Turkish nurses’ decision making in the distribution of intensive care beds

The aim of this study was to assess the opinions and role of intensive care unit (ICU) nurses regarding the distribution of ICU beds. We conducted this research among 30% of the attendees at two ICU congresses in Turkey. A self-administered questionnaire was used, which included 13 cases and allocation criteria. Of the total (136 nurses), 53.7% participated in admission/discharge decisions. The most important criterion was quality of life as viewed by the physician; the least important was the patient’s social status. According to the findings, the nurses thought that medical benefit and avoiding discrimination were important. On the other hand their ignorance of patients’ autonomous preferences arouses suspicions about these nurses’ role in advocating for patients’ rights. For this reason, nurses’ role in allocation decisions should be clearly described and should also be the basis on which intensive care nurses’ duties in allocation decisions should be determined.

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Palliative Care

Advances in Medical Technologies and Clinical Practice - Modern Concepts and Practices in Cardiothoracic Critical Care ◽

10.4018/978-1-4666-8603-8.ch005 ◽

2015 ◽

pp. 105-123

Author(s):

May Hua

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Intensive Care ◽

Critical Illness ◽

Serious Illness ◽

Surgical Units ◽

Potential Benefits

Palliative care is a specialty of medicine that focuses on improving quality of life for patients with serious illness and their families. As the limitations of intensive care and the long-term sequelae of critical illness continue to be delimited, the role of palliative care for patients that are unable to achieve their original goals of care, as well as for survivors of critical illness, is changing and expanding. The purpose of this chapter is to introduce readers to the specialty of palliative care and its potential benefits for critically ill patients, and to present some of the issues related to the delivery of palliative care in surgical units.

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Restoring Speech to Tracheostomy Patients

Critical Care Nurse ◽

10.4037/ccn2015401 ◽

2015 ◽

Vol 35 (6) ◽

pp. 13-28 ◽

Cited By ~ 10

Author(s):

Linda L. Morris ◽

Ana M. Bedon ◽

Erik McIntosh ◽

Andrea Whitmer

Keyword(s):

Quality Of Life ◽

Mechanical Ventilation ◽

Intensive Care ◽

Patient Satisfaction ◽

Chronic Illness ◽

Vocal Communication ◽

Active Role ◽

Intensive Care Nurses ◽

Spontaneously Breathing

Tracheostomies may be established as part of an acute or chronic illness, and intensive care nurses can take an active role in helping restore speech in patients with tracheostomies, with focused nursing assessments and interventions. Several different methods are used to restore speech, whether a patient is spontaneously breathing, ventilator dependent, or using intermittent mechanical ventilation. Restoring vocal communication allows patients to fully express themselves and their needs, enhancing patient satisfaction and quality of life.

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Impact of Performance Obstacles on Intensive Care Nurses' Workload, Perceived Quality and Safety of Care, and Quality of Working Life

Health Services Research ◽

10.1111/j.1475-6773.2008.00934.x ◽

2009 ◽

Vol 44 (2p1) ◽

pp. 422-443 ◽

Cited By ~ 77

Author(s):

Ayse P. Gurses ◽

Pascale Carayon ◽

Melanie Wall

Keyword(s):

Intensive Care ◽

Working Life ◽

Perceived Quality ◽

Quality And Safety ◽

Quality Of Working Life ◽

Intensive Care Nurses ◽

Performance Obstacles

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Role of intensive care nurses on guiding patients’ families/relatives to organ donation

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.4.1285 ◽

2019 ◽

Vol 35 (4) ◽

Author(s):

Ahmet Karaman ◽

Neriman Akyolcu

Keyword(s):

Intensive Care ◽

Brain Death ◽

Organ Donation ◽

Organ Transplant ◽

University Hospitals ◽

Intensive Care Nurses ◽

Creative Commons ◽

The Family ◽

Using Data

Objective: The aim was to determine the role of intensive care nurses on guiding the families/relatives of brain-death patients to organ donation. Methods: This research is a descriptive study. While the population of the study consisted of 1710 nurses working in the intensive care units of public, private and university hospitals in the city of Istanbul, the sample consisted of 353 intensive care nurses selected with stratified random sampling method from the probability sampling methods from this population. The data were collected by using “Data Collection Form”. Results: It was determined that 74.5% of the intensive care nurses carefully listened the family/relatives of the patient with possible brain death or suffering from brain death and supported them to express their emotion and thoughts clearly; when the family/relatives of the patients hospitalised in the intensive care unit wanted to get information about organ donation, 20.7% of the nurses made the preliminary explanation themselves and then guided the patient to an organ transplant coordinator for detailed information and 3.1% of the nurses generally gave this information themselves. Conclusions: It was determined that the knowledge of the intensive care nurses about brain death and organ donation was partially adequate and the function of guiding the families/relatives of brain-death patients to organ donation was mostly done by the physician. doi: https://doi.org/10.12669/pjms.35.4.1285 How to cite this:Karaman A, Akyolcu N. Role of intensive care nurses on guiding patients’ families/relatives to organ donation. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1285 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Role of Family Members in Pain Management in Adult Critical Care

