 11:healthcare11020164. [PMID: 36673532 PMCID: PMC9859179 DOI: 10.3390/healthcare11020164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Whilst nurses and critical care services have been at the forefront of the COVID-19 pandemic, it has become more apparent that intensive care nurses are presented with challenging ethical and clinical decisions and are required to care for individuals with critical illnesses under high-pressure conditions. This is not a new phenomenon. The aim of this study, which was conducted before the outbreak of COVID-19, was to explore the experience of caring through the narratives of intensive care nurses in Greece. METHODS A qualitative study was conducted through in-depth, semi-structured interviews with nineteen ICU nurses in Athens. Transcripts were subjected to Braun and Clarke's thematic analysis and organised with Atlas.ti v8 QDA software. RESULTS The intensive care nurses' experience of caring in Greece encompassed four themes: (A) being "proximal", "co-present" and caring with empathy, (B) being "responsible" for your patient and negotiating with the doctors, (C) technology and "fighting with all you've got", and (D) "not being kept informed" and disappointment. CONCLUSIONS The narratives of this study highlight that ICU nurses in Greece provide patient-centred and compassionate care. Nurse leaders should develop appropriate healthcare policies so as to ensure the adequate provision of staff, specialist education, and support to nurses working in critical care. Failure to address these issues may lead to poor quality of care and negative patient outcomes.
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Olausson S, Lindahl B. On photovoice-Applications and reflections to an intensive care context. Scand J Caring Sci 2022; 36:1123-1133. [PMID: 35307842 PMCID: PMC9790407 DOI: 10.1111/scs.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND In this paper, we share our experiences of using 'photovoice' methodology as a way to generate data in intensive care units concerning the place and space of care. We have adapted and modified 'photovoice' in researching people's lived experiences of ICU. Researching lived experiences in an intensive care context is challenging because of the complex nature of critical care. AIM This study aims to explore and discuss photovoice methodolgy in ICU as a data collection method. MATERIALS AND METHODS Photos and interviews collected from patients, loved ones and staff collected in a previous research proejct. RESULTS Although there are challenges in using cameras and photographing the environment in the ICU, due to ethics and the voiceless patients therein, many advantages are presented to the researchers in capturing the meaning of lived experiences of various phenomena in the lifeworld in general and in the meaning of place and space. This paper offers applications and reflection over ontological, epistemological and methodological concerns and also offers a detailed approach on how to employ photovoice for successful and rich data generation. DISCUSSION developing and adapting scientific methods and methodologies contributes to knowledge development in caring science and is therefore an important subject of matter. CONCLUSIONS Photovoice also presents a powerful tool in disseminating the findings as it opens up the closed world of ICU to the public and increases people's understanding of the significance of place and space of caring practice.
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Affiliation(s)
- Sepideh Olausson
- Institute of Health and Caring SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anesthesiology and Intensive CareSahlgrenska University HospitalGothenburgSweden
| | - Berit Lindahl
- Faculty of MedicinePalliative Care Knowledge CenterInstitute of Health SciencesLund UniversityLundSweden
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Choe K, Kwon S, Kim S. How do ethically competent nurses behave in clinical nursing practice? A qualitative study. J Nurs Manag 2022; 30:4461-4471. [PMID: 36326092 DOI: 10.1111/jonm.13884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/30/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
AIM This study explored how ethically competent nurses behave in clinical nursing practice. BACKGROUND Nurses' ethical competency is crucial in nursing practice as it promotes patients' safety and quality of care. METHODS Using a purposive sampling technique, 20 clinical nurses in South Korea were interviewed via an online video platform. The data were analysed using a thematic analysis based on phenomenological approach. RESULTS The main theme found among the participating nurses' ethical competency was caring beyond egocentrism, with two subthemes: (1) patient-centred care based on compassion and (2) responsible behaviour based on nursing professionalism. Factors that enabled this included (1) reasonable work conditions, (2) interpersonal relationships, and (3) nurses' rich personal experiences. CONCLUSIONS Nurses' ethical competency depends on how far they can move away from their own egocentrism and act for their clients' benefit, wherein an appropriate workload and warm human relationships with one's colleagues are essential. Nurses should thus receive education on ethics and professionalism and participate in volunteer and leisure activities that cultivate their degree of empathy. IMPLICATION FOR NURSING MANAGEMENT Nursing leaders and managers should understand nurses' ethical competency and its enabling factors to devise effective strategies to promote it.
