Nursing patients with ventricular assist devices: an interpretive description.

ABSTRACT

CONTEXT-Although researchers have studied the experience of caring for patients with ventricular assist devices from the perspective of family caregivers, few reports address the experience of nursing patients with such devices. OBJECTIVE -To investigate the experience of nursing patients who have a ventricular assist device. DESIGN -A qualitative approach called interpretive description was used to conduct semistructured, 1-on-1 interviews. PARTICIPANTS-Six registered nurses with a range of clinical experiences were interviewed in a 1-year period from 2009 to 2010. Data were transcribed and analyzed by the researcher in conjunction with a research team. RESULTS-Four distinct themes were interpreted from the interview data exclusive knowledge, human connection, ethics, and interdisciplinary stress and technology. CONCLUSION -Nursing patients who have a ventricular assist device is a complex experience. Nurses develop expert knowledge that is related to direct exposure to patients; this unique knowledge should be formally considered in team decision making. Nursing care of patients who have a ventricular assist device also has features that might result in overconnected nurse-patient relationships. Closely connected nurse-patient relationships intensified the emotional difficultly of experiences of exposure to illness or suffering, or exposure to an unpredictable dying trajectory. Nursing patients with ventricular assist devices can be difficult, and nursing leaders should be aware of the emotional reactions that can result from direct exposure to patients who might be perceived as very ill or suffering. Institutions with ventricular assist device programs should consider providing emotional support for health care workers who find this type of work emotionally difficult.