Zusammenfassung Der Hirntod wird festgestellt, aber das Herz schl?gt noch, der Brustkorb hebt und senkt sich, wenn auch mit maschineller Hilfe, der K?rper ist warm. Was f?r Angeh?rige schwer zu begreifen ist, stellt auch f?r Pflegende oft eine Belastung dar. Sabine Drexler beleuchtet die Rolle der Intensivpflegenden in der Betreuung von (potenziell) hirntoten Patienten.

Aim Aim of this study was to describe the experiences of intensive care unit (ICU) nurses, physicians and relatives of (potentially) brain dead patients; and to develop recommendations to optimize the workflows on ICUs. Background Limited published information on caring for brain dead patients suggest it to be a burden for the nursing staff. It also remains unclear how physicians and relatives of (potentially) brain dead patients perceive these experiences. Design Interpretive phenomenology according to Benner. Methods Medical caregivers (nurses’ und physicians) from multiple wards in a German University Medical Center and relatives of (potentially) brain dead patients will be interviewed. Data collection will include episodic interviews with participants’ experiences in care of (potentially) brain dead patients. The study is funded by the Ministry of Science, Research and the Arts, Baden‐Württemberg (1 February 2016). Discussion Gaining insights into caring for (potentially) brain dead patients and its associated burden will lead to the development of better recommendations to assist all people involved. Impact Expand the understanding of the experience of healthcare professionals in the care for (potentially) brain dead patients. Understand the experience of relatives of (potentially) brain dead patients. Findings from this study will support the development of recommendations for action by a multi‐professional expert group consisting of nurses, physicians, healthcare managers and patient advocates. Trial registration: Protocol version. German Register for Clinical Studies (Registration No. DRKS00010420) Database of Health Services Research Germany (Project Nr. VfD_16_003710).

Zusammenfassung Ziel Ziel der vorliegenden Studie war die Untersuchung des Erlebens von Ärzten bei der Betreuung von (potenziell) hirntoten Patienten. Methodik Durchgeführt wurden episodische Interviews. Die Auswertung fand in Anlehnung an die interpretative Phänomenologie nach Benner statt. Ergebnisse Elf Ärzte haben an den Interviews teilgenommen. Folgende Phänomene konnten aus den Daten gewonnen werden: 1) Begegnungen mit den Angehörigen, 2) Angehörigen den Hirntod begreiflich machen, 3) Hirntod ist Tod, 4) Erleben der Pflegenden und 5) Belastungen. Schlussfolgerung Die Ergebnisse zeigen die Komplexität, die bei der Betreuung eines (potenziell) hirntoten Patienten aus Sicht der Ärzte wahrgenommen wird. Der Übergang vom Erhalt des Lebens des Patienten zum Organerhalten oder zum Abstellen der Geräte und die dazugehörige Aufklärung der Angehörigen erfordern hohe Kompetenzen der Ärzte. Symptome der Patienten geben den Ärzten klare diagnostische Vorgehensweisen, bestehende Unklarheiten im (Behandlungs‑)Prozess sollten behoben werden.

Aim: This study explores nurses' experiences of caring for (potentially) brain-dead patients. Design: A qualitative interpretative phenomenological design was chosen to describe the phenomenon in all its complexity and dimensions. Methods: In 2016, twelve episodic interviews were conducted with intensive care nurses from six wards. The interviews related to their experiences of caring for (potentially) brain-dead patients and were analyzed according to Benner's Interpretative Phenomenology. Results: Three key phenomena were generated: 1) The brain is dead; the body is alive; 2) Coping within high performance medicine and 3) Power(-lessness). The participants' experience was that caring for a (potentially) brain-dead patient and explaining brain death to the patient's relatives is very demanding. In the intensive care unit, nurses are required to diligently provide exemplary methodical and routine care, most of the time without an outlet to relieve their own work-related burdens. In some situations, the interviewees felt powerless. Conclusion: The data collected have provided a deeper insight into the situation intensive care nurses face when caring for (potentially) brain-dead patients. Nevertheless, the authors recommend further research on all phenomena, and also the design of appropriate training and support for nurses.

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