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Affiliation(s)
- Kwisoon Choe
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Soojin Kwon
- Department of Nursing, Ansan University, Ansan, Republic of Korea
| | - Sunghee Kim
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
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Henao-Castaño ÁM, Rivera-Romero N, Garzón HPO. Health Care at the End of Life: Experience of Nurses at the Adult Intensive Care Unit. Crit Care Nurs Q 2021; 44:387-392. [PMID: 34437317 DOI: 10.1097/cnq.0000000000000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to determine the experience of the nurses who provide health care in the final stages of life in the intensive care unit for adults. The authors report the results of their study, which used a qualitative design with a phenomenological approach. Eighteen adults participated by being interviewed using semistructured questions. The nurses expressed that health care at the end of life represents an emotional and psychological burden for them. They also recognized that health care was given based on the empiricism achieved through clinical experience. In this regard, they emphasize the importance of having the proper education in this area to provide comprehensive care to the patient, the family, and the nurse.
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Affiliation(s)
- Ángela María Henao-Castaño
- Universidad Nacional de Colombia, Sede Bogotá, Colombia (Dr María Henao-Castaño and Ms Rivera-Romero); and Especialista en Cuidado Critico Adulto, Enfermero, Colombia (Ms Paola Ospina Garzón)
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Gullick J, Wu J, Reid C, Tembo AC, Shishehgar S, Conlon L. Heideggerian structures of Being-with in the nurse-patient relationship: modelling phenomenological analysis through qualitative meta-synthesis. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:645-664. [PMID: 32894396 DOI: 10.1007/s11019-020-09975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Abstract
Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse-patient relationship. We firstly considered and secured the most relevant Heideggerian elements to nurse-patient Being-with (Dasein-with, circumspection, solicitude, and discourse). Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode (task-orientated busyness, existential abandonment, rough handling and deficient modes of concern in potentially violent encounters), and the authentic self-mode (seeking connection [knowing], and openness [unknowing], which exposed their emotional vulnerability). Through circumspection (making room for, deseverance and directionality), technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement (solicitude) was expressed through either leaping-in care (also perceived as 'power over') or leaping-ahead care (moving the patient towards independence). There was a place for both inauthentic (idle talk) and authentic discourse (including non-verbal and spiritual discourse) that nurses wove through the ontic everydayness of nursing tasks.
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Affiliation(s)
- Janice Gullick
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia.
| | - John Wu
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
- University of Sydney (Sydney Conservatorium of Music and University Library), Sydney, NSW, Australia
| | - Cindy Reid
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
| | - Agness Chisanga Tembo
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
- Maitland Hospital (Intensive Care Unit), Maitland, NSW, Australia
| | - Sara Shishehgar
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Lisa Conlon
- University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia
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Kerr F, Wiechula R, Feo R, Schultz T, Kitson A. Neurophysiology of human touch and eye gaze in therapeutic relationships and healing: a scoping review. ACTA ACUST UNITED AC 2020; 17:209-247. [PMID: 30730854 PMCID: PMC6382052 DOI: 10.11124/jbisrir-2017-003549] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: The primary objective of this scoping review was to examine and map the range of neurophysiological impacts of human touch and eye gaze, and consider their potential relevance to the therapeutic relationship and to healing. Introduction: Clinicians, and many patients and their relatives, have no doubt as to the efficacy of a positive therapeutic relationship; however, much evidence is based on self-reporting by the patient or observation by the researcher. There has been little formal exploration into what is happening in the body to elicit efficacious reactions in patients. There is, however, a growing body of work on the neurophysiological impact of human interaction. Physical touch and face-to-face interaction are two central elements of this interaction that produce neurophysiological effects on the body. Inclusion criteria: This scoping review considered studies that included cognitively intact human subjects in any setting. This review investigated the neurophysiology of human interaction including touch and eye gaze. It considered studies that have examined, in a variety of settings, the neurophysiological impacts of touch and eye gaze. Quantitative studies were included as the aim was to examine objective measures of neurophysiological changes as a result of human touch and gaze. Methods: An extensive search of multiple databases was undertaken to identify published research in the English language with no date restriction. Data extraction was undertaken using an extraction tool developed specifically for the scoping review objectives. Results: The results of the review are presented in narrative form supported by tables and concept maps. Sixty-four studies were included and the majority were related to touch with various types of massage predominating. Only seven studies investigated gaze with three of these utilizing both touch and gaze. Interventions were delivered by a variety of providers including nurses, significant others and masseuses. The main neurophysiological measures were cortisol, oxytocin and noradrenaline. Conclusions: The aim of this review was to map the neurophysiological impact of human touch and gaze. Although our interest was in studies that might have implications for the therapeutic relationship, we accepted studies that explored phenomena outside of the context of a nurse-patient relationship. This allowed exploration of the boundary of what might be relevant in any therapeutic relationship. Indeed, only a small number of studies included in the review involved clinicians (all nurses) and patients. There was sufficient consistency in trends evident across many studies in regard to the beneficial impact of touch and eye gaze to warrant further investigation in the clinical setting. There is a balance between tightly controlled studies conducted in an artificial (laboratory) setting and/or using artificial stimuli and those of a more pragmatic nature that are contextually closer to the reality of providing nursing care. The latter should be encouraged.
