Critical Care Nurses' perceptions of caring: A phenomenological study

The present study investigated critical care nurses' perceptions of caring and the factors which influence caring. Fifteen registered nurses who were actively employed in the critical care setting were interviewed. Two open-ended questions and appropriate cue questions were asked during the interviews. The interviews were tape recorded and then transcribed by the researcher. The data from the transcription were analyzed according to the steps outlined in the Colaizzi (1978) method.

Analysis of the data yielded findings whihc included (a) the description of a model for caring in the critical care setting and (b) identification of factors which positively and negatively influence caring in the critical care setting. Critical care nurses described eight major concepts which comprise the model for caring: (a) totality of care, (b) priority of care, (c) nature of caring, (d) the blending of attitude with action, (e) recognition of patient's individuality, (f) family involvement, (g) teaching and communication, and (h) patient perception of outcomes.

Positive factors which influence caring in the critical care setting included patient progress, positive patient and family interaction, nurse's knowledge and experience, nurse receiving support of colleagues, nurse's personal attraction to some patients, expanded visiting hours, and adequate staff and work environment. Examples of negative factors which influence caring in the critical care setting were difficult or confused or noncommunicating patients, absent or hostile or uncooperative families, lack of continuity in patient care, nonsupport from colleagues, nurse's fear of some disease conditions, economic conditions, bureaucratic forces, and inadequate patient assessment data.

The findings of the study suggested several avenues which could be explored to improve caring in the critical care setting such as increased family involvement, adequate orientation and continuing education for nurses, provision of support systems, better planning of the physical plant of critical care units, increased usage of step-down units in the critical care setting, and revision of patient assessment forms.