A description of intensive care nursing practices in two private intensive care units in Ciudad de Buenos Aires
Date
2013-06-06
Authors
Alberto, Laura María
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Wainerman, Catalina
Chaboyer, Wendy
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad de San Andrés. Escuela de Educación
Abstract
Florence Nightingale, founder of modern nursing in nineteenth century, asserted the
nurse‟s role was to assist the nature reparative process. And, while this holds true today,
nursing has developed into a profession in its own right with its own unique body of
knowledge, scope of practice and educational preparation. This thesis focuses on
intensive care nursing practices in two private intensive care units (ICU) in Ciudad de
Buenos Aires. Specifically, it explores the knowledge, skills and attitudes critical care
nurses require to undertake their practice.
An ethnographic approached was used in this study. Twelve critical care nurses, from
two private ICUs of Ciudad de Buenos Aires were invited to participate in the study.
Both ICUs were considered Level 1 units according to the classification of the
Argentine Society of Intensive Care Medicine and the Argentinean Health Ministry, that
is they provide services for the most complex patient groups. Four data collection
strategies were used: participant observation, a reflective journal, and both formal and
short focused interviews. Thematic analyses uncovered five themes that reflect the core
of intensive care nursing practices and one theme related to the context. The main
themes were gaining competence; assessing, anticipating deterioration, acting;
collaborating to provide care; individualizing care; and caring.
Argentinian participants acquired their competence through a journey of learning. The
journey provide them a „know what‟ and a „know how‟, that is their knowledge and
skills. ICU nurses learn by repetitive exposure to clinical situations, from their peers and
other practitioners. The knowledge and skills they acquired developed and mutated.
They have understanding that lifelong learning was vital to their performance in
intensive care. Experience helped nurses to perform intuitively. A significant skill was
the ability of nurses to assess, anticipate deterioration and act in smooth, continuous
fashion. Assessment allowed nurses to identify signs of clinical deterioration and
respond appropriately in a timely manner. The patient‟s clinical condition was a driverof nursing actions. Nurses were able to perform collaboratively. They understood their
contribution to the team in terms of effective communication and understanding.
Caring attitudes were also uncovered. Participants made efforts to identify and meet
patient particular needs. They tried to recognize the patient as whole and connect with
the patient. Participants also provided compassionate care. They could understand
patient suffer, even though it was difficult for them. They empathized with the patient.
Sometimes they couldn‟t be compassionate; as a result detachment was evident.
However they acknowledged their difficulty to balance detachment and compassion.
Finally, intensive care nursing practice was influenced by the context and by some
nurses‟ personal characteristics.
Understanding intensive care nursing practice is important for many reasons. First, it
may inform future postgraduate education in the specialty of intensive care nursing.
Second, it may guide in-service training. Third, it may assist managers in recruitment
intensive care nurses. Lastly, it may serve as a foundation for future certification
processes. While these findings provide a beginning understanding of intensive care
nursing practices in Argentina; they highlight many issues for further inquiry.
Additionally, this study provides a view of the gap between intensive care practice in
Argentina and its counterpart in developed countries. Thus, it also helps to envision
future developments of intensive care nursing as discipline in Argentina.
Description
Fil: Alberto, Laura María. Universidad de San Andrés. Escuela de Educación; Argentina.
Keywords
Intensive care nursing -- Study and teaching -- Argentina. , Nurses -- In-service training -- Argentina. , Intensive care nursing -- Study and teaching -- Argentina -- Buenos Aires -- Case studies. , Nurses -- In-service training -- Argentina -- Buenos Aires -- Case studies. , Cuidados intensivos en enfermería -- Enseñanza -- Argentina. , Enfermeras -- Entrenamiento en el servicio -- Argentina. , Cuidados intensivos en enfermería -- Enseñanza -- Argentina -- Buenos Aires -- Casos de estudio. , Enfermeras -- Entrenamiento en el servicio -- Argentina -- Buenos Aires -- Casos de estudio.