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Affiliation(s)
- Fiona Kerr
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia.,Faculty of the Professions, University of Adelaide, Adelaide, Australia.,The NeuroTech Institute Pty. Ltd., Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Rick Wiechula
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia.,Centre for Evidence-based Practice South Australia: a Joanna Briggs Institute Centre of Excellence
| | - Rebecca Feo
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia.,Centre for Evidence-based Practice South Australia: a Joanna Briggs Institute Centre of Excellence
| | - Tim Schultz
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia.,Centre for Evidence-based Practice South Australia: a Joanna Briggs Institute Centre of Excellence
| | - Alison Kitson
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia.,Centre for Evidence-based Practice South Australia: a Joanna Briggs Institute Centre of Excellence
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Aristidou M, Vouzavali F, Karanikola MN, Lambrinou E, Papathanassoglou E. A Meta-ethnography of Out-of-Hospital Cardiac Arrest Survivors' Meanings on Life and Death. J Cardiovasc Nurs 2019; 33:E10-E20. [PMID: 29634649 DOI: 10.1097/jcn.0000000000000467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although out-of-hospital cardiac arrest (OHCA) survivors' physiological outcomes have been addressed, less is known on the holistic needs of individuals after OHCA, which hinders our ability to prioritize care around what really matters to survivors. AIM The aim of this study was to interpretatively synthesize qualitative findings on OHCA survivors' perceptions and meanings of life and death and existential issues. METHODS We used a meta-ethnographic synthesis of published qualitative studies addressing the experiences of OHCA survivors based on a systematic literature search (CINAHL, PsycINFO, Scopus, PubMed). Studies were selected based on predefined inclusion/exclusion criteria. The identified studies were subjected to a quality appraisal based on the Critical Appraisal Skills Programme. RESULTS Based on eligibility criteria, 6 phenomenological studies were included, of overall medium to high quality. One core theme, "the reality of death," and 4 main themes were identified: "redefining existence"; "revaluing death"; "being familiar with, yet oblivious of death"; and "living consciously." Emerging from the realization of death, the themes appeared to describe a gradual progression toward living consciously. CONCLUSIONS An existential trajectory and a need for meaning are central in the experience of OHCA survivors. When existential issues are not addressed, the ongoing suffering may interfere with survivors' recovery and quality of life. Future research needs to address specific needs and ways to support survivors' meaning-making.
