Nursing and the chronically ill patient in the acute-care hospital

The purpose of this exploratory interview study was to delineate the experience of nurses in a large acute-care/teaching hospital who provided nursing care to patients whose condition is characterized by: (a) chronicity, (b) severe functional debilitation, (c) whose care needs require maximum staff effort, and (d) whose potential for improvement was minimal. These patients are of significance for nurses because their predominant care needs are nursing, yet most nurses in the acute setting find the experience of providing care to these patients to be burdensome and discouraging. However, based on the data to be reported on here, there were nurses in the study who found the experience to be both challenging and rewarding. Discussion is on the experience of nurses who found a challenge and reward in the experience and focuses on (a) what they found in the nursing care of these patients to be a challenge and rewarding and why, (b) how their expectations for the patient and their perspective on the patient's progress enhanced provision of care to these patients, and (c) their impact on the ward vis-à-vis their peers. Implications for nursing practice are discussed.