Abstract
Intensive Care Unit (ICU) nurses are charged with the responsibility of providing healthcare to patients in the unit. Such services are essential since they provide an avenue through which patients can interact with their family members. Families of patients in the ICU suffer from physiological stress and anxiety arising from the fear of losing their loved ones who are usually in critical conditions. Communication between patients and their family members is usually important since it relieves the relatives from the stress that accompany such incidents. According to the different researches conducted in this field, relatives of the ill people have overwhelmingly cited lack of effective communication amongst them, health providers, and their patients as the key cause of their psychological suffering. The ICU nurses play a significant role in connecting the two parties. This paper will explore the effectiveness of the role of nurses in reducing fear and anxiety that is evident among family members of the ICU patients. The paper will analyze in details the role of ICU nurses in reducing stress and anxiety among relatives and family members of the ill patients. In addition, the paper will come up with a conclusion on whether nurses actually play an active role in reducing fear and anxiety among the aforementioned groups.
Introduction
Patients in the ICU are either very ill or seriously injured and they require special attention (Olsen, Dysvik & Hansen, 2009). Healthcare providers in the ICU are highly trained professionals to save lives. Research indicates that family members and relatives who have their loved ones admitted in the ICU are at risk of suffering from stress and anxiety if proper and timely interventions are not made (Høye & Severinsson, 2010). Presumably, nurses are the most influential people in the ICU, and thus they are strategically placed to provide cancelling services to the family members in order to reduce the ensuing stress. In a bid to accomplish this important role, nurses should listen to the family members’ questions and provide timely and professional answers. Research indicates that good communication and involvement of family members in decision-making, in what is referred to as shared decision-making, help in fighting stress (McAdam & Puntillo, 2009). In addition, spiritual and professional counseling can go a long way in dealing with emotional discomforts that befall the relatives (Schaefer & Block, 2009). Family members’ involvement in making critical decisions regarding continuance or withdrawal of life support is important since it leads to reduced stress amongst patients since the outcomes are due to their own decisions (Kentish-Barnes, Lemiale, Chaize, Pochard, & Azoulay, 2009). Therefore, communication is crucial and it can only be availed by nurses. This paper looks into the effectiveness of nurses in reducing stress among family members with patients in the ICU.
Communication and shared decision
Good communication between healthcare providers and relatives must be maintained throughout (Olsen et al., 2009). Nurses have the responsibility of ensuring that news of the ill patients is communicated to the family members in time. At times, hard decisions have to be made, for instance, on whether to withdraw life-supporting machines. Such decisions are hard to make and they require the involvement of the family members. They must