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Affiliation(s)
- Maria Aristidou
- Maria Aristidou, MSc, RN Doctoral Candidate, Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, and Special Scientist, Department of Nursing, School of Health Sciences, European University of Cyprus. Fotini Vouzavali, PhD, MSc, RN High School Teacher, Vocational High School of Nurse Assistants, and Laboratory Instructor, Department of Nursing, Technological Educational Institute of Athens, Greece. Maria N. Karanikola, PhD, MSc, RN Assistant Professor, Department of Nursing, Cyprus University of Technology, Limassol. Ekaterini Lambrinou, PhD, MSc, RN Associate Professor, Department of Nursing, Cyprus University of Technology, Limassol. Elizabeth Papathanassoglou, PhD, MSc, RN Associate Professor, Faculty of Nursing, University of Alberta, Edmonton, Canada
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8
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Flinterud SI, Moi AL, Gjengedal E, Narvestad Grenager L, Muri AK, Ellingsen S. The creation of meaning – Intensive care nurses’ experiences of conducting nurse-led follow-up on intensive care units. Intensive Crit Care Nurs 2019; 53:30-36. [DOI: 10.1016/j.iccn.2019.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/12/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022]
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Suddick KM, Cross V, Vuoskoski P, Stew G, Galvin KT. The acute stroke unit as a meaningful space: The lived experience of healthcare practitioners. Health Place 2019; 57:12-21. [PMID: 30849691 DOI: 10.1016/j.healthplace.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/08/2018] [Accepted: 02/07/2019] [Indexed: 11/17/2022]
Abstract
This hermeneutic phenomenological study was undertaken in response to the recent re-organization of stroke unit provision in the United Kingdom. Through the analysis of four acute stroke unit practitioners' subjective accounts, the acute stroke unit emerged as a dynamic, meaningful space, where they experienced authenticity and belonging. The findings showed how these practitioners navigated their way through the space, thriving, and/or surviving its' associated vulnerabilities. They offer a different gaze on which to attend to the complexity and challenge that is interwoven with health professionals' flourishing, the spatiality of healthcare practice, and perhaps other demanding places of work.
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Affiliation(s)
- Kitty Maria Suddick
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
| | - Vinette Cross
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom
| | - Pirjo Vuoskoski
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
| | - Graham Stew
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
| | - Kathleen T Galvin
- School of Health Sciences, University of Brighton, Robert Dodd Building, 49 Darley Road, Eastbourne, East Sussex, BN20 7UR, United Kingdom.
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Tolotti A, Bagnasco A, Catania G, Aleo G, Pagnucci N, Cadorin L, Zanini M, Rocco G, Stievano A, Carnevale FA, Sasso L. The communication experience of tracheostomy patients with nurses in the intensive care unit: A phenomenological study. Intensive Crit Care Nurs 2018; 46:24-31. [PMID: 29709466 DOI: 10.1016/j.iccn.2018.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit. RESEARCH METHODOLOGY/DESIGN Benner's interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses. SETTING The intensive care unit of a hospital in Northern Italy. FINDINGS Eight patients and seven nurses were included in this study. Two main themes were identified 1) feeling powerless and frustrated due to the impossibility to use voice to communicate; 2) facing continual misunderstanding, resignation, and anger during moments of difficulty and/or communication misunderstandings. The main communication discomfort factors were: struggling with not knowing what was happening, feeling like others had given up on me, living in isolation and feeling invisible. The main comfort factors were: being with family members, feeling reassured by having a call bell nearby and nurses' presence. CONCLUSIONS This study highlights the important role of communication in tracheostomy patients in intensive care and how closely it is linked to all the aspects of a person's life, which cannot be underestimated as just not being able to use one's voice.
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Affiliation(s)
- Angela Tolotti
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Nicola Pagnucci
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - Lucia Cadorin
- CRO Aviano National Cancer Institute, Via F. Gallini, 2, 22081 Aviano, Italy.
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Gennaro Rocco
- Italian Nurses' National Social Security Council (ENPAPI), Via A. Farnese 3, 00192 Rome, Italy
| | - Alessandro Stievano
- Centro di Eccellenza per la Cultura e la Ricerca Infermieristica, Via G. Cesare 78, 00192 Rome, Italy
| | | | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
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Bäcklund K, Persson K, Hadziabdic E. Intensive Care Nurses’ Experiences of Caring for Intubated Patients under Light Sedation: A Qualitative Study. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojn.2018.87036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dadzie G, Aziato L, Aikins ADG. "We are the best to stand in for patients": a qualitative study on nurses' advocacy characteristics in Ghana. BMC Nurs 2017; 16:61. [PMID: 29162984 PMCID: PMC5686914 DOI: 10.1186/s12912-017-0259-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 11/07/2017] [Indexed: 01/08/2023] Open
Abstract
Background Patient advocacy has been identified as a core duty of the nurse, and certain nurse characteristics influence the performance of the role. However, these characteristics have not been adequately explored in Ghana. This study aimed to explore the perspectives of nurses about the characteristics of nurses that influence their role as patient advocates. Methods An exploratory descriptive qualitative study was conducted among 15 nurses from a regional hospital in Ghana. Purposive sampling was used to select participants and individual in-depth interviews were conducted in English using a semi-structured interview guide. The interviews were audio-taped and transcribed. Data analysis was done concurrently employing the principles of thematic analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute of Medical Research and the Ghana Health Service Ethical Review Committee. Results Themes generated revealed nurse traits which enhanced the advocacy role of nurses such as being empathetic, nurturing, ethical, assertive and persistent and nurse states which hindered the performance of the role such as fatigue and frustration. However, “compassionate” emerged as an additional nurse trait from this study. Out of empathy, participants availed themselves for patients to share their problems with them. In their nurturing roles, spending more time with patients and providing personal care fostered closeness which helped in identifying patients’ problems. Helping patients navigate the health system was also found. They perceived patient advocacy as a moral responsibility and identified good communication skills and determination to help patients get their problems solved as important in patient advocacy. Some participants also described compassion-based activities such as pleading on patients’ behalf, providing material and financial assistance, facilitating care and providing emotional support in their advocacy. However, heavy workload and lack of appreciation from patients were found to hinder the performance of the advocacy role. Conclusions We concluded that nurse characteristics that influence patient advocacy are comparable to those identified internationally such as being empathetic, assertiveness and fatigue. Enhancing these characteristics could help nurses overcome the negative states that undermine the patient advocacy role of nurses.
