The concept "caring" is complex. Numerous theoretical and operational perspectives of caring within the context of nursing have emerged. The ongoing discussion about what constitutes caring within nursing practice domains is nowhere more evident than in the adult ICU specialization, where humanistic caring is juxtaposed with advanced technology. Caring in ICU has been discussed in terms of one entity as the patient (Cutler et al., 2013), their family (Mackie et al., 2017), nurses (Hales et al., 2018), health professionals (Handberg & Voss, 2018) or a couple of entities such as patients and nurses (Happ et al., 2014). However, ICU is not limited to caring for patients, their families and nursing staff. This study examines the multidimensional inclusive nature of caring in ICU. | BACKG ROU N DSeveral authors discussed different caring ICU entities from various perspectives, including patients' perspectives and experiences of care (Cutler et al., 2013), patients' descriptions of the art of nursing (Gramling, 2004), and patients' perceptions of nursing care qual-
Aim: To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU). Design: A focused ethnography.Methods: This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information -oversix months (April-September, 2014). The data were analysed thematically. Findings: This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients' psychological and emotional needs, and nurses' caring behaviours are crucial. These findings need further consideration from all stakeholders.
The concept of caring is vague and complex, especially in critical environments such as the intensive care unit (ICU). ICU nursing care includes not only patients but also extends to patients’ families, nurses, other health team members and the unit’s environment. A focused ethnographic study was conducted in an Australian ICU. The data was collected from 35 registered nurses through various resources: participants' observations, documents reviews, interviews, and additional participants’ notes. Data were analysed inductively and thematically. The study outlines comprehensively and widely a wide range of enablers and challenges affecting caring in the ICU - which originate from different sources such as patients, families, nurses and the ICU environment. Nurses and other stakeholders such as clinicians, educators, researchers, managers and policymakers need to recognise these factors and their implications for providing quality care in order to enhance and maintain the optimal level of caring in the ICU. This paper is the first in a two-part series that explores the enablers and challenges to caring in the ICU. This paper explores the ICU nurses’ experiences and perspectives of the enablers and challenges to caring in the intensive care setting, in relation to patients, families and the ICU environment, while the second part will be concerned with the enablers and challenges of caring that are related to the nurses in ICU.
The concept of caring is vague and complex, especially in critical environments such as the intensive care unit (ICU), where technological dehumanisation is a challenge for nurses. ICU nursing care includes not only patients but also extends to patients’ families, nurses, other health team members and the unit’s environment. Caring in critical care settings is affected by enabling and impeding factors. To explore these enablers and challenges factors, a focused ethnographic study was conducted in an Australian ICU. The data was collected from 35 registered nurses through various resources: participants' observations, documents reviews, interviews, and additional participants’ notes. Data were analysed inductively and thematically. The study outlines comprehensively and widely a wide range of enablers and challenges affecting caring in the ICU - which originate from different sources such as patients, families, nurses, and the ICU environment. This paper is the second in a two-part series which explores the ICU nurses’ experiences and perspectives of the enablers and challenges of caring in the ICU. Part 1 was concerned with the enablers and challenges to caring that are related to ICU patients, families, and environment. While Part 2 introduces readers to the enablers and challenges factors that are concerned with the nurses in ICU. These factors include nurses’ educational backgrounds and professional experience, employment working factors, leadership styles, relationships, and personal factors. Nurses and other stakeholders such as clinicians, educators, researchers, managers, and policymakers need to recognize these factors and their implications for providing quality care, in order to enhance and maintain the optimal level of caring in the ICU.
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