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Unsuccessful patient resuscitation: understanding aspects of the critical care nurse's experience Isaak, Cheryl Lynn


This study describes aspects of critical care nurses' experience of unsuccessful patient resuscitation. The study was guided by the philosophical perspective of phenomenology in the tradition of Benner (1984, 1994) and Benner and Wrubel (1989) because of the intent to understand the commonalities and differences of the experience. Critical care nurses (CCNs) frequently care for patients who are unsuccessfully resuscitated, however, there i s a lack of research concerning this phenomenon. The purpose of this study was to explore and describe the experience of CCNs who participate in unsuccessful patient resuscitation. Data were collected through twenty seven interviews with nine participants who work in an urban tertiary critical care area in one Canadian city. The paradigm case interview focused on the participant's narrative account of an unsuccessful patient resuscitation. The researcher sought to understand the CCN's experience through hearing and analyzing the paradigm case. The interviews were analyzed using constant comparative analysis and substantive coding. The theme of "knowing" was central to the participants' accounts of unsuccessful patient resuscitation. Knowing involved three themes: knowing the case, knowing the patient, and knowing the person. Each of the critical care nurses began to know the individual through "knowing the case". Knowing the case was significant as i t allowed the participants to care competently and confidently for the case as they developed a relationship with the patient. "Knowing the patient" involves a relationship characterized by professional concern and responsibility , between the critical care nurse, the patient, and the patient's significant others. The nurse's understanding of the patient allows her or him to identify and anticipate the patient's instability and the unsuccessful resuscitation. The nurses valued knowing the patient as a mechanism f o r preparing themselves to be emotionally stable during and after an unsuccessful patient resuscitation. "Knowing the person" involved a strong connection between the patient and nurse that created an emotional attachment to the patient and his or her significant others. The critical care nurses' involvement with the person and his or her significant others was frequently painful as they experienced the loss of a person they had come to know and care for prior to the resuscitation effort.

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