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Affiliation(s)
- Grace Dadzie
- Department of Adult Health, School of Nursing, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Accra, Ghana
| | - Lydia Aziato
- Department of Adult Health, School of Nursing, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Accra, Ghana
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Accra, Ghana
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Ong KK, Ting KC, Chow YL. The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study. J Clin Nurs 2017; 27:257-268. [DOI: 10.1111/jocn.13882] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Keh Kiong Ong
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | | | - Yeow Leng Chow
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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Ednell AK, Siljegren S, Engström Å. The ICU patient diary-A nursing intervention that is complicated in its simplicity: A qualitative study. Intensive Crit Care Nurs 2017; 40:70-76. [PMID: 28233651 DOI: 10.1016/j.iccn.2016.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 11/19/2016] [Accepted: 12/03/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Writing a diary for intensive care patients has been shown to facilitate patientrecovery and prevent post-traumatic stress following hospitalisation. AIM This study aimed to describe the experiences of critical care nurses' (CCNs') in writing personal diaries for ICU patients. METHOD The study was conducted with a qualitative design. Ten CCNs from two hospitals participated. Data were collected with semi-structured interviews and analysed using a qualitative thematic content analysis. FINDINGS The result consists of a theme: Patient diary: a complex nursing intervention in all its simplicity, as well as four categories: Writing informatively and with awareness shows respect and consideration; The diary is important for both patient and CCN; To jointly create an organisation that facilitates and develops the writing; Relatives' involvement in the diary is a matter of course. CONCLUSION CCNs are aware of the diary's importance for the patient and relatives, but experience difficulties in deciding which patients should get this intervention and how to prioritize it. Writing a personal diary for an ICU patient is a nursing intervention that is complicated in its simplicity.
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Affiliation(s)
| | | | - Åsa Engström
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden.
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Kerr F, Wiechula R, Feo R, Schultz T, Kitson A. The neurophysiology of human touch and eye gaze and its effects on therapeutic relationships and healing: a scoping review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2016; 14:60-6. [PMID: 27532310 DOI: 10.11124/jbisrir-2016-2628] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this scoping review is to examine and map the range of neurophysiological impacts of human touch and eye gaze, and better understand their possible links to the therapeutic relationship and the process of healing. The specific question is "what neurophysiological impacts of human touch and eye gaze have been reported in relation to therapeutic relationships and healing?"
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Affiliation(s)
- Fiona Kerr
- 1School of Nursing, University of Adelaide, Adelaide, Australia 2Centre for Evidence-based Practice South Australia: an Affiliate Center of the Joanna Briggs Institute
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Kisorio LC, Langley GC. Intensive care nurses' experiences of end-of-life care. Intensive Crit Care Nurs 2016; 33:30-8. [PMID: 26791353 DOI: 10.1016/j.iccn.2015.11.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 09/25/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To explore intensive care nurses' experiences of end-of-life care in adult intensive care units. DESIGN AND METHODS An exploratory, descriptive qualitative approach was utilised. Purposive sampling method was used to select nurse participants (n=24) working at the selected intensive care units in the three academic affiliated, tertiary specialist hospitals in the Johannesburg and Pretoria regions, South Africa. Using a focus group guide, three focus group discussions were conducted. Data were analysed using the long-table approach (Krueger and Casey, 2000). Trustworthiness of the study was ensured by following the criteria set out by Lincoln and Guba (1985). FINDINGS Five major themes related to nurses' experiences of end-of-life care emerged. These included: "difficulties we experience", "discussion and decision making", "support for patients", "support for families" and "support for nurses". CONCLUSION End-of-life care can be difficult and a challenging process. Nevertheless, this study has highlighted some of the interventions and support systems that could be incorporated for improved caring process. Whereas the dying patients and their families need to be continuously supported, critical care nurses too need to be taken care of for them to continue providing the best possible end-of-life care.
