Rural people's experience of critical illness involving inter-hospital transportation: a qualitative study

In recent years there has been a growing awareness of the problems people living in rural areas of Australia face in accessing health-care services. In particular, those experiencing a critical illness or major trauma and requiring specialist critical care services, often available only in metropolitan areas, may require inter-hospital transportation, usually by air ambulance. Management of such patients aims at achieving physiological stabilisation, organising the transfer and communicating with the transport team. As critical care nurses espouse a holistic approach to care, it is imperative that nursing practice aim to meet all the needs of these people. Therefore, critical care nurses should be aware of what such patients are experiencing. A qualitative research study, using Heideggerian hermeneutic phenomenology, was undertaken to explore the experiences of a group of people from rural NSW with a critical illness that necessitated their transfer by air ambulance to a metropolitan critical care unit for further management. Data analysis from interviews with the study participants revealed four major themes. This paper discusses the findings from one such theme, the impact of interhospital transportation, and highlights the anxiety and confusion experienced by rural people transferred to a metropolitan critical care unit. Recommendations for nursing care that minimises this anxiety and confusion are discussed.