Mukuve Paulus, Nuuyoma Vistolina
School of Nursing and Public Health, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek, Namibia.
SAGE Open Nurs. 2023 Oct 10;9:23779608231205691. doi: 10.1177/23779608231205691. eCollection 2023 Jan-Dec.
Managing a patient on mechanical ventilation is a vital aspect of clinical scope in intensive and critical care units. In addition, it is a highly technical, intricate, dynamic task requiring extensive knowledge and skills. Little is known about critical care nurses' experiences caring for patients on mechanical ventilation in contexts where resources are constrained, creating an empirical gap in the available body of knowledge.
This study explored critical care nurses' experiences caring for patients on mechanical ventilators at an intermediate hospital in northeastern Namibia.
The study followed qualitative descriptive and explorative designs. The purposive sample included 13 critical care nurses who had cared for patients on mechanical ventilation for more than 6 months. Data were collected via individual unstructured interviews and analyzed using a reflexive thematic analysis approach.
Four themes and eight subthemes emerged. Varied personal feelings, such as feeling proud, competent, exhausted, traumatized, overwhelmed, and concerns for patients' well-being were experienced by critical care nurses. Participants described learning from colleagues in the unit and expressed concerns about not having postbasic training in critical care nursing. Negative experiences included concerns about community members' misconceptions about critical care units and mechanical ventilators, and challenges with resources, personnel, and admission procedures.
Critical care nurses in resource-constrained settings have positive and negative experiences caring for patients on mechanical ventilators. The findings have implications for the development of support systems for critical care nurses, including induction programs, competence enhancement, psychological support, the development of guiding documents for admission, patient preparation and sensitization of community members. There is a need for this study to be replicated in other resource-constrained contexts where specialized critical care nurses are available.
管理接受机械通气的患者是重症监护病房临床工作的重要方面。此外，这是一项技术要求高、复杂且动态的任务，需要广泛的知识和技能。在资源有限的情况下，对于重症监护护士护理接受机械通气患者的经验了解甚少，这在现有的知识体系中造成了实证空白。
本研究探讨了纳米比亚东北部一家中级医院的重症监护护士护理使用机械通气患者的经验。
该研究采用定性描述性和探索性设计。目的抽样包括13名护理接受机械通气患者超过6个月的重症监护护士。通过个人非结构化访谈收集数据，并使用反思性主题分析方法进行分析。
出现了四个主题和八个子主题。重症监护护士经历了各种个人感受，如感到自豪、有能力、疲惫、受创伤、不堪重负以及对患者福祉的担忧。参与者描述了向科室同事学习的情况，并表达了对没有接受重症护理进阶培训的担忧。负面经历包括对社区成员对重症监护病房和机械通气的误解的担忧，以及资源、人员和入院程序方面的挑战。
在资源有限的环境中，重症监护护士在护理使用机械通气的患者时既有积极的经历，也有消极的经历。这些发现对重症监护护士支持系统的发展具有启示意义，包括入职培训计划、能力提升、心理支持、制定入院指导文件、患者准备以及社区成员的宣传教育。有必要在其他有专业重症监护护士的资源有限环境中重复这项研究。
