Personal cost, caring and communication: an analysis of communication between relatives and intensive care nurses

Much of health care is seen as 'communication-centred' (Smith & Bass 1982) and the interpersonal nature of nursing gives this view particular relevance. The potential contribution to patient well-being which is offered by good communication is being recognised by professional service providers and consumers alike. Whilst relatives or 'significant others' have an important impact on patient well-being, recognition of their own needs is becoming more evident. This paper, therefore, is intended to focus attention on communication between nurses and patients' relatives in critical care settings. Needs of relatives are discussed along with an analysis of nurses' responses to these needs, and nurses' apparent reluctance to be involved is explored. A critical appraisal of the literature reveals compelling arguments for a decisive contribution by nurses to this area of care. Initiatives aimed at placing communication needs of relatives more firmly within a nursing remit are then explored. Whilst intensive care units (ICUs) may generally demonstrate good practice in relation to communicating with relatives it is suggested that exploration of concepts surrounding both the nature of nursing and caring may offer valuable insights into this aspect of critical care nurses' role.