Critical care nurses and relatives of elderly patients in intensive care unit – Ambivalent interaction

SummaryObjectiveThe objective was to explore the experiences of CCNs in relation to relatives of elderly patients 80 years and older admitted to ICU.Design and settingThrough methods grounded in phenomenology, six CCNs were purposefully selected for their experiences with relatives of elderly patients admitted to an ICU in Norway. Each CCN participated in semi-structured personal interviews. Using content analysis, interviews were coded and categories and themes were identified.FindingsAn overall theme emerged: “CCNs ambivalent interactive struggle with the relatives of elderly patients”, which reflected the mixed feelings that CCNs recalled having towards relatives. Two themes emerged during the analysis. These were: “relatives are a resource for CCNs and the patient”; and “relatives are seen as challenge”. Six sub-themes were identified: (1) CCNs are relying on relatives, (2) relatives and their understanding of the situation, (3) relatives are committed, (4) relatives have high expectations, (5) relatives can be seen as burden and (6) relatives with cultural differences are a challenge.ConclusionCCN's experiences with the relatives of elderly patients in ICU represent a significant personal, mixed struggle.Relevance to clinical practiceThe findings indicate that development of communication, education, reflection and a more structured organization of intensive care unit can improve results for CCNs and may improve the possibilities for CCNs to promote an excellent family nursing for the elderly patient and his relatives.