Critical Care Nursing in a Resource-Constrained Setting: A Qualitative Study of Critical Care Nurses’ Experiences Caring for Patients on Mechanical Ventilation

Abstract

Introduction Managing a patient on mechanical ventilation is a vital aspect of clinical scope in intensive and critical care units. In addition, it is a highly technical, intricate, dynamic task requiring extensive knowledge and skills. Little is known about critical care nurses’ experiences caring for patients on mechanical ventilation in contexts where resources are constrained, creating an empirical gap in the available body of knowledge. Objective This study explored critical care nurses’ experiences caring for patients on mechanical ventilators at an intermediate hospital in northeastern Namibia. Method The study followed qualitative descriptive and explorative designs. The purposive sample included 13 critical care nurses who had cared for patients on mechanical ventilation for more than 6 months. Data were collected via individual unstructured interviews and analyzed using a reflexive thematic analysis approach. Results Four themes and eight subthemes emerged. Varied personal feelings, such as feeling proud, competent, exhausted, traumatized, overwhelmed, and concerns for patients’ well-being were experienced by critical care nurses. Participants described learning from colleagues in the unit and expressed concerns about not having postbasic training in critical care nursing. Negative experiences included concerns about community members’ misconceptions about critical care units and mechanical ventilators, and challenges with resources, personnel, and admission procedures. Conclusion Critical care nurses in resource-constrained settings have positive and negative experiences caring for patients on mechanical ventilators. The findings have implications for the development of support systems for critical care nurses, including induction programs, competence enhancement, psychological support, the development of guiding documents for admission, patient preparation and sensitization of community members. There is a need for this study to be replicated in other resource-constrained contexts where specialized critical care nurses are available.