AACN Advanced Critical Care ◽

10.4037/aacnacc2019275 ◽

2019 ◽

Vol 30 (4) ◽

pp. 398-410 ◽

Cited By ~ 1

Author(s):

Émilie Gosselin ◽

Mélissa Richard-Lalonde

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pain Management ◽

Pain Assessment ◽

Family Members ◽

Future Research ◽

Rigorous Research ◽

Family Member Involvement

This review describes family member involvement in intensive care unit pain assessment and management and generates implications for clinical practice, education, and future research. A literature review was performed in MEDLINE, PubMed, EMBASE, Cochrane, and CINAHL databases from their inception until April 30, 2019. Only 11 studies addressing the topic were identified, and the current quality of evidence is low. Family members can be involved in pain assessment by describing patients’ pain behaviors and in pain management by selecting and delivering nonpharmacological interventions tailored to patients’ needs, if the family members feel comfortable with this role. More-rigorous research is required to describe the role of family members in patients’ pain assessment and management. Advancing knowledge in this field could improve patients’ and family members’ experiences with pain assessment and management in the intensive care unit.

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Ethical considerations of age-based allocation of intensive care treatments amid the COVID-19 outbreak

University of Western Ontario Medical Journal ◽

10.5206/uwomj.v89is1.10637 ◽

2021 ◽

Author(s):

David Zheng

Keyword(s):

Quality Of Life ◽

Intensive Care ◽

Later Life ◽

The Elderly ◽

Therapeutic Success ◽

Ethical Frameworks ◽

Life Years ◽

Allocation Criteria ◽

Normal Life Span

With the COVID-19 outbreak severely overwhelming healthcare systems worldwide, countries must decide on allocation criteria for scarce intensive care resources such as ventilators, leaving some without life-saving treatment. Groups such as the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) have suggested using age as allocation criteria, prioritizing the young over the elderly. In judging the morality of such criteria, different ethical frameworks must be applied. From a utilitarian perspective, age-based allocation ensures “the greatest good” – that those with greater “therapeutic success” or “quality-of-life” get access to intensive treatment. However, age poorly predicts prognostic outcomes, and quality-of-life measures are inherently value-laden. From a contractarian view, a morally justifiable action is one made in ignorance of one’s own stake in the outcome. In this lens, age-based allocation is justified since it maximizes the most life-years for the most people. However, it relies on the same flawed assumptions as utilitarianism. From a prioritarian view, age-based allocation ensures that the rights of the young to live out a “normal life span” are respected. However, such judgements ignore the positive experiences of later life and cannot be made on a patient’s behalf. Through a deontological lens, age-based allocation is discriminatory as it views elderly people as means to an end rather than individual agents. Ultimately, the rationing criteria a society uses reflects its values, with age limitations implicitly devaluating the elderly. Therefore, allocation guidelines should deemphasize age in favor of more predictive and less discriminatory measures like multimorbidity or frailty.

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Intensive care nurses’ involvement in the end-of-life process – perspectives of relatives

Nursing Ethics ◽

10.1177/0969733011433925 ◽

2012 ◽

Vol 19 (5) ◽

pp. 666-676 ◽

Cited By ~ 32

Author(s):

Ranveig Lind ◽

Geir F Lorem ◽

Per Nortvedt ◽

Olav Hevrøy

Keyword(s):

Decision Making ◽

Intensive Care ◽

End Of Life ◽

Decision Making Process ◽

Intensive Care Nurses ◽

Decision Making Processes ◽

Nurses Role ◽

End Of Life Decision ◽

Life Decision

In this article, we report findings from a qualitative study that explored how the relatives of intensive care unit patients experienced the nurses’ role and relationship with them in the end-of-life decision-making processes. In all, 27 relatives of 21 deceased patients were interviewed about their experiences in this challenging ethical issue. The findings reveal that despite bedside experiences of care, compassion and comfort, the nurses were perceived as vague and evasive in their communication, and the relatives missed a long-term perspective in the dialogue. Few experienced that nurses participated in meetings with doctors and relatives. The ethical consequences imply increased loneliness and uncertainty, and the experience that the relatives themselves have the responsibility of obtaining information and understanding their role in the decision-making process. The relatives therefore felt that the nurses could have been more involved in the process.

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