Navigating Spinal Safety: Critical Care Nurses' Experiences of Caring for Patients With Spinal Trauma and Disorders

Patients with spinal trauma and disorders admitted to intensive care units (ICUs) require complex care that combines life-sustaining treatment, spinal precautions, complication prevention and rehabilitation-related support. Although ICU nurses are central to maintaining patient safety, little is known about their experiences of caring for this patient group.

To explore ICU nurses' experiences of caring for patients with spinal trauma and disorders.

A descriptive qualitative study.

Fifteen ICU nurses from three tertiary hospitals in Hunan Province, China, were recruited using purposive sampling. Data were collected through one-to-one semi-structured interviews between January and April 2026. Interviews were audio-recorded, transcribed verbatim and analysed using Braun and Clarke's thematic analysis. The study was reported in accordance with the COREQ checklist.

Five themes were generated: maintaining spinal safety during ICU care; managing the burden of immobility and high dependency; working under pressure in high-risk spinal care; making care safer through team support; and building specialist competence within ICU practice. Nurses experienced spinal safety as a continuous concern embedded in routine ICU care, including coordinating high-risk logrolling and transfer, recognising neurological changes with limited confidence and balancing positioning, orthosis use and pressure-injury risks. They also described interrelated physiological needs, frequent and precise patient needs, rehabilitation limits, uncertain prognosis, reliance on team support and more vigilant, anticipatory and holistic care.

Caring for patients with spinal trauma and disorders in ICUs requires nurses to balance spinal safety, critical illness management, high dependency care and emotional support. ICU nurses developed anticipatory and holistic approaches, but also experienced uncertainty and pressure when specialist spinal care knowledge was limited.

ICU teams should develop spinal safety checklists, standardised guidance for logrolling, transfer, positioning and orthosis management and practical training programmes. Strengthening collaboration between ICU teams and spinal specialists may improve nurse competence and patient safety.