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Affiliation(s)
- Leah C Kisorio
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town 2193, Johannesburg, South Africa.
| | - Gayle C Langley
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town 2193, Johannesburg, South Africa.
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Scholtz S, Nel EW, Poggenpoel M, Myburgh CPH. The Culture of Nurses in a Critical Care Unit. Glob Qual Nurs Res 2016; 3:2333393615625996. [PMID: 28462324 PMCID: PMC5342286 DOI: 10.1177/2333393615625996] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 12/01/2015] [Accepted: 12/07/2015] [Indexed: 01/12/2023] Open
Abstract
Critical care nurses have to adapt to a fast-paced and stressful environment by functioning within their own culture. The objective of this study was to explore and describe the culture of critical care nurses with the purpose of facilitating recognition of wholeness in critical care nurses. The study had a qualitative, exploratory, descriptive, and contextual design. The ethnographic study included data triangulation of field notes written during 12 months of ethnographic observations, 13 interviews from registered nurses, and three completed diaries. Coding and analysis of data revealed patterns of behavior and interaction. The culture of critical care nurses was identified through patterns of patient adoption, armor display, despondency because of the demands to adjust, sibling-like teamwork, and non-support from management and medical doctors. An understanding of the complexity of these patterns of behavior and interaction within the critical care nursing culture is essential for transformation in the practice of critical care nursing.
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Affiliation(s)
| | - Elsabe W. Nel
- University of Johannesburg, Johannesburg, South Africa
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OʼHara S. Planning intensive care unit design using computer simulation modeling: optimizing integration of clinical, operational, and architectural requirements. Crit Care Nurs Q 2015; 37:67-82. [PMID: 24309461 DOI: 10.1097/cnq.0000000000000006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nurses have increasingly been regarded as critical members of the planning team as architects recognize their knowledge and value. But the nurses' role as knowledge experts can be expanded to leading efforts to integrate the clinical, operational, and architectural expertise through simulation modeling. Simulation modeling allows for the optimal merge of multifactorial data to understand the current state of the intensive care unit and predict future states. Nurses can champion the simulation modeling process and reap the benefits of a cost-effective way to test new designs, processes, staffing models, and future programming trends prior to implementation. Simulation modeling is an evidence-based planning approach, a standard, for integrating the sciences with real client data, to offer solutions for improving patient care.
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Affiliation(s)
- Susan OʼHara
- O'Hara HealthCare Consultants, LLC, Marlborough, Massachusetts
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Laerkner E, Egerod I, Hansen HP. Nurses' experiences of caring for critically ill, non-sedated, mechanically ventilated patients in the Intensive Care Unit: a qualitative study. Intensive Crit Care Nurs 2015; 31:196-204. [PMID: 25743598 DOI: 10.1016/j.iccn.2015.01.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/27/2015] [Accepted: 01/29/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective was to explore nurses' experiences of caring for non-sedated, critically ill patients requiring mechanical ventilation. DESIGN AND SETTING The study had a qualitative explorative design and was based on 13 months of fieldwork in two intensive care units in Denmark where a protocol of no sedation is implemented. Data were generated during participant observation in practice and by interviews with 16 nurses. Data were analysed using thematic interpretive description. FINDINGS An overall theme emerged: "Demanding, yet rewarding". The demanding aspects of caring for more awake intubated patients included unpredictability, ambiguous needs and complex actions, while the rewarding aspects included personal interaction. Three sub-themes were identified: (i) caring for and with the patient, (ii) negotiating relational and instrumental care and (iii) managing physical and emotional closeness. CONCLUSION Despite the complexity of care, nurses preferred to care for more awake rather than sedated patients and appreciated caring for just one patient at a time. The importance of close collaboration between nurses and doctors to ensure patient comfort during mechanical ventilation was valued. Caring for more awake non-sedated patients required the nurses to act at the interface between ambiguous possibilities and needs, which was perceived as both demanding and rewarding.
