It Starts With Access!

Abstract

The critical illness of an adult constitutes a crisis for the patient's family. They relinquish primary responsibility for the physical well-being of the patient to health providers, but remain involved, working to get through the situation. What constitutes this "work"? Results of two grounded theory studies revealed that family members were engaged first in the pivotal work of gaining access because of their overarching need to be present with and for their critically ill relative. Other work included patient-related work, nurse/physician-related work, and self-related work. These findings extend our understanding of their experiences beyond current knowledge and paternalistic perceptions of burden, stress and coping, and need recognition and fulfillment. Critical care nurses are exhorted to support family members in their work by removing barriers to patient, staff, and information access and to partnering opportunities.

“I’m Trying To Be the Safety Net”: Family Protection of Patients With Moderate-To-Severe TBI During the Hospital Stay

“…Like this study, research has shown that family caregivers also monitored patient care to make sure the care provided by staff was appropriate, termed “vigilant observation” (Hupcey, 1999; Jamerson et al, 1996; Salmond, 2011; Vandall-Walker & Clark, 2011). However, unlike our study, the literature does not provide nuanced strategies used to protect the patient.…”

“…Limited mentions of family work occur in the literature, but when discussed, family work describes the effort of family caregivers to assist patients in health care settings (Bischofberger & Spirig, 2004; Vandall-Walker & Clark, 2011). The concept of in-hospital family caregiving seen in these findings is also present in the literature (Sapountzi-Krepia et al, 2008; Stavrou, Ploumis, Zyga, & Kotrotsiou, 2014).…”

Thinking Big, Supporting Families and Enabling Coping: The Value of Social Work in Patient and Family Centered Health Care

“…Previous research has noted that HSW should strive to identify the coping resources of families to facilitate healthy adjustment (Benzein, Johansson, Årestedt, Berg, & Saveman, 2008;Vandall-Walker, & Clark, 2011) and our participants enhanced the coping capacity of the patients and families in their care.…”

Using Simulation Pedagogy in the Formation of Family-Focused Generalist Nurses

“…Despite the increasing knowledge of the importance of family nursing, research continues to report defi ciencies in the current state of family nursing practice and limitations in the relational practice of nurses caring for families (Coughlin, 2013;Duhamel, 2010). Nurses report a lack of competence and confi dence in focusing on the family, whereas families describe limited, and often diffi cult, interactions with nurses (Mak, Chiang, & Chu, 2013;Vandall-Walker & Clark, 2011). Nurses often feel ill prepared to develop caring relationships with family members and often prioritize individual relationship building and obtaining technical skills over developing family unit or relational skills (Eggenberger & Regan, 2010;Riley, White, Graham, & Alexandrov, 2014).…”

“…Whether the illness is chronic or acute, multiple family responses contribute to a complex experience that affects the individual with the illness and the health of the family (Davidson et al, 2007;King et al, 2013). Yet, nurses report concerns with their ability to provide nursing care to families, and families often describe troubling relationships with nurses (Santiago, Lazar, Jiang, & Burns, 2014;Vandall-Walker & Clark, 2011). Such gaps in family practice possibly have roots in the education of nursing students.…”