Post on 05-Aug-2018
Lotte Abildgren Schultz CCRN, Msc Nursing
“Some of us are actually aware, you know”A study of psychosocial nursing, in the encounter between the awake intubated patient and the critical care nurse
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Lotte Abildgren Schultz
Supervisor:Lise Hounsgaard, Associate Professor, Research Unit in Nursing, University of Southern Denmark
Lotte Abildgren Schultz CCRN, Msc Nursing
Aim
… to develop knowledge of the encounter between the intubated critical care patient and the nurse
"being a living dead"
"being a garbage can for pipes and hoses"
"loneliness"
Lotte Abildgren Schultz CCRN, Msc Nursing
Flow chart
Preparations
8 h.Descriptive observation
24 h.Focused
observation
12 h.Selected
observation
Structural analysis
Critical interpretation
Interactio
nal N
ursin
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ractice -C
ritical herm
eneu
tics–
Eth
nog
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New recognition/realisation
Naivereading
Critical Care Patient’s lifeworldPrefiguration - preconception
Data Collection Configuration
Analysis & interpretation Refiguration
Dialogue with nursing
practice
Lotte Abildgren Schultz CCRN, Msc Nursing
Data collection
Three phases of participant observation:
A descriptive phase (8 h.)
A focused phase (24 h.)
A selective phase (12 h.)
A total of 44 hours of participant observation
Lotte Abildgren Schultz CCRN, Msc Nursing
Interpretation
A phenomenological hermeneutic approach
Ricoeur inspired interpretation theory
To obtain a deeper understanding of being-in-world -through tales of the participants life world
Text interpretation
A continuous dialectical movement between units and wholes - between description and understanding
To understand a possible way of ”being in the world” in which critical reflection can increase awareness of variations in the phenomenon
Lotte Abildgren Schultz CCRN, Msc Nursing
Findings
The three themes emerged:
Contact Information Interaction
Contact in the encounter emerged as a dominant finding
Lotte Abildgren Schultz CCRN, Msc Nursing
Theme I: Contact
Contact was defined as:
Nurse's ability to establish and maintain contact in the encounter with the awake intubated patient, in order to ensure an experience of intimacy and caring in the patient-nurse relation.
Lotte Abildgren Schultz CCRN, Msc Nursing
Theme II: Information
Information was defined as:
Nurse's practice in the encounter with the awake intubated patient, in terms of providing information, psychosocial care, and nursing interventions.
Lotte Abildgren Schultz CCRN, Msc Nursing
Theme III: Interaction
Interaction was defined as:
Nurse's ability to communicate, collaborate, involve, create and maintain a patient-nurse relation with the awake intubated patient in the encounter - Interactions in critical nursing care are depending on the patient's resources
Lotte Abildgren Schultz CCRN, Msc Nursing
Concluding Suggestions
Divergence between the Critical care nurse's intention and action in the encounter
Patient's psychosocial needs are being overlooked, despite the fact that the nurse consider the basis of care as good and professional
Direct contact in the encounter increases:• The critical care nurses ability to read, assess and
interpret the patients psychosocial needs• The critical care patients possibility to receive
psychosocial care
Lotte Abildgren Schultz CCRN, Msc Nursing
QUESTIONS ?
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Lotte Abildgren Schultz CCRN, Msc Nursing
Discussion
How many of your patients are sedated when intubated? How many are awake?
Do nurses do, what they think they do, in the Critical care nursing?
How do you, in your daily critical care practice, meet the critical care patients psychosocial needs?
Lotte Abildgren Schultz CCRN, Msc Nursing
Thank you for your attention
Contact info:
Lotte Abildgren SchultzProject CoordinatorCCRN, Msc NursingAnaesthesiology & Critical Care Unit Odense University Hospital, Denmark
lotte.schultz@ouh.regionsyddanmark.dk
Lotte Abildgren Schultz CCRN, Msc Nursing
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Lotte Abildgren Schultz CCRN, Msc Nursing
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Lotte Abildgren Schultz CCRN, Msc Nursing
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