The experiences of intensive care nurses caring for intubated patients with delirium

Abstract

Background: The presence of delirium predicts an increased ICU and hospital length of stay, high cost of care and mortality rate. Patients with delirium become distressed, confused, disoriented and unpredictable thereby making nurses encounter difficulty in understanding their needs. Aim: The aim of this study was to explore and describe the experiences of Intensive Care nurses, caring for intubated patients with delirium in Intensive Care Units of an academic hospital in Johannesburg. Methods: A descriptive qualitative design was used in this study. A purposive sampling method was used to choose the sample of 10 (n=10) registered Intensive Care nurses who had over two years of experience in the adult General ICU. In depth interviews were used to collect data and Braun and Clarke’s (2006) thematic data analysis approach was used to analyse the transcribed audiotaped information. Trustworthiness was ensured by following the criterion of Lincoln and Guba (1985), which includes credibility, dependability, confirmability and transferability. Results: Four major themes emerged from this study. These included it’s exhausting, caring, factors that promote care, and factors that hinder care. Conclusion: Nurses described their experience of caring for intubated patients with delirium as exhausting, difficult, challenging and frustrating yet nurses found a way to “care with care”. Majority of the participants recommended that the use of the delirium assessment tool (CAM-ICU) should be implemented in the ICUs and nurses should be educated on the use of this for the assessment of delirium. Key words: intensive care nurses, delirium, intubated patients, experience.