Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Dec 1998
Patients' experience of being critically ill or severely injured and cared for in an intensive care unit in relation to the ICU syndrome. Part I.
The intensive care unit (ICU) syndrome is regarded principally as a complex interaction of several contributory factors, all of which can be seen as partly responsible for the development of the syndrome. The purpose of this study was to describe and give a deeper insight into patients' experiences and memory recall, both during and after their stay in the ICU. Nineteen patients who had been respirator treated (ventilated), and had stayed at least 36 hours in the ICU, were interviewed about one week after discharge, and again 4-8 weeks after their discharge from the ICU. ⋯ The caring relationship was perceived as providing an important degree of security and comfort. Nursing care actions can therefore be seen as vital factors in patients overcoming the accompanying horrific experiences to which they can be subjected. This state of chaotic feeling, and how it is combated and treated, appear to be one critical factor in the development and progression of the ICU syndrome.
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Intensive Crit Care Nurs · Dec 1998
Intensive therapy unit nurses' beliefs about and attitudes towards visiting in three district general hospitals.
The beliefs and attitudes of intensive therapy unit (ITU) nurses regarding visiting of critically ill patients are believed to be influenced by many factors, such as the need to promote patient rest, the need to prevent physiological and psychological complications to the patient and the need to improve communications between all parties. In this paper, some of the factors are examined with attempts to establish whether there are any correlations between such factors as the length of time individual nurses have worked in the area, their professional qualifications, their job satisfaction and their perceptions of visiting and visitors. ⋯ The conclusion was that nurses still have many negative beliefs and attitudes towards visiting and visitors. ITU nurses in this study generally appeared to consider the effects of visiting pessimistically, suggesting they believe they are doing so in the best interests of the patients, themselves and the ITU itself.
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Intensive Crit Care Nurs · Dec 1998
Analgesics in the management of chronic pain. Part four: Step 3 oral analgesic drug therapy.
Reluctance to commence treatment with a Step 3 drug on the Analgesic Stepladder is a common reason for failure to manage chronic severe pain in many situations. The fourth article in the series reviews the potent opioid analgesics for oral use and in doing so addresses the various prejudices that surface when such therapy is denied.
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Intensive Crit Care Nurs · Dec 1998
ReviewInhaled nitric oxide: are the safety issues being addressed?
Interest in the therapeutic uses of Nitric Oxide (NO) has gathered pace over the last decade. It is no exaggeration for the UK Guidelines on the Use of Inhaled Nitric Oxide (Cuthbertson et al. 1997) to say that 'the use of inhaled nitric oxide in the UK has become commonplace'. ⋯ It also holds promise in the treatment of acute respiratory distress syndrome (ARDS). It is in this context that this discussion will seek to raise fundamental questions about the health and safety aspects of this substance.
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Intensive Crit Care Nurs · Dec 1998
ReviewShould relatives of patients with cardiac arrest be invited to be present during cardiopulmonary resuscitation?
Witnessing the attempted resuscitation of a loved one is likely to be traumatic and distressing. However, because the majority of patients requiring cardiopulmonary resuscitation (CPR) die, this raises the question, within the hospital environment, of whether relatives should be invited to be present. ⋯ With particular reference to the intensive care unit (ICU), the discussion in this paper includes not only family presence during CPR from the perspective of the patient, relatives and healthcare professionals, but also the potential legal implications. Recommendations for nursing practice are offered.