Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Intensive Crit Care Nurs · Aug 2008
End of life decisions: nurses perceptions, feelings and experiences.
Decisions to withdraw treatment are made on a regular basis in intensive care units. While nurses play a central role in patient care, previous studies have found that they are not always involved in withdrawal decisions. ⋯ Nurses make an important contribution to end of life decisions and care. Guidelines recommend they have input into withdrawal decisions, therefore it is imperative that nurses are supported in this role and their responsibilities to continue to provide care during withdrawal.
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Intensive Crit Care Nurs · Aug 2008
Re-visiting the ICU Experiences of follow-up visits to an ICU after discharge: a qualitative study.
The aim of this study is to describe how people who have been critically ill, and their close relatives experience a post-discharge, follow-up visit to the intensive care unit (ICU) that provided the care. There is a lack of studies from such a standpoint. The study design is qualitative. ⋯ People who had been critically ill and close relatives felt that returning together was valuable. Meeting the staff, with whom participants felt they had developed a relationship, made it possible for them to express their gratitude for the treatment and nursing care received, and to suggest improvements. The interviews revealed that the follow-up visit was seen as an important way of learning what had happened and why during the period of critical illness.
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Intensive Crit Care Nurs · Aug 2008
Patient's self-determination in intensive care-from an action- and confirmation theoretical perspective. The intensive care nurse view.
When becoming an intensive care patient life changes dramatically. In order to save life, different actions are performed by the caregivers and the patient's ability to exercise self-determination is non-existent. After the acute phase the patient is more awake and the possibilities for self-determination change. ⋯ It was more common that the ICN acted to strengthen the patient's self-determination in nursing care, but there were no specific nursing goals for patient's self-determination. The most common actions for supporting self-determination were supplying the patient with information and engaging the patient in making a day plan. The nursing implications are that the ICN's view of human being as an acting subject is important for the ICN's awareness to recognise the patient's own personal resources to handle the critically ill situation and that the ICN's competence to manifest qualified nursing is necessary for strengthening patient's self-determination.
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Intensive Crit Care Nurs · Jun 2008
The current role of the consultant nurse in critical care: consolidation or consternation?
The consultant nurse role emerged into the National Health Service in 1999, presented against a backdrop of practice and service modernisation. As with any innovative development, the role was originally subject to much scrutiny with regards to impact and outcome. However, six years after its initial introduction, continued focus and support on this role is less visible. This paper presents a follow-up review of the role and function of consultant nurses in critical care, using an original survey tool that underpinned Dawson and McEwen's work in 2003. From the results of the current study, key changes in role are identified and areas for further development are highlighted. ⋯ This paper has identified ongoing strengths and limited developments of the consultant nurse in critical care role. Whilst it is clear that core role functions have not dramatically changed, there are demonstrable shifts towards more strategic engagement within Acute Care Trusts. This has brought about concerns regarding overall management of the role, and sustainability of postholders to balance this ever-increasing portfolio. It is also clear that there has been little new investment in this key leadership role, and this raises concerns as to the perceived contribution that experienced clinical nurses bring to a currently financially and operationally driven health service agenda.
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Intensive Crit Care Nurs · Jun 2008
Nursing Activities Score in the intensive care unit: analysis of the related factors.
High costs of intensive care as well as quality of care and patient safety demand measurement of nursing workload in order to determine nursing staff requirements. It is also important to be aware of the factors related to high patient care demands in order to help forecast staff requirements in intensive care units (ICUs). ⋯ This study shows that the highest NAS scores were associated with increased mortality, LOS, severity of the patient illness (SAPS II), and particularly to TISS-28 in the ICU.