Being family: The family experience when an adult member is critically ill

Patients enter a critical care setting in physiologic crisis but families enter the setting in psychologic crisis. Nursing practice in critical care settings has traditionally focused on addressing individual patient needs with only a tangential recognition of the needs of the patient's family. Investigation at the family level to describe the family experience with a member hospitalized with a critical illness and illuminate the phenomenon of family nursing in this experience has been lacking. The purpose of this phenomenologic study was to understand and interpret the phenomenon of this family experience within a framework of phenomenology and family systems theory. Van Manen's hermeneutic method was used to explore the family experience. Eleven families in various family life cycle stages participated in unstructured family interviews. Trustworthiness of the study was established through prolonged engagement within the study setting; consultation with experts in family nursing and phenomenology; and creating rich description. One constitutive pattern, Being Family, with several themes, Recognizing Vulnerability, Being on Guard, Suffering the Struggle Together and Separately, Connecting Amidst the Turmoil, Sensing Discomfort, and Enduring Unrelenting Uncertainty was revealed. Findings revealed that the family's way of being in the world was shaped by the meanings of the critical illness experience for the family and their meaning of family in the context of a critical illness. Families are exceedingly strong and it is being family and all that being family means to them that makes them able to endure the extreme emotional upheaval and suffering of the experience. The phenomenon of Being Family also revealed the profound power that nurses have to help families hear this experience. Family caring, based on the understanding of the family experience, is enhanced through the presence of a nurse that acknowledges the significance of the nurse-family relationship and acts on a commitment to be with and for the family. This understanding supports family level approaches to nursing care that decrease the family's suffering and struggle during this experience. Recommendations arc made for nursing practice, nursing research, and nursing education.