Reconnecting: the experiences of nurses caring for hopelessly ill patients in intensive care

The aim of this grounded theory study was to examine the experiences of intensive care nurses caring for patients whom they did not believe were going to survive. Participant observation was undertaken in a large intensive care unit (ICU), and formal unstructured interviews conducted with 14 qualified nurses, in order to discover the nurses' perspectives, dilemmas, and role in caring for hopelessly ill patients and their families. The data were analysed by coding and memos, using a constant comparative analysis. The findings emerged into 11 themes which were condensed into three categories: (i) family separation; (ii) trust; and (iii) family reconnection. The core category is 'reconnecting'; the process by which nurses attempt to overcome the dehumanizing aspects of dying in a technological environment. The context, conditions and consequences of this process are discussed and depicted in a conceptual framework. The conclusions drawn include the idea that nurses require instruction regarding managing death in ICUs to enable as peaceful death as possible, not only for the benefit of the patients and their families, but also for the nurses themselves.