Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Mar 1993
The communication process with ventilator patients in the ICU as perceived by the nursing staff.
Intensive care unit (ICU) nurses (n = 27) were interviewed about their experiences and opinions of the communication process with ventilator treated patients. Nurses with limited ICU experience considered the initial contact with a new critically ill ventilated patient more frustrating than experienced nurses. The nurses thought that the content of the communication commonly requested by a patient was dominated by factors related to the clinical condition, prognosis and reassurance that the situation was under control. ⋯ For nurses with an ICU experience of more than 5 years stress was more commonly evoked by the presence of worried and anxious spouses/relatives, and by the feeling that something was wrong with the patient but they were unable to identify the problem. Failure to understand a ventilated patient could induce feelings of incompetence, stress and sometimes even despair. The present small scale study shows that there are many factors, in addition to ICU experience, that may influence the ability of an ICU nurse to establish and maintain a well functioning communication with ventilated patients and the likelihood of doing so.
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The last decade has witnessed phenomenal developments available for the critically ill, especially for the patient in shock. These advances have implications for all members of the health care team as new roles and functions are constantly emerging. As the therapies practised today continue to expand, this demands a greater level of expertise for all those involved in critical care. ⋯ From a theoretical knowledge base on shock with a review of patient goals of therapy, the discussion is developed with reference to the clinical application of the haemodynamic profile. The parameters, their calculation and meaning for patient treatment is examined using clinical exemplars. The paper concludes by re-affirming the themes drawn on throughout the paper of holistic care, independent and interdependent team relationships and accountable professional practice.