Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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This study was designed to examine, describe and elucidate patients' experiences of the presence and visits of the nearest and their participation in the care process during their stay in the ICU. Five patients, three men and two women, were interviewed for about one hour each. A hermeneutic approach was used when the texts from the interviews were interpreted and analysed. ⋯ The threat can, however, be neutralized by the nearests' presence and visits. These represent fellowship, togetherness and participation and thus can help to maintain the patient's identity and individuality. By experiencing this, patients as individuals may be able to affirm themselves and their 'courage to be' will be given strength and support.
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As nurses, we are knowledgeable about nursing and able, immediately and intuitively, to identify the needs and demands of a given situation. Experienced nurses practise intuitively by virtue of having developed, through critical thought, a deeply grounded knowledge base that can be applied in daily practice. Each gains knowledge about nursing practice in such a way that every clinical experience becomes a lesson which informs the next experience. ⋯ When we as nurses report our intuitions, subjective feelings are often at odds with the objective signs and symptoms. Nurses have made great strides in recognizing, analysing and teaching concepts related to logical, rational decision-making. It is imperative, however, also to recognize and teach the concepts related to the intuitive and precognitive components of making decisions in clinical practice.
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Our knowledge about the content of the clinical knowledge used by nurses in a surgical recovery unit for assessment of postoperative pain is fairly limited. The aim of the present study was to analyse and describe the variations of nurses' conceptions of the impact of clinical experience on competence in post-operative pain assessment. The informants consist of critical care nurses. ⋯ The results reveal that clinical competence in pain assessment was described in three categories: (a) to be able to see; (b) to be able to differentiate; (c) to be able to give. The observations articulate what nurses perceive that they have learnt from experience in performing many clinical pain assessments and point to some difficulties in using a single-data source for the development of valid and truthful professional knowledge. In the development of professional experience, it is of the utmost importance to be able to change perspective from what is most frequent and general to what is special and unique, to base one's standpoint on the individual patient's experience and integrate this with previous professional experience.
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Intensive Crit Care Nurs · Oct 2000
Hong Kong patients' experiences of intensive care after surgery: nurses' and patients' views.
This study was designed to explore the lived experience of patients after elective surgery when they were being cared for in a surgical intensive care unit (ICU) in the immediate post-operative period. A phenomenological approach using unstructured interviews was employed and 10 ICU nurses and 10 patients were recruited for the study. Thematic data analysis was used. ⋯ They appreciated the preoperative visit and preferred the open unit design and flexible visiting hours. The four sub-categories: pain, sleep, pre-operative visits and family visits are discussed in detail and are reviewed in the light of other studies to compare the results. Ideas for nursing interventions to help overcome these problems are outlined and recommendations for future research are presented.
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Dexmedetomidine is new sedative being developed for use in postoperative sedation in ICU. It acts at a 2 adrenoceptors to produce sedation, anxiolysis and analgesia. Patients remain easily rousable and do not suffer significant respiratory depression, consequently dexmedetomidine may be continued post extubation.