Mahon Paula R
Department of Occupational Science, Faculty of Medicine, UBC, Developmental Neurosciences and Child Health, BC Children's Hospital, F606, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada.
Intensive Crit Care Nurs. 2014 Feb;30(1):45-53. doi: 10.1016/j.iccn.2013.08.002. Epub 2013 Sep 13.
The aim of this study is to examine key features within the cultural context in a Canadian Paediatric Intensive Care Unit (PICU) environment as experienced by nurses and to identify what these influences are and how they shape nurses' intentions to remain at critically ill children's bedsides for the duration of their careers. This is a qualitative study which follows a critical ethnographic approach. Over 20 hours of observation and face-to-face semi-structured interviews were conducted. Approximately one third of the nursing population at the research site PICU were interviewed (N=31). Participants describe a complex process of becoming an expert PICU nurse that involved several stages. By the time participants became experts in this PICU they believed they had significantly narrowed the power imbalance that exists between nursing and medicine. This study illuminates the role both formal and informal education plays in breaking the power barrier for nurses in the PICU. This level of expertise and mutual respect between professions aids in retaining nurses in the PICU. The lack of autonomy and/or respect shown to nurses by administrators appears to be one of the major stressors in nurses' working lives and can lead to attrition from the PICU. Family Centred Care (FCC) is practiced in paediatrics and certainly accentuated in the PICU as there is usually only one patient assigned per nurse, who thus afforded the time to provide comprehensive care to both the child and the family. This is considered one of the satisfiers for nurses in the PICU and tends to encourage retention of nurses in the PICU. However, FCC was found to be an inadequate term to truly encompass the type of holistic care provided by nurses in the PICU.
本研究旨在考察护士所体验到的加拿大儿科重症监护病房（PICU）环境文化背景中的关键特征，确定这些影响因素是什么，以及它们如何塑造护士在其职业生涯中始终坚守在重症患儿床边的意愿。这是一项采用批判性人种志方法的定性研究。进行了超过20小时的观察和面对面的半结构化访谈。研究地点PICU约三分之一的护理人员接受了访谈（N = 31）。参与者描述了成为一名专业PICU护士的复杂过程，这一过程涉及几个阶段。当参与者成为该PICU的专家时，他们认为自己已显著缩小了护理与医学之间存在的权力不平衡。本研究阐明了正规教育和非正规教育在打破PICU护士权力障碍方面所起的作用。这种专业水平以及职业间的相互尊重有助于PICU留住护士。管理人员对护士缺乏自主权和/或尊重似乎是护士工作生活中的主要压力源之一，可能导致护士从PICU流失。儿科实行以家庭为中心的护理（FCC），在PICU中这一点当然更为突出，因为通常每位护士只负责一名患者，因此有时间为患儿及其家庭提供全面护理。这被认为是PICU护士的满足因素之一，往往会鼓励护士留在PICU。然而，人们发现FCC这个术语不足以真正涵盖PICU护士提供的整体护理类型。
