Realization impact: nursing assessment and strategies

Dealing with the anguish of family members who stand at the threshold of the awareness that their loved one is in danger of dying requires great ingenuity on the part of the critical care nurse. This article describes a phenomenon called "realization impact," which is a process through which family members proceed before facing the fact that their family member could die. An understanding of the realization impact phenomenon can facilitate transactions (defined as the purposeful interaction toward a common goal) between the critical care nurse and the family members of patients in danger of dying.