What are Staff Nurses Perspectives on Physical and Psychological Barriers to Care in the Treatment of Sickle Cell Anemia Patients in Acute Crisis?
The staff nurse in the inpatient setting is perhaps the provider with the most frequent interaction and care interventions during the acute stay of a client with sickle cell anemia. A review of the current nursing literature prompted the current study to expand inquiry into the physical and psychological barriers perceived by staff nurses in the care of the sickle cell patient in crisis. A qualitative study of these barriers within the Humanistic Nursing Communication Theory framework will guide further quantitative and qualitative research relevant to interventions that will enhance the care of this population. Three focus groups of 5 participants each will be selected from a range of hospital sizes and care units using systematic sampling from those nurses responding to an initial email questionnaire. Focus groups will be conducted using a semi-structured interview guide. Additional focus groups could be conducted as necessary to reach data saturation. Transcripts from the focus group interviews will be analyzed to uncover themes that reveal perceived barriers in the care of the sickle cell patient in crisis and if the barriers relate to the descriptions of communication and listening as expressed in the theoretical framework. Relationships between themes and demographic data gathered from the initial questionnaires will also be explored to discover trends or themes. The study may encounter limitations in the richness of the information revealed by the participants if they are uncomfortable in a group setting discussing nursing care practices. However, the researchers anticipate that the study will reveal nurses’ perceptions about barriers to compassionate nursing care of sickle cell patients. Areas for nursing education related to pain management and more effective communication techniques to utilize with sickle cell clients may also be revealed. Introduction
Questioning of nurses across the nation regarding reasons for seeking a position in the nursing field would likely yield as many varied responses as there are types of nursing positions available today. Historically, the nursing profession has been viewed as being comprised of caring individuals motivated by a sense of altruism and service to others (Miers, Rickaby, & Pollard, 2007; Shaw, & Degazon, 2008). Nurses are frequently described as caring, empathetic, kind, knowledgeable, gentle, interested, sympathetic, understanding, as well as many other positive terms. The type of care provided by these professionals varies from acute to chronic care, involving both physical and emotional aspects, according to the health care environment in which they serve. One of the most important and rewarding facets of nursing care is the nurse/patient relationship that develops at the bedside.
Extensive education prepares the professional nurse to care for a diverse population of clients and their families. The acute care setting affords the nurse the opportunity to care for patients with a myriad of disorders and disabilities ranging from acute trauma patients to patients afflicted with chronic disease states. A particularly challenging group of clients with chronic illness to care for is the sickle cell anemia population. The presentation of the disease can vary greatly with each hospital admission. Many of these patients are prone to repetitive hospitalizations due to debilitating episodes of vaso-occlusive crisis involving severe, acute pain (Wright & Adeosun, 2009). Optimal care of this patient during acute hospitalization often requires a multidisciplinary approach, involving the physician, staff nurses, respiratory therapists, pharmacists and even counselors (Pack-Mabien & Haynes, 2009). Members of the nursing profession are in a unique position to...