How can nurses facilitate patient's transitions from intensive care?: a grounded theory of nursing

Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process.

Group interviews, individual interviews and participant observations were conducted with nurses in two hospitals in Sweden and were analysed using grounded theory.

The substantive theory shows the process of nursing care activities - from the contexts of the ICU and the general ward. The main concern was to achieve a coordinated, strengthening, person-centered standard of care to facilitate patient transitions. The core category "being perceptive and adjustable" was a strategy to individualise, that was related to the other categories; "preparing for a change" and "promoting the recovery". However, the nurses were forced to "balance between patient needs and the caregivers' resources" and consequently were compromising their care.

To facilitate an ICU-patient's transition, individual care planning is needed. It is also essential that the patients are adequately prepared for the change to facilitate the transitional care. Knowledge about transitional needs, empowerment and patient-education seems to be important issues for facilitating transitions.