Journal of clinical nursing
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It has been estimated that between 12.5% and 38% of conscious patients admitted to critical care settings experience Intensive Care Unit psychosis, a condition which seems to resolve upon transfer to the ward. This phenomenon was traditionally recognized when the patient outwardly exhibited abnormal behaviours and signs in the form of confusion, delirium, anxiety, depression, delusions and audiovisual hallucinations, yet it has been argued that due to the illness of the patient and their suppressed ability to communicate, such overt displays of unusual behaviour are the tip of the iceberg. In recognizing this phenomenon, it is felt that a relationship exists between Intensive Care Unit Psychosis, the therapeutic nurse-patient relationship, and the environment in which nurses' interactions with their clients occur. This paper will explore the interaction between these three elements while considering the implications for contemporary nursing practice.
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It has been suggested that there are three major disasters each week world-wide of such a magnitude that local services are overwhelmed. Nurses are frequently involved in assisting in emergencies. ⋯ Strategies aimed at reducing this damage, such as debriefing, are poorly evaluated but often carried out as an act of faith. This is an area that needs to be addressed as nurses will increasingly be involved in this work.
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As more intensive care units (ICU) are adopting the policy of unrestricted family visiting, families are playing an increasing role in the unit. This role may be restricted to being involved in discussions and decisions related to the patient or may entail a caregiving role. ⋯ This model was developed around the core variable of 'looking out for the patient-looking out for ourselves'. The perspectives of ICU nurses, families and ICU patients in the process of looking out for the patient while they look out for themselves are discussed, as well as nurses maintaining the position of power and families remaining on guard and enduring the ICU experience.