Communication when patients are conscious during respirator treatment--a hermeneutic observation study.

ABSTRACT

AIM: The aim of this study was to observe, interpret and describe nurses' communication with conscious patients receiving mechanical ventilation treatment (MVT) in an intensive care unit (ICU), and to examine if such communication could be interpreted as caring. DESIGN: Hermeneutic observational study inspired by the philosophy of Gadamer. METHOD: Nineteen patients were observed on several occasions for a total of 66 hours, when conscious during MVT. FINDINGS: A form of caring communication was identified and interpreted as comprising seven themes being attentive and watchful, being inclusive and involving, being connected, remaining close, being reassuring and providing security, keeping company and using humour and using a friendly approach. Communication that mediated a non-caring approach was also identified and described under two thematic headings, i.e. being neglectful and being absent. CONCLUSIONS: Caring is communicated by the caring act of "standing-by" the patient. Caring or non-caring is communicated in non-verbal and verbal communication, in the words used, the tone of voice and behaviour, as well as in the performance of nursing care activities.