Critical Care Nursing

Vbg Intensive and Critical Care Nursing
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doi:10.1016/j.iccn.2011.01.001 | How to Cite or Link Using DOI
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Original article
The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

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Thomas Erikssona, b, , , Ingegerd Bergbomb, and Berit Lindahlc, a CIVA/96, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden b Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30 Göteborg, Sweden c School of Health Sciences, Borås University College, Allégatan 1, SE-501 90 Borås, Sweden
Accepted 7 January 2011.
Available online 1 February 2011.

Summary
Aim
The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families.
Method
The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots.
Findings
Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it.
Conclusion
The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay

References: 1. Ulrich BT, Woods D, Hart KA, Lavandero R, Leggett J, Taylor D. Critical care nurses’ work environments: value of excellence in Beacon units and Magnet organizations. Crit Care Nurse. 2007;27(3):68–77.[Free Full Text] 1 1. Aiken LH, Clarke S, Sloane D. Hospital restructuring: does it adversely affect care and outcomes? J Nurs Adm. 2000;30(10): 457–465.[Medline] 1 1. Scott LD, Rogers AE, Hwang WT, Zhang Y. Effects of critical care nurses’ work hours on vigilance and patients’ safety. Am J Crit Care. 2006;15:30–37.[Abstract/Free Full Text] 1 1. Kirchhoff KT, Dahl N. American Association of Critical-Care Nurses’ national survey of facilities and units providing critical care. Am J Crit Care. 2006;15(1):13–27.[Abstract/Free Full Text] 1 1. Malaney GD. You still need high response rates with web-based surveys. Student Affairs On-Line Web site. http://www.studentaffairs.com/ejournal/Winter_2002/rates.html. Published February 15, 2002. Accessed July 29, 2008. 1. Greco P, Laschinger HK, Wong C. Leader empowering behaviours, staff nurse empowerment, and work engagement /burnout. Nurs Leadersh (Tor Ont). 2006; 19(4):41–56. 1. Boyle DK, Bott MJ, Hansen HE, Woods CQ, Taunton RL. Managers’ leadership and critical care nurses’ intent to stay. Am J Crit Care. 1999;8:361–371.[Abstract] 1 1. Shirey MR. Authentic leaders creating healthy work environments for nursing practice. Am J Crit Care. 2006;15:256–268.[Abstract/Free Full Text] 1 1. American Organization of Nurse Executives. Acute care hospital survey of RN vacancy and turnover rates in 2000. http://www.wha.org/workForce/pdf/aone-surveyrnvacancy.pdf. Published January 2002. Accessed July 29, 2008. 1. Davies JL. Managing the "span of control" during rapid growth in small companies. http://www.thebusinessplan.info/Organization/Span_of_Control.htm. Published October 2004. Accessed July 29, 2008. 1. Cathcart D, Jeks S, Karnas J, Miller S, Pechacek J, Rheault L. Span of control matters. J Nurs Adm. 2004;34:395–399.[Medline] 1 1. US Department of Commerce. US census 2000. July 2002. http://www.census.gov/prod/2002pubs/c2kprof00-us.pdf. Accessed August 1, 2008. 1. Vahey DC, Aiken LH, Sloane DM, Clarke SP, Vargas D. Nurse burnout and patient satisfaction. Med Care. 2004;42:1157–1166. 1. Aiken LH. Recruitment, retention, and safety through accountable leadership. Paper presented at: Fall Meeting of the Indiana Organization of Nurse Executives; October 19, 2005; Nashville, IN. 1. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Selber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288:1987–1993.[Abstract/Free Full Text] 1 1. Mallison MB. Prying the lid off wage compression. Am J Nurs. 1989;89(7):909.