Like an ace up the sleeve: an interview study of nurses’ experiences of the contact with relatives in a somatic emergency ward

Abstract

Research indicates that active involvement of patients' relatives generally has a positive impact on patients' hospitalisation, including patient safety. Campaigns urge relatives to ask questions in relation to nursing care and treatment to enhance patient safety and to increase involvement of both patient and relatives. The question is how nurses experience relatives who ask questions. The aim of this study was to explore how nurses experienced contact with patients' relatives during admissions to a somatic emergency ward including nurses' experience of relatives asking questions related to nursing care and treatment. Six nurses were interviewed. The participants gave written consent to participate after receiving both oral and written information about the study. Data were analysed using combined theory and data-driven qualitative content analysis. The findings formed three main themes: (i) relatives' involvement as a means to efficiency during hospitalisation, (ii) relatives welcomed on the terms of the system and (iii) tension between high ideals and frustrating realities. The six interviews answered the research questions. However, more interviews could have broadened the study and contributed with further details. The nurses experienced relatives as an important resource - 'an ace up the sleeve', while reality seemed to challenge the relationship between nurses and relatives. The study contributes to discussions before development and implementation of specific initiatives aiming at increasing involvement of relatives of patients in a somatic emergency ward.

Health professionals’ perspectives of patients’ and family members’ needs in emergency departments and patient pathway improvement: a qualitative study in Denmark

“…In a previous research, ED nurses found that working with families is either a bother or a benefit depending on whether the family members understand the healthcare system. 14 45 Furthermore, the HCPs discussed whether they were obligated to involve family members. The culture and attitudes influence how HCPs engage with families, and HCP training in communication skills is required to improve their relationship with families.…”

“…The involvement of family members in discharge information, such as medication and treatment adherence, has been acknowledged globally as a factor in improving patient outcomes 13 14. Moreover, family inclusion and partnership in care strengthen patients’ readiness for discharge 6.…”

What are the needs and preferences of patients and family members discharged from the emergency department within 24 hours? A qualitative study towards a family-centred approach

“…9 10 In this care, family members play an active role in maintaining patient outcomes after early discharge to homes. 11 12 Mackie et al found in a qualitative study that health professionals identified the advantage of family participation in care for enhancing the quality of care and improving patient satisfaction. 13 14 However, research on the needs of family members involved in short visits to EDs is sparse or focuses on elderly patients.…”

Manoeuvring between interplay and context- an ethnographic study of social interaction in encounters between registered nurses, older patients and their relatives

“…The presence of relatives can be crucial for supporting older persons in various healthcare situations, as the social interaction includes both an exchange of information and collaboration between patients, nurses and relatives [2]. Relatives can act as social support, as they can reduce the patient's stress, increase the nurse's understanding, confirm instructions and agreements, promote communication between family members and work to preserve positive relationships between those involved [8]. However, a third person can prolong the conversation, as more information is usually needed, but also limit the exchange of information as the patient tends to leave the responsibility and social interaction to the relative.…”