Experiences of Critical Care Nurses Caring for Unresponsive Patients

Villanueva, Nancy

doi:10.1097/01376517-199908000-00003

Cited by 18 publications

(31 citation statements)

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“…These findings are consistent with previous research examining nurses who showed compassion for the families of neurologically devastated adult patients under their care (6,7,9,10). Similarly, the key to obtaining job satisfaction for the nurse is development of a good nurse-parent relationship (19).…”

Section: Discussionsupporting

confidence: 90%

“…Depersonalization has been reported in other studies in which intensive care nurses caring for adult organ donors focused on the "organs to be donated" (9) and in which nurses caring for unresponsive, traumatic brain-injured patients "forgot the person" (6). One nurse in our study described ventilating a patient in PVS as "hooking up a cadaver to a ventilator so you can see some lungs inflate."…”

Section: Discussionmentioning

confidence: 76%

“…In the absence of a conventional nurse-patient relationship, nurses may find themselves depersonalizing the patient and becoming task-oriented. Critical care nurses caring for unresponsive adult patients secondary to traumatic brain injury or neuromuscular blocking agents struggled with the dilemma of "forgetting there is a person" (6). Some nurses used negative terms (e.g., anxious, detached, discouraged) when describing their experience of caring for this population of patients (7)(8)(9)(10).…”

mentioning

confidence: 99%

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The experiences of pediatric nurses caring for children in a persistent vegetative state*

Montagnino

Ethier

2007

Pediatric Critical Care Medicine

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 99%

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The experiences of pediatric nurses caring for children in a persistent vegetative state*

Montagnino

Ethier

2007

Pediatric Critical Care Medicine

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“…[30][31][32][33][34][35][36][37][38][39][40] The types of judgments typically made by nurses can vary, depending on the shift worked and whether or not a nurse is performing an initial assessment on a patient or has provided care for that patient before.…”

Section: Situational Variables and Nurses' Judgmentsmentioning

confidence: 99%

Judgments of Critical Care Nurses About Risk for Secondary Brain Injury

McNett

Doheny

Sedlak

et al. 2010

American Journal of Critical Care

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Background Interdisciplinary care for patients with traumatic brain injury focuses on treating the primary brain injury and limiting further brain damage from secondary injury. Intensive care unit nurses have an integral role in preventing secondary brain injury; however, little is known about factors that influence nurses’ judgments about risk for secondary brain injury. Objective To investigate which physiological and situational variables influence judgments of intensive care unit nurses about patients’ risk for secondary brain injury, management solely with nursing interventions, and management by consulting another member of the health care team. Methods A multiple segment factorial survey design was used. Vignettes reflecting the complexity of real-life scenarios were randomly generated by using different values of each independent variable. Surveys containing the vignettes were sent to nurses at 2 level I trauma centers. Multiple regression was used to determine which variables influenced judgments about secondary brain injury. Results Judgments about risk for secondary brain injury were influenced by a patient’s oxygen saturation, intracranial pressure, cerebral perfusion pressure, mechanism of injury, and primary diagnosis, as well as by nursing shift. Judgments about interventions were influenced by a patient’s oxygen saturation, intracranial pressure, and cerebral perfusion pressure and by nursing shift. The initial judgments made by nurses were the most significant variable predictive of follow-up judgments. Conclusions Nurses need standardized, evidence-based content for management of secondary brain injury in critically ill patients with traumatic brain injury.

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“…The nurse talking to the patient is clearly recognized as a nursing intervention. 4,27,28 In the ICU, the nurse is often the gatekeeper and therefore, it is reasonable to assume that the nurse facilitates and encourages patients' family members to interact with the patient. 22,29 Having family members talk to or around the neurologically impaired patient in our study was associated with an increased likelihood of decreasing ICP values at 1-and 5-minute intervals.…”

mentioning

confidence: 99%

Effects of Nursing Interventions on Intracranial Pressure

Olson

McNett

Lewis

et al. 2013

American Journal of Critical Care

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Background Intracranial pressure is a frequent target for goaldirected therapy to prevent secondary brain injury. In critical care settings, nurses deliver many interventions to patients having intracranial pressure monitored, yet few data documenting the immediate effect of these interventions on intracranial pressure are available. Objective To examine the relationship between intracranial pressure and specific nursing interventions observed during routine care. Methods Secondary analysis of prospectively collected observational data. Results During 3118 minutes of observation, 11 specific nursing interventions were observed for 28 nurse-patient dyads from 16 hospitals. Family members talking in the room, administering sedatives, and repositioning the patient were associated with a significantly lower intracranial pressure. However, intracranial pressure was sometimes higher, lower, or unchanged after each intervention observed. Conclusion Response of intracranial pressure to nursing interventions is inconsistent. Most interventions were associated with inconsistent changes in intracranial pressure at 1 or 5 minutes after the intervention.

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Experiences of Critical Care Nurses Caring for Unresponsive Patients

Cited by 18 publications

References 0 publications

The experiences of pediatric nurses caring for children in a persistent vegetative state*

The experiences of pediatric nurses caring for children in a persistent vegetative state*

Judgments of Critical Care Nurses About Risk for Secondary Brain Injury

Effects of Nursing Interventions on Intracranial Pressure

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