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Affiliation(s)
- Eva Laerkner
- Faculty of Health, Department of Public Health, University of Southern Denmark, Denmark; Dept. of Anesthesiology and Intensive Care, Odense University Hospital, Denmark.
| | - Ingrid Egerod
- University of Copenhagen, Copenhagen University Hospital Rigshospitalet, Trauma Centre, Denmark
| | - Helle Ploug Hansen
- Faculty of Health, Department of Public Health, University of Southern Denmark, Denmark
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Ritmala-Castren M, Axelin A, Kiljunen K, Sainio C, Leino-Kilpi H. Sleep in the intensive care unit - nurses' documentation and patients' perspectives. Nurs Crit Care 2014; 22:238-246. [DOI: 10.1111/nicc.12102] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 02/12/2014] [Accepted: 04/08/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Marita Ritmala-Castren
- Department of Nursing Science, University of Turku, and Clinical nurse consultant, Department of Surgery/Critical Care Clinic; Helsinki University Hospital; Helsinki Finland
| | - Anna Axelin
- Department of Nursing Science; University of Turku; Turun Yliopisto Finland
| | | | - Carita Sainio
- Department of surgery; Helsinki University Hospital; Helsinki Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science; University of Turku, Finland and Nurse Manager, Turku University Hospital; Turku Finland
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21
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Olausson S, Ekebergh M, Osterberg SA. Nurses' lived experiences of intensive care unit bed spaces as a place of care: a phenomenological study. Nurs Crit Care 2014; 19:126-34. [PMID: 24646033 DOI: 10.1111/nicc.12082] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/06/2013] [Accepted: 12/15/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The environment of an intensive care unit (ICU) is, in general, stressful and has an impact on quality of care in terms of patient outcomes and safety. Little is known about nurses' experiences, however, from a phenomenological perspective with regard to the critical care settings as a place for the provision of care for the most critically ill patients and their families. AIM The aim of this study was to explore nurses' lived experiences of ICU bed spaces as a place of care for the critically ill. DESIGN AND METHODS A combination of qualitative lifeworld interviews and photos --photovoice methodology --was used when collecting data. Fourteen nurses from three different ICUs participated. Data were analysed using a phenomenological reflective lifeworld approach. FINDINGS An outer spatial dimension and an inner existential dimension constitute ICU bed spaces. Caring here means being uncompromisingly on call and a commitment to promoting recovery and well-being. The meanings of ICU bed spaces as a place of care comprise observing and being observed, a broken promise, cherishing life, ethical predicament and creating a caring atmosphere. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE The architectural design of the ICU has a great impact on nurses' well-being, work satisfaction and the provision of humanistic care. Nurses need to be involved in the process of planning and building new ICU settings. There is a need for further research to highlight the quality of physical environment and its impact on caring practice.
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Affiliation(s)
- Sepideh Olausson
- S Olausson, PhD candidate, RN, CCRN, MSn, Department of Health Sciences, University of Borås, Borås, Sweden; Linnaeus University, Växjö, Sweden
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Abstract
This qualitative study examines the spiritual needs of staff nurses. Focus group participants discussed "care of the patient" and "care of self." We use theory to argue that self-care is essential for the care of both nurses and patients, and spirituality is the foundation of nurses' work.
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Engström A, Lindberg I. Critical care nurses' experiences of nursing mothers in an ICU after complicated childbirth. Nurs Crit Care 2013; 18:251-7. [PMID: 23968444 DOI: 10.1111/nicc.12027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/13/2013] [Accepted: 04/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Providing nursing care for a critically ill obstetric patient or a patient who has just become a mother after a complicated birth can be a challenging experience for critical care nurses (CCNs). These patients have special needs because of the significant alterations in their physiology and anatomy together with the need to consider such specifics as breastfeeding and mother-child bonding. AIM The aim with this study was to describe CCNs' experience of nursing the new mother and her family after a complicated childbirth. METHOD The design of the study was qualitative. Data collection was carried out through focus group discussions with 13 CCNs in three focus groups during spring 2012. The data were subjected to qualitative content analysis. FINDINGS The analysis resulted in the formulation of four categories: the mother and her vital functions are prioritized; not being responsible for the child and the father; an environment unsuited to the new family and collaboration with staff in neonatal and maternity delivery wards. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE When nursing a mother after a complicated birth the CCNs give her and her vital signs high priority. The fathers of the children or partners of the mothers are expected to take on the responsibility of caring for the newborn child and of being the link with the neonatal ward. It is suggested that education about the needs of new families for nursing care would improve the situation and have clinical implications. Whether the intensive care unit is always the best place in which to provide care for mothers and new families is debatable.
