Intensive Care Nurses' Experiences With Digital Silence and Implications for Care: A Qualitative Study

In intensive care units (ICUs), where digital transformation is at its most complex, advanced technology, continuous data flow and alarm systems expose the most pronounced and vulnerable consequences of digitalisation.

To gain an in-depth understanding of intensive care nurses' experiences with digital silence behaviour and its implications for patient care.

This phenomenological study is reported according to the Consolidated Criteria for Reporting Qualitative Research guidelines. Seventeen ICU nurses were purposefully selected. Face-to-face interviews were conducted, and narratives analysed using Colaizzi's phenomenological method.

'Digital Silence Experiences of Intensive Care Nurses' is summarised under two themes: (1) Digital Silence Awareness and Attributes, and (2) Individual and Collective Implications of Digital Silence. ICU nurses ranged from being aware to not recognising digital silence behaviours, which resulted in both an individual emotional burden and a factor that limits professional functionality and collective clinical performance. Seven types of digital silence emerged, categorised as behavioural (Delayed or Missed Responses to Messages, Neglect of Alarms and Notifications, Preference for Informal or Non-Official Platforms and Silence Towards Digital Education and Guidelines), technical (Indifference to Technical Problems), organisational (Delayed or Incomplete Electronic Documentation in Clinical Care Processes) and mixed digital silence (Intentional or Unintentional Blocking of Information Sharing). For each type, causes, implications and mitigation strategies are provided.

In the ICU, digital silence is not merely an individual preference or negligence; it also arises from technical and organisational issues, indicating that interacting factors such as high workload, intense digital data flow, user-unfriendly systems and limited organisational support play a role.

Action is needed, beginning with undergraduate education, rethinking system design, ensuring sustained implementation over time and actively involving nurses to better understand how to integrate digital systems into work processes and transform them.