Nurse–Family Communication During and After Family Meetings in the Intensive Care Unit

Abstract

Purpose: To explore nurse-family communication during and after family meetings. Design: A cross-sectional study in which 36 family meetings were audiorecorded in two intensive care units in an urban, community hospital. Methods: Data were analyzed using conversation analysis, a qualitative method. Findings: Nurses spoke during 10 (28%) of the family meetings. During the family meetings, nurses mostly self-selected to take a turn by interrupting a physician or family member, finishing their sentences, responding to questions, and, in one instance, asking a question. Nurses were mostly selected as the next speaker to address logistical issues, but were also asked questions. Most of nurses' turns were short and simple, and aimed to provide clarification, reassurance, and information regarding the patient's status. Immediately after the family meetings, nurses offered to provide family members clarification or gestures of empathy, but these offers were met with resistance from family members. Conclusions: Despite calls for nurses to take a more active role in surrogate decision making, nurses minimally participated during family meetings. Empowering nurses to share their expertise is one solution for nurses to contribute during family meetings. Further research is needed to explore nurse-family bedside interactions to improve our understanding of the nurse's role in the surrogate decision-making process. Clinical Relevance: Findings from this exploration of nurse communication during and after family meetings can inform how nurses may best assist families during surrogate decision making in the intensive care unit.

Early Career Nurses’ Experiences of Providing Family Nursing Care: Perceived Benefits and Challenges

“…In particular, nurses who assume positions in acute care settings often describe limited contributions to family care and family engagement (Frampton et al, 2017;Pecanac & King, 2019) and barriers to integrating family care with individual care (Karanikola & Mpouzika, 2018;Nassar Junior et al, 2018). Similarly, families report troubling relationships and communication with nurses that limit the positive impact of nursing care during stressful illness experiences (Carlson et al, 2015;Vandall-Walker & Clark, 2011).…”

Needs of family members of patients in a coronary care unit

“…The needs of families of hospitalized patients are often disregarded due to the complexity of the intensive care environment by the technical and reductionist behavior of providers, and the lack of training in appropriate communication with family members. (15,16) For this reason, one of the intensive care nurses' responsibilities is to identify the specific needs of family members and implement appropriate and essential interventions. (17) In this study, the importance assigned to the needs of family members of patients hospitalized in a coronary ICU and the satisfaction with care were assessed and compared.…”

Nurse’s Roles in Patient-Family Decision Making for Palliative Patients in Indonesia and Malaysia

“…The education includes the patients' condition, updates of all the examinations taken, and how to take care of themselves at home. The patients and family preferred nurses to re-explain and re-educate them after doctors' explanation because nurses' explanation was simpler and easier to understand [27], [28]. Thus, the patients and family will able to make decisions wiser.…”

“…Nurses are the best facilitator that may lead the patients and family to end of life easier. They help facilitate the patients and family on how to handle the bad news better by creating time-space and showing empathy and support for them [28]. When nurses facilitated them while they were in the grieving stage, they could get through it faster and feel comfortable, which is very important for decision making.…”