Caught between ideals and reality: Phenomenological-hermeneutic study of healthcare providers’ experiences while interacting with mechanically ventilated patients

ABSTRACT

This study aimed to explore healthcare providers’ experiences of their communication and interaction with conscious patients on mechanical ventilation in intensive care. Nurses, physicians, and physiotherapists were interviewed after they had been video recorded in naturally occurring interactions with patients. The interviews were analyzed using a phenomenological-hermeneutical approach. Three themes were identified: The willingness to engage and understand the mechanically ventilated patient, the potential risk of neglecting the patient in the encounters, and provider interdependence as the core of intensive care. The themes elicited how providers handled the dissonance between their own personal ideals of care and their real-world encounters with patients and other professionals. The healthcare providers were aware of how easily patients could be neglected while being non-vocal, and therefore invested time and effort communicating with the patients. Based on their personal ideals of patient participation and autonomy, it was difficult to perform procedures, such as weaning off the ventilator or mobilization, to which the patient was opposed. Interprofessional collaboration was valued by the providers in such situations. The study revealed that providers need to consider the communication barriers that exist on the individual and team levels when interacting with patients on mechanical ventilation.

KEYWORDS:

• Communication
• intensive care
• interprofessional relations
• interviews
• patient-provider communication
• qualitative research

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Lovisenberg Diaconal University College.

Notes on contributors

Marte-Marie Wallander Karlsen

Marte-Marie Wallander Karlsen, PhD, MNSc, RN, CCN is program director of the master studies at Lovisenberg Diaconal University College and critical care nurse at The Postoperative and Intensive Care Departement, Oslo University Hospital. Her research interests is within the field of communication and interaction with mechanically ventilated patients and simulation-based learning methods in communication.

Arnstein Finset

Arnstein Finset, Professor Emeritus, Psychologist, at the Faculty of medicine, institute of Basic Medical Sciences, University of Oslo, Norway. He is also editor-in-chief, for Elsevier’s Patient Education & Counseling. He is also former president of EACH, the international Association for Communication in Healthcare.

Kristin Heggdal

Kristin Heggdal, PhD, MNSc, RN, is Professor in Nursing and Health Sciences at VID Specialized University, Faculty of Health Sciences and former Head of Research at Lovisenberg Diaconal University College, Oslo, Norway. She was awarded a Fullbright Scholarship in 2018 for the further development of her research on Health Promotion in Chronic Illness.