Some of us are actually aware, you know - EfCCNA 22/Session 22.8... · “Some of us are actually aware, you know ... C. N. & Varney, K. ... Fort Worth: Harcourt Brace College

Lotte Abildgren Schultz CCRN, Msc Nursing

“Some of us are actually aware, you know”A study of psychosocial nursing, in the encounter between the awake intubated patient and the critical care nurse

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Lotte Abildgren Schultz

Supervisor:Lise Hounsgaard, Associate Professor, Research Unit in Nursing, University of Southern Denmark


Aim

… to develop knowledge of the encounter between the intubated critical care patient and the nurse

"being a living dead"

"being a garbage can for pipes and hoses"

"loneliness"


Flow chart

Preparations

8 h.Descriptive observation

24 h.Focused

observation

12 h.Selected

observation

Structural analysis

Critical interpretation

Interactio

nal N

ursin

g P

ractice -C

ritical herm

eneu

tics–

Eth

nog

raph

y

New recognition/realisation

Naivereading

Critical Care Patient’s lifeworldPrefiguration - preconception

Data Collection Configuration

Analysis & interpretation Refiguration

Dialogue with nursing

practice


Data collection

Three phases of participant observation:

A descriptive phase (8 h.)

A focused phase (24 h.)

A selective phase (12 h.)

A total of 44 hours of participant observation


Interpretation

A phenomenological hermeneutic approach

Ricoeur inspired interpretation theory

To obtain a deeper understanding of being-in-world -through tales of the participants life world

Text interpretation

A continuous dialectical movement between units and wholes - between description and understanding

To understand a possible way of ”being in the world” in which critical reflection can increase awareness of variations in the phenomenon


Findings

The three themes emerged:

Contact Information Interaction

Contact in the encounter emerged as a dominant finding


Theme I: Contact

Contact was defined as:

Nurse's ability to establish and maintain contact in the encounter with the awake intubated patient, in order to ensure an experience of intimacy and caring in the patient-nurse relation.


Theme II: Information

Information was defined as:

Nurse's practice in the encounter with the awake intubated patient, in terms of providing information, psychosocial care, and nursing interventions.


Theme III: Interaction

Interaction was defined as:

Nurse's ability to communicate, collaborate, involve, create and maintain a patient-nurse relation with the awake intubated patient in the encounter - Interactions in critical nursing care are depending on the patient's resources


Concluding Suggestions

Divergence between the Critical care nurse's intention and action in the encounter

Patient's psychosocial needs are being overlooked, despite the fact that the nurse consider the basis of care as good and professional

Direct contact in the encounter increases:• The critical care nurses ability to read, assess and

interpret the patients psychosocial needs• The critical care patients possibility to receive

psychosocial care


QUESTIONS ?

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Discussion

How many of your patients are sedated when intubated? How many are awake?

Do nurses do, what they think they do, in the Critical care nursing?

How do you, in your daily critical care practice, meet the critical care patients psychosocial needs?


Thank you for your attention

Contact info:

Lotte Abildgren SchultzProject CoordinatorCCRN, Msc NursingAnaesthesiology & Critical Care Unit Odense University Hospital, Denmark

[email protected]

mailto:[email protected]


References

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References

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References

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Documents

Some of us are actually aware, you know - EfCCNA 22/Session 22.8... · “Some of us are actually aware, you know ... C. N. & Varney, K. ... Fort Worth: Harcourt Brace College