Weaning from ventilation needs to be tailored to individual patients and involve them

To improve understanding of how nurses use technology to wean patients from mechanical ventilation.

The literature tends to focus on weaning indices, predictors of success or weaning methods. Few papers address patients' experiences of weaning.

An ethnographic approach was adopted to understand how nurses used technology to wean patients from ventilation.

Data was gathered by participant observation and interviews over six months. In total, 250 hours of field notes were recorded.

Data was analysed using the content analysis method. A central theme of knowing the patient was identified, as well as three sub-themes: ways of knowing; continuity of care; and patients' role in the weaning trajectory.

Participants implied during interviews that "knowing the patient" was essential to delivering patient centred care. Two main factors are necessary for nurses to know their patients: continuity of care and expertise. "Ways of knowing" relied on gaining information about patients and their role as passive recipients of treatment.

Staff allocation systems should enable them to learn from experienced nurses, while work schedules should be organised to ensure nurses begin weaning when they can offer continuity of care. Knowing the patient has been defined as a characteristic of expert nursing. To be truly patient centred, nurses need to address the barriers that prevent them from getting to "know" patients.