Enablers and challenges of caring in the Intensive Care Unit--Part 2: In relation to nurses

Abstract

The concept of caring is vague and complex, especially in critical environments such as the intensive care unit (ICU), where technological dehumanisation is a challenge for nurses. ICU nursing care includes not only patients but also extends to patients’ families, nurses, other health team members and the unit’s environment. Caring in critical care settings is affected by enabling and impeding factors. To explore these enablers and challenges factors, a focused ethnographic study was conducted in an Australian ICU. The data was collected from 35 registered nurses through various resources: participants' observations, documents reviews, interviews, and additional participants’ notes. Data were analysed inductively and thematically. The study outlines comprehensively and widely a wide range of enablers and challenges affecting caring in the ICU - which originate from different sources such as patients, families, nurses, and the ICU environment. This paper is the second in a two-part series which explores the ICU nurses’ experiences and perspectives of the enablers and challenges of caring in the ICU. Part 1 was concerned with the enablers and challenges to caring that are related to ICU patients, families, and environment. While Part 2 introduces readers to the enablers and challenges factors that are concerned with the nurses in ICU. These factors include nurses’ educational backgrounds and professional experience, employment working factors, leadership styles, relationships, and personal factors. Nurses and other stakeholders such as clinicians, educators, researchers, managers, and policymakers need to recognize these factors and their implications for providing quality care, in order to enhance and maintain the optimal level of caring in the ICU.