scholarly journals Communicating with Mechanically Ventilated Patients Who Are Awake. A Qualitative Study on the Experience of Critical Care Nurses in Cyprus during the COVID-19 Pandemic.

2021 ◽  
Author(s):  
Maria Kyranou ◽  
Charikleia Cheta ◽  
Eliada Pampoulou
Keyword(s):  
Intensive Care ◽  
Structured Interviews ◽  
Design Data ◽  
Mechanically Ventilated ◽  
Intensive Care Nurses ◽  
Number Of Patients ◽  
Research Questions ◽  
Alternative And Augmentative Communication ◽  
Communication Needs ◽  
Light Sedation

Abstract Background: Modern protocols for light sedation in combination with the increased turnover of COVID-19 infected patients hospitalized in Intensive Care Units (ICUs) have increased the number of patients who are mechanically ventilated and awake. Nurses require specific skills to care for this vulnerable group of patients. At the same time, nurses report feeling inadequate and frustrated when they attempt to establish communication with mechanically ventilated, conscious patients. Methods: The purpose of this study was to explore nurses’ experiences taking care of conscious, intubated patients in the intensive care unit. The research questions aimed to identify i. the strategies that nurses use for communicating with patients, and ii. the barriers in communication between nurses and patients. This study employed a qualitative design. Data were collected using semi-structured interviews with 14 intensive care nurses working at ICUs in four different hospitals of Cyprus. The data were analyzed by applying thematic analysis.Results: We identified several strategies of unaided (movements -lips, hands, legs- facial expressions, gestures, touching) and aided forms of communication (pen and paper, boards, tablets, mobiles) used by nurses to communicate with patients. Additionally, barriers in communication were reported by participating nurses mainly pertaining to patients’, nurses’ characteristics and the ICU environment. The health protocols imposed by the pandemic added more barriers in the communication between nurses and patients mostly related to the use of protective health equipment.Conclusions: The results of this study, combined with those of others in different countries, point to the difficulties nurses face when trying to communicate with conscious patients during mechanical ventilation. It appears that the complex communication needs of this group of patients are not being met mainly due to the lack of nurses’ training and of appropriate equipment to facilitate alternative and augmentative communication. Our study is amongst the first to add that the protective health protocols due to the pandemic imposed further communication barriers. Undoubtedly, the recognition of such an important issue creates an urgent need to educate nurses in alternative ways of communication with mechanically ventilated, conscious patients during their ICU stay.

scholarly journals The Experiences of Intensive Care Nurses in Advocacy of COVID-19 Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110565
Author(s):  
Bahman Aghaie ◽  
Reza Norouzadeh ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
Reza Negarandeh ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Qualitative Content Analysis ◽  
Active Role ◽  
Structured Interviews ◽  
Intensive Care Nurses ◽  
Clinical Nurses ◽  
Number Of Patients ◽  
Patient Advocates ◽  
Life Threatening

The lack of face-to-face interactions with families, the increase in the number of patients admitted to the ICU, nursing staff shortages, and inadequate personal protective equipment has created many challenges for nurses in advocacy of the COVID-19 patient with life-threatening conditions. This study aimed to explore the experiences of intensive care nurses in the advocacy of COVID-19 patients. This study was performed using a qualitative content analysis method with Graneheim and Lundman approach, Iran, 2020. Data were collected through semi-structured interviews with eighteen clinical nurses from the intensive care units of three hospitals. Themes extracted from the nurses’ statements were promoting patient safety (informing physicians about the complications and consequences of treatment, preventing medical errors, protecting patients from threats), respecting the patients’ values (providing comfort at the end of life, providing a comfortable environment, commitment to confidentiality, cultural observance, respect for individualism, fair care), and informing (clarifying clinical conditions, describing available services, and being the patients’ voice). ICU nurses in health crises such as COVID-19 as patient advocates should promote patient safety, respect patients’ values, and inform them. The results of this study could help enhance the active role of intensive care nurses in the advocacy of COVID-19 patients.

Intensive care nurses’ experiences of Covid-19 care: A practical and ethical challenge – a qualitative descriptive design

2021 ◽  
pp. 205715852110627
Author(s):  
Anna-Lena Stenlund ◽  
Gunilla Strandberg
Keyword(s):  
Intensive Care ◽  
Qualitative Content Analysis ◽  
Treatment Strategies ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Structured Interviews ◽  
Intensive Care Nurses ◽  
Qualitative Descriptive ◽  
Heavy Burden ◽  
New Treatment

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

Identifying Performance Obstacles among Intensive Care Nurses

2005 ◽  
Vol 49 (11) ◽  
pp. 1019-1023 ◽  
Author(s):  
Ayse P. Gurses ◽  
Pascale Carayon
Keyword(s):  
Intensive Care ◽  
Work Organization ◽  
Cross Sectional Study ◽  
Physical Work ◽  
Nursing Workload ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Quality Of Working Life ◽  
Intensive Care Nurses ◽  
Performance Obstacles

In this paper, we compare findings of two studies aimed at identifying performance obstacles among intensive care nurses. The first study is a qualitative study where data was collected from 15 intensive care nurses using individual, semi-structured interviews. The second study is a cross-sectional study conducted among 298 nurses from 17 intensive care units (ICUs) of seven hospitals using a questionnaire survey. Based on the results of these two studies, the most commonly experienced performance obstacles among ICU nurses include inadequate help from others, tools and equipment, ineffective inter-provider communication, materials and supplies, poor physical work environment, and family issues. The results of these two studies have implications regarding efforts aimed at redesigning ICU work organization in order to reduce nursing workload and improve quality of working life and quality and safety of care.

Practised sedation in mechanically ventilated patients: A survey of nurses’ perceptions

2020 ◽  
Vol 40 (2) ◽  
pp. 105-112
Author(s):  
Vivian Nystrøm ◽  
Brita Fosser Olsen ◽  
Idunn Brekke
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Assessment Tool ◽  
Scoring Systems ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Nurses Perceptions ◽  
Light Sedation

Recent clinical practice guidelines recommend analgosedation in intensive care unit patients, where the patients' pain first is relieved, followed by sedatives only on indication. The aims of the present study was to examine sedation practice today, to evaluate the degree to which there is a difference in sedation practice between units, and to investigate the associations between nurses' demographic characteristics and their perception of sedation practice. A cross sectional survey was conducted to the nurses in three intensive care units in Norway. The results indicated that light sedation was implemented in the three intensive care unit studied. Continuous infusion of propofol and dexmedetomidine were used most frequently, and continuous infusion of midazolam was used occasionally. However, the sedation practices varied significantly between the units. Subjective scoring systems, physician's prescriptions, and prescription follow-up were reported to be most frequently used as guidelines and directives, and Richmond Agitation–Sedation Scale was reported to be the most frequently used sedation assessment tool.

scholarly journals Selected methods of measuring workload among intensive care nursing staff

2012 ◽  
Vol 25 (3) ◽  
Author(s):  
Katarzyna Kwiecień ◽  
Maria Wujtewicz ◽  
Wioletta Mędrzycka-Dąbrowska
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Staff ◽  
Working Environment ◽  
Average Life Expectancy ◽  
Intensive Care Nurses ◽  
Hospital Facility ◽  
Number Of Patients ◽  
Measurement Tools ◽  
Intensive Care Nursing

AbstractIntensive care units and well-qualified medical staff are indispensable for the proper functioning of every hospital facility. Due to demographic changes and technological progress having extended the average life expectancy, the number of patients hospitalized in intensive care units increases every year [9,10]. Global shortages of nursing staff (including changes in their age structure) have triggered a debate on the working environment and workload the nursing staff are exposed to while performing their duties. This paper provides a critical review of selected methods for the measurement of the workload of intensive care nurses and points out their practical uses. The paper reviews Polish and foreign literature on workload and the measurement tools used to evaluate workload indicators.

scholarly journals The meaning of nursing 200 years after Nightingale - perceptions of professional practice in the intensivist context

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Emanuelle Caires Dias Araújo Nunes ◽  
Regina Szylit
Keyword(s):  
Intensive Care ◽  
Professional Identity ◽  
Professional Practice ◽  
Methodological Framework ◽  
Structured Interviews ◽  
Interpretive Interactionism ◽  
Intensive Care Nurses ◽  
Self Image ◽  
Professional Self ◽  
One Year

ABSTRACT Objectives: to know the meaning of contemporary nursing from the experience of intensive care nurses. Methods: qualitative research based on the theoretical framework of Symbolic Interactionism and the methodological framework of Interpretive Interactionism. The setting was a general hospital in Bahia, being carried out with 12 nurses working in intensive care for at least one year, through semi-structured interviews and drawing-text-theme technique, whose data were organized according to Miles and Huberman and analyzed upon the referential. Results: the sense of being a nurse was evidenced; a being for care, resulting from the experience in intensive care, capable of promoting the development of professional self-image, by causing, in nurses, other skills - besides the scientific ones, such as empathy, creativity, spirituality and compassion. Final Considerations: the sense of being a nurse, currently, expresses developments inherited from the Nightingalean proposal, but transcends the technical-managerial emphasis of this to a humanistic care perspective converging with our contemporary professional identity: a being for care.

Intensive Care Nurses’ Experiences Related to Dying Patients: A Qualitative Study

2021 ◽  
pp. 003022282110518
Author(s):  
Selin Keskin Kızıltepe ◽  
Zeliha Koç
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Thematic Analysis ◽  
Structured Interviews ◽  
Coping Methods ◽  
Intensive Care Nurses ◽  
Qualitative Thematic Analysis ◽  
Dying Patients ◽  
First Time ◽  
Purposive Sample

Objective: To describe intensive care nurses’ experiences of caring for dying patients. Method: This study was carried out between July 15, 2019, and September 15, 2019, in a university hospital’s intensive care unit. We conducted in-depth semi-structured interviews with a purposive sample of 14 intensive care nurses to describe their experiences related to patient deaths. Qualitative thematic analysis was used to identify, analyse and report the identified themes. Results: Four themes were identified: (I) Emotions experienced the first time their patient passed away; (II) feelings and thoughts on impact of death; (III) difficulties encountered when providing care and (IV) coping methods with this situation. Conclusion: Despite the passage of time, nurses are unable to forget their death experiences when they first encountered. They oftentimes use ineffective methods of coping and were negatively affected physically and emotionally.

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