Caring for Patients Receiving Continuous Renal Replacement Therapy in the Intensive Care Unit: A Qualitative Study

Continuous renal replacement therapy (CRRT) is a complex, high-risk life-sustaining intervention in intensive care units (ICUs). Despite its widespread use, understanding of how nurses navigate 'human-machine' interactions to develop professional competence remains limited.

To describe the clinical experiences of critical care nurses in caring for patients receiving CRRT and to explore their professional growth trajectory from technical anxiety to autonomy.

A descriptive qualitative study design was employed. Ten registered nurses with at least 1 year of ICU experience were recruited from a tertiary medical centre using purposeful sampling. Data from semi-structured interviews were analysed using inductive content analysis. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Methodological rigour was ensured using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research.

A dynamic growth trajectory from 'technical anxiety' to 'professional mastery' emerged, consisting of four core themes: (1) navigating uncertainty, (2) battling the machine, (3) beyond the numbers: developing clinical judgement and (4) the safety net of interprofessional collaboration. A critical turning point occurred when nurses integrated machine data with physiological responses to see the 'patient behind the machine'.

Caring for patients on CRRT involves a complex psychological and professional maturation process. Through accumulated practice and interprofessional support, nurses overcome initial fears and develop 'technological competency as caring'.

Healthcare institutions should implement simulation-based education focusing on clinical troubleshooting and establish robust interprofessional support systems to reduce cognitive load and foster professional resilience among nurses.