Background and aim of the research

This grounded theory research into the patient’s perception of the nursing contribution to the patient’s experience of intensive care aimed to provide critical care nurses with evidence, which articulates their contribution to the patient’s experience of intensive care. The research also identified aspects of nursing care patients considered helpful and those less helpful to their entire critical care experience.

The Findings

Interviews from 20 patients, demonstrated a grounded theory that critical care nurses nurture a:

Strong sense of belonging to a ‘critical care family,’ within the patient.

Nurses do this through:

  1. Ensuring the patient remains their key priority at all times
    • "They explained everything, what the machine was doing for me and what it weren’t doing."
    • "They would sit down with me after handover and explain what had happened to me."
    • "There’s that moment of salvation, you think, I’m better now, I’m getting better now, and these are the people that are helping me. So I think by virtue of the fact that they’re in that position, would generally make one feel that way anyway. But it’s much more than that because it was much more personal than just the person."
  2. Their constant presence providing the patient with feelings of safety and security
    • " They were there."
    • "I was remarkably calm. An element of that is the level of care I was receiving from the nurses and what they did for me. I suppose it’s the reassurance, because they are so constant."
    • "They’ve got the expertise, they’ve got the care and understanding, they know what you have been through."
    • "With the level of nursing you felt they were in control."
    • "I was very confident with the nursing staff. I offered myself up to them to manage my care and they did a fantastic job…"
    • "On all levels I wasn’t worried because I was so well looked after which is a reflection on the nursing staff."
    • "It made you feel like you were in safe hands, no matter what it was."
  3. Providing interventions to promote a return to good health, enhancing the patient’s recovery from critical illness.
    • "They fed me."
    • "Washing me."
    • "I couldn’t drink straightaway, so they bought me a lollypop thingamajig and a cup of water, my daughter was allowed to dip it in and it made me feel lovely"
    • "They put ice on my lips… it was heaven."
    • "I feel if I didn’t have that amount of care I might not be here."
    • "The care is where it starts to get you through it."
    • "I think it’s the care, the consideration, just talking to you, they’ve always got a couple of minutes to stop and even if you can’t respond they will still stand there and talk to you."

Having reviewed the literature further, it became clear that whilst the grounded theory that intensive care nurses nurture the sense of belonging to a ‘critical care family’ in the patient, the real problem for the patient is when they move from intensive care to the ward. It is unclear if belonging to this critical care family promotes an unrealistic patient expectation of the nursing support they will receive on the wards. This could be a contributory factor to the patient’s difficulty with this transition.

The next stage of the research

The research will now consider how the patient’s experience of nursing care on the intensive care unit, influences their experience of transitional care from intensive care to the ward. The data identified the most difficult period for the patient, remains the transitional period, which is the only point in their journey where patient’s lose contact with the critical care family.

Acknowledgements

I would like to thank Mo Peskett Sister Critical Care; Milton Keynes Hopsital and ICUsteps for their constant support throughout this research project.

About the author

Sarah McGloin is a PhD Nursing Candidate at City University, London. Sarah has previously worked in the regional tertiary referral intensive care units at Frenchay Hospital in Bristol and Oldchurch Hospital in Essex. Sarah is currently the course leader of the PGCert Critical Care at Anglia Ruskin University. Her interest in the patient’s experience of intensive care nursing stemmed from her work in practice and her frustration at being unable to articulate to colleagues the contribution of the intensive care nurse to the patient’s experience of intensive care. Sarah felt the best way to achieve an understanding of this was to ask the patients themselves. The result is a grounded theory articulating the patients understanding of the intensive care nurses contribution to their intensive care experience.