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Affiliation(s)
- Asa Engström
- Division of Nursing, Department of Health Science, Luleå, Luleå University of Technology, Sweden.
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Locsin RC, Kongsuwan W. Lived experience of patients being cared for in ICUs in Southern Thailand. Nurs Crit Care 2013; 18:200-11. [PMID: 23782114 DOI: 10.1111/nicc.12025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 03/16/2013] [Accepted: 03/19/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Technologies in ICUs are increasingly saving human lives. The challenge for nursing in ICUs is to use technologies competently in order to know patients more fully within the harmonized view of technology, nursing and human care. PURPOSE The purpose of this study was to describe the meaning of the experiences of patients who were dependent on technologies while being cared for in ICUs. METHOD A hermeneutic phenomenological approach was used to describe the experiences of 10 participants who were discharged from adult ICU units in Southern Thailand. Lincoln and Guba's criteria for trustworthiness was used to establish the rigour of the study. FINDINGS Four thematic categories structured the meaning of the participants' experiences: Living suffering; Harmonizing living; Being in trust and security; and Transitioning to a better life. These thematic categories were reflective of the four lived worlds of corporeality, relationality, spatiality and temporality. CONCLUSION The description of being cared for was based on the narratives of patients who were discharged from ICUs in Southern Thailand. In conclusion, the lived experience of being cared for with technologies in ICU was described as living suffering within trust and security, and harmonizing living while transitioning to a better life. RELEVANCE TO CLINICAL PRACTICE The findings of the study could be used to design innovative nursing strategies and interventions to enhance understanding of human health and well-being while maintaining and advancing competencies in the use of technologies for human care.
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Affiliation(s)
- Rozzano C Locsin
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL 33431, USA.
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Everingham K, Fawcett T, Walsh T. 'Targeting' sedation: the lived experience of the intensive care nurse. J Clin Nurs 2013; 23:694-703. [PMID: 23336366 DOI: 10.1111/jocn.12058] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To discuss the findings from a phenomenological study that provides insights into the intensive care nurses' 'world' following changes in the sedation management of patients in an intensive care unit. BACKGROUND Intensive care sedation practices have undergone significant changes. Patients, where possible, are now managed on lighter levels of sedation, often achieved through the performance of sedation holds (SHs). The performance of SHs is normally carried out by the bedside nurse but compliance is reported to be poor. There has been little exploration of the nurses' experiences of these changes and the implications of SHs and subsequent wakefulness on their delivery of care. DESIGN Following ethical approval, 16 intensive care nurses, experienced and inexperienced, from within a general intensive care unit. METHODS A Heideggerian phenomenological approach was used. Data collection consisted of interviews guided by an aide memoir and a framework adapted from Van Manen informed the analysis. RESULTS The findings reveal new insights into the world of the intensive care nurse in the light of the changes to sedation management. They demonstrate that there have been unforeseen outcomes from well-intentioned initiatives to improve the quality of patients' care. There were implications from the changes introduced for the nurses care delivery. The main themes that emerged were 'working priorities' and 'unintended consequences', in turn revealing embedded tensions between evidence-based targets and holistic care. CONCLUSIONS Intensive care nurses find that the current approach to the changes in sedation management can threaten their professional obligation and personal desire to provide holistic care. The 'targeted' approach by healthcare organisations is perceived to militate against the patient-centred care they want to deliver. RELEVANCE TO CLINICAL PRACTICE Sedation management is complex and needs further consideration particularly the potential constraints 'target-led' care has on nursing practice.
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Boström M, Magnusson K, Engström Å. Nursing patients suffering from trauma: Critical care nurses narrate their experiences. Int J Orthop Trauma Nurs 2012. [DOI: 10.1016/j.ijotn.2011.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Scholes J, Albarran J. What's in this issue? Nurs Crit Care 2011; 16:111-2. [PMID: 21481111 DOI: 10.1111/j.1478-5153.2011.00460.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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