• Eva Laerkner, Ingrid Egerod, and Helle Ploug Hansen.
• Faculty of Health, Department of Public Health, University of Southern Denmark, Denmark; Dept. of Anesthesiology and Intensive Care, Odense University Hospital, Denmark. Electronic address: elaerkner@health.sdu.dk.
• Intensive Crit Care Nurs. 2015 Aug 1; 31 (4): 196-204.

ObjectiveThe objective was to explore nurses' experiences of caring for non-sedated, critically ill patients requiring mechanical ventilation.Design And SettingThe study had a qualitative explorative design and was based on 13 months of fieldwork in two intensive care units in Denmark where a protocol of no sedation is implemented. Data were generated during participant observation in practice and by interviews with 16 nurses. Data were analysed using thematic interpretive description.FindingsAn overall theme emerged: "Demanding, yet rewarding". The demanding aspects of caring for more awake intubated patients included unpredictability, ambiguous needs and complex actions, while the rewarding aspects included personal interaction. Three sub-themes were identified: (i) caring for and with the patient, (ii) negotiating relational and instrumental care and (iii) managing physical and emotional closeness.ConclusionDespite the complexity of care, nurses preferred to care for more awake rather than sedated patients and appreciated caring for just one patient at a time. The importance of close collaboration between nurses and doctors to ensure patient comfort during mechanical ventilation was valued. Caring for more awake non-sedated patients required the nurses to act at the interface between ambiguous possibilities and needs, which was perceived as both demanding and rewarding.Copyright © 2015 Elsevier Ltd. All rights reserved.

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