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  • 1.
    Tingsvik, Catarina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Bexell, Eva
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Andersson, Ann-Christine
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Henricson, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Meeting the challenge: ICU-nurses' experiences of lightly sedated patients2013In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 26, no 3, p. 124-129Article in journal (Refereed)
    Abstract [en]

    Background

    Sedation of intensive care patients is necessary for comfort and to implement appropriate treatment. The trend of sedation has gone from deep to light sedation. The topic is of interest to intensive care nursing because patients are generally more awake, which requires a different clinical approach than caring for deeply sedated patients.

    Purpose

    The aim of this study was to describe intensive care unit (ICU) nurses experiences of caring for patients who are lightly sedated during mechanical ventilation.

    Methods

    A qualitative approach was used. Semi-structured interviews with nine intensive care nurses were conducted. The interview texts were subjected to qualitative content analysis, resulting in the formulation of one main category and six sub-categories.

    Findings

    The nurses’ experience of lightly sedated patients was described as a challenge requiring knowledge and experience. The ability to communicate with the lightly sedated patient is perceived as important for ICU nurses. Individualised nursing care respecting the patients’ integrity, involvement and participation are goals in intensive care, but might be easier to achieve when the patients are lightly sedated.

    Conclusion

    The results reinforce the importance of communication in nursing care. It is difficult however to create an inter-personal relationship, encourage patient involvement, and maintain communication with deeply sedated patients. When patients are lightly sedated, the nurses are able to communicate, establish a relationship and provide individualised care. This is a challenge requiring expertise and patience from the nurses. Accomplishing this increases the nurses satisfaction with their care. The positive outcome for the patients is that their experience of their stay in the ICU might become less traumatic.

  • 2.
    Tingsvik, Catarine
    et al.
    Jönköping University, School of Health and Welfare. Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Hammarskjöld, Fredrik
    Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Henricson, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Patients' lived experience of intensive care when being on mechanical ventilation during the weaning process: A hermeneutic phenomenological study.2018In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 47, p. 46-53Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The medical and nursing care of the patient on mechanical ventilation has developed and proceeds in terms of ventilator functions, sedation strategies and patient participation. New data are needed to explore the weaning process from the patients' perspective. Therefore, the aim of this study was to explore the meaning of being a patient on mechanical ventilation during the weaning process in the intensive care unit.

    METHODS: This study used van Manen's hermeneutic phenomenological approach. Interviews were conducted, including twenty former intensive care patients from three different hospitals in Sweden.

    FINDINGS: Five themes emerged including thirteen related themes; Maintaining human dignity, Accepting the situation, Enduring the difficulties, Inadequate interaction and A sense of unreality. The experiences differed from each other and varied over time, and the same patient expressed both pleasant and unpleasant experiences. Weaning was not a separate experience but intertwined with that of being on mechanical ventilation in the intensive care unit.

    CONCLUSIONS: The patient's experiences differ and vary over time, with the same patient expressing various experiences. The favourable experiences were more clearly described, compared to previous research, this might depend on factors related to communication, participation and proximity to healthcare professionals and next-of-kin.

  • 3.
    Tingsvik, Catarine
    et al.
    Operations- and Intensive care Units, Ryhov County Hospital, Jönköping, Sweden.
    Johansson, Karin
    Operations- and Intensive care Units, Ryhov County Hospital, Jönköping, Sweden.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Weaning from mechanical ventilation: factors that influence intensive care nurses' decision-making2015In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, no 1, p. 16-24Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of the study was to describe the factors that influence intensive care nurses' decision-making when weaning patients from mechanical ventilation.

    Background

    Patients with failing vital function may require respiratory support. Weaning from mechanical ventilation is a process in which the intensive care nurse participates in both planning and implementation.

    Design and method

    A qualitative approach was used. The data were collected by means of semi-structured interviews with 22 intensive care nurses. The interviews were transcribed and analysed using qualitative content analysis.

    Findings

    One theme emerged: ‘A complex nursing situation where the patient receives attention and which is influenced by the current care culture’. There was consensus that the overall assessment of the patient made by the intensive care nurse was the main factor that influenced the decision-making process. This assessment was a continuous process consisting of three factors: the patient's perspective as well as her/his physical and mental state. On the other hand, there was a lack of consensus about what other factors influenced the decision-making process. These factors included the care culture constituted by the characteristics of the team, the intensive care nurses' professional skills, personalities and ability to be present.

    Conclusions and relevance to clinical practice

    The individual overall assessment of the patient enabled nursing care from a holistic perspective. Furthermore, the weaning process can be more effective and potential suffering reduced by creating awareness of the care culture's impact on the decision-making process.

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