[Medline] 1 1. Reineck C, Furino A. Nursing career fulfillment: statistics and statements from registered nurses. Nurs Econ. 2005;23:25–31.[Medline] 1 1. Nelson JA, Folbre N. Why a well-paid nurse is a better nurse. Nurs Econ. 2006; 24:127–130.[Medline] 1 1. Disch J, Walton M, Barnsteiner J. The role of the clinical nurse specialist in creating a healthy work environment. AACN Clin Issues. 2001;12:345–355.[Medline] 1 1. Duffy JR. The clinical leadership role of the CNS in the identification of nursing-sensitive and multidisciplinary quality indicator sets. Clin Nurse Spec. 2002;16:70–76.[Medline] 1 1. Cisar NS, Mitchel A. Development of a program to manage costly outliers. Clin Nurse Spec. 2001;15:25–33.[Medline] 1 1. Soukup SM. The Center for Advanced Nursing Practice evidence-based practice model: promoting the scholarship of practice. Nurs Clin North Am. 2000;35(2):301–309.[Medline] 1 1. American Nurses Credentialing Center. Forces of magnetism. American Nurses Credentialing Center Web site. http://www.nursecredentialing.org/Magnet/ProgramOverview/ForcesofMagnetism.aspx. Accessed July 29, 2008. 1. Bliss-Holtz J, Winter N, Scherer EM. An invitation to magnet accreditation. Nurs Manage. 2004;35:36–43.[Medline] 1 1. Godinez G, Schweiger J, Gruver J, Ryan P. Role transition from graduate to staff nurse: a qualitative analysis. J Nurses Staff Dev. 1999;15(3):97–110.[Medline] 1 1. Block LM, Claffey C, Korow MK, McCaffrey R. The value of mentorship within nursing organizations. Nurs Forum. 2005; 40:134–140.[Medline] 1 1. Bailey FA, Burgio KL, Woodby LL, et al. Improving processes of hospital care during the last hours of life. Arch Intern Med. 2005;165:1722–1727.[Abstract/Free Full Text] 1 1. Beckstrand RL, Callister LC, Kirchhoff KT. Providing a "good death": critical care nurses’ suggestions for improving end-of-life care. Am J Crit Care. 2006;15:38–45.[Abstract/Free Full Text] 1 1. Clark AP. Can we improve the quality of dying in hospitals? Clin Nurse Spec. 2002; 16:180–181.[Medline] 1 1. Hamner JB. Visitation policies in the ICU: a time for change. Crit Care Nurse. 1990; 10(1):48–53.[Abstract] 1 1. Quinlan B, Loughrey S, Nicklin W, Roth VR. Restrictive visitor policies: feedback from healthcare workers. Hosp Q. 2003; 7:33–37.[Medline] 1 1. Fontaine DK, Prinkey-Briggs L, Pope-Smith B. Designing humanistic critical care environments. Crit Care Nurs Q. 2001;24:21–34.[Medline] 1 1. Huber D, Schumacher L, Delaney C. Nursing Management Minimum Data Set (NMMDS). J Nurs Adm. 1997;27:42–48.[Medline] 1 1. Kramer M, Schmalenberg C. Revising the Essentials of Magnetism tool: there is more to adequate staffing than numbers. J Nurs Adm. 2005;35(4):188–198.[Medline] 1 1. Ritter-Teitel J. Registered nurse hours worked per patient day: the key to assessing staffing effectiveness and ensuring patient safety. J Nurs Adm. 2004;34:167–169.[Medline] 1 1. Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003;290:1617–1623.[Abstract/Free Full Text] 1 1. Forbes T. Accelerating onboarding. Talent Management Web site. http://www.talentmgt.com/recruitment_retention/2007/March/275/index.php. Published March 2007. Accessed July 29, 2008. 1. D’Aurizio P. Onboarding: delivering on the promise. Nurs Econ. 2007;25:228–229.[Medline] 1 1. American Association of Critical-Care Nurses. AACN and AONE announce plans for nurse manager certification exam. Crit Care Newsline [serial online]. January 31, 2008. http://classic.aacn.org/AACN/mrkt.nsf/vwdoc/pressRelease. Accessed July 30, 2008. 1. Hu J, Herrick C, Hodgin KA. Managing the multigenerational nursing team. Health Care Manag (Frederick). 2004;23:334–340.