Some of us are actually aware, you know

Transcription

1 Some of us are actually aware, you know Kilde: A study of psychosocial nursing, in the encounter between the awake intubated patient and the critical care nurse Supervisor: Lise Hounsgaard, Associate Professor, Research Unit in Nursing, University of Southern Denmark

2 Aim to develop knowledge of the encounter between the intubated critical care patient and the nurse "loneliness" "being a living dead" "being a garbage can for pipes and hoses"

3 Interactional Nursing Practice - Critical hermeneutics Ethnography Flow chart Preparations 8 h. Descriptive observation Critical Care Patient s lifeworld Prefiguration - preconception 24 h. Focused observation Data Collection Configuration 12 h. Selected observation Naive reading Structural analysis Analysis & interpretation Refiguration Critical interpretation New recognition/realisation Dialogue with nursing practice

4 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

5 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

6 Findings The three themes emerged: Contact Information Interaction Contact in the encounter emerged as a dominant finding

7 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.

8 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.

9 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

10 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

11 Kilde: Atul Gawande (10, 2007) The Newyorker QUESTIONS?

12 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?

13 Thank you for your attention Contact info: Project Coordinator Anaesthesiology & Critical Care Unit Odense University Hospital, Denmark

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