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Caring for non-sedated mechanically ventilated patients in ICU : A qualitative study comparing perspectives of expert and competent nurses

Mortensen, Camilla Bekker ; Kjær, Maj-Brit Nørregaard and Egerod, Ingrid (2019) In Intensive and Critical Care Nursing 52. p.35-41
Abstract

BACKGROUND: Sedation practice has evolved from deep to lighter or no sedation in mechanically ventilated patients in the intensive care unit (ICU). The care of conscious intubated patients constitutes a change in the nurse-patient interaction.

OBJECTIVE: We aimed to compare the perspectives of expert and competent nurses regarding their interaction with non-sedated mechanically ventilated ICU patients.

METHOD: The study had a qualitative comparative design applying semi-structured dyadic interviews. We interviewed five pairs of expert and competent ICU nurses with respectively >8 and 2-3 years of ICU experience and performed qualitative content analysis to explore the two perspectives.

FINDINGS: We identified four... (More)

BACKGROUND: Sedation practice has evolved from deep to lighter or no sedation in mechanically ventilated patients in the intensive care unit (ICU). The care of conscious intubated patients constitutes a change in the nurse-patient interaction.

OBJECTIVE: We aimed to compare the perspectives of expert and competent nurses regarding their interaction with non-sedated mechanically ventilated ICU patients.

METHOD: The study had a qualitative comparative design applying semi-structured dyadic interviews. We interviewed five pairs of expert and competent ICU nurses with respectively >8 and 2-3 years of ICU experience and performed qualitative content analysis to explore the two perspectives.

FINDINGS: We identified four main categories illustrating complexities of nurse-patient interaction: Managing frustration, Attempting dialogue, Negotiating reality and Alleviating discomfort. Expert nurses expressed more frustration and ambivalence towards light sedation than competent nurses, who took awake patients for granted. All nurses experienced communication issues, demanding patients, and inability to provide adequate patient comfort.

CONCLUSION: Our study added to the knowledge of nurse-patient interaction by describing issues of frustration, ambivalence and insecurity in a contemporary context of minimal sedation. Expert nurses were mere concerned by awake patients than competent nurses. Lighter sedation in ICU requires better staffing and improved communication tools.

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author
; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Denmark, Female, Humans, Intensive Care Units/organization & administration, Male, Middle Aged, Nurse-Patient Relations, Nurses/psychology, Nursing Care/methods, Qualitative Research, Respiration, Artificial/adverse effects
in
Intensive and Critical Care Nursing
volume
52
pages
35 - 41
publisher
Elsevier
external identifiers
  • scopus:85060976937
  • pmid:30737100
ISSN
1532-4036
DOI
10.1016/j.iccn.2019.01.004
language
English
LU publication?
no
id
4763b0c9-6175-4207-b5b9-f0798caac0cd
date added to LUP
2021-09-09 10:30:08
date last changed
2024-04-06 07:06:37
@article{4763b0c9-6175-4207-b5b9-f0798caac0cd,
  abstract     = {{<p>BACKGROUND: Sedation practice has evolved from deep to lighter or no sedation in mechanically ventilated patients in the intensive care unit (ICU). The care of conscious intubated patients constitutes a change in the nurse-patient interaction.</p><p>OBJECTIVE: We aimed to compare the perspectives of expert and competent nurses regarding their interaction with non-sedated mechanically ventilated ICU patients.</p><p>METHOD: The study had a qualitative comparative design applying semi-structured dyadic interviews. We interviewed five pairs of expert and competent ICU nurses with respectively &gt;8 and 2-3 years of ICU experience and performed qualitative content analysis to explore the two perspectives.</p><p>FINDINGS: We identified four main categories illustrating complexities of nurse-patient interaction: Managing frustration, Attempting dialogue, Negotiating reality and Alleviating discomfort. Expert nurses expressed more frustration and ambivalence towards light sedation than competent nurses, who took awake patients for granted. All nurses experienced communication issues, demanding patients, and inability to provide adequate patient comfort.</p><p>CONCLUSION: Our study added to the knowledge of nurse-patient interaction by describing issues of frustration, ambivalence and insecurity in a contemporary context of minimal sedation. Expert nurses were mere concerned by awake patients than competent nurses. Lighter sedation in ICU requires better staffing and improved communication tools.</p>}},
  author       = {{Mortensen, Camilla Bekker and Kjær, Maj-Brit Nørregaard and Egerod, Ingrid}},
  issn         = {{1532-4036}},
  keywords     = {{Adult; Denmark; Female; Humans; Intensive Care Units/organization & administration; Male; Middle Aged; Nurse-Patient Relations; Nurses/psychology; Nursing Care/methods; Qualitative Research; Respiration, Artificial/adverse effects}},
  language     = {{eng}},
  pages        = {{35--41}},
  publisher    = {{Elsevier}},
  series       = {{Intensive and Critical Care Nursing}},
  title        = {{Caring for non-sedated mechanically ventilated patients in ICU : A qualitative study comparing perspectives of expert and competent nurses}},
  url          = {{http://dx.doi.org/10.1016/j.iccn.2019.01.004}},
  doi          = {{10.1016/j.iccn.2019.01.004}},
  volume       = {{52}},
  year         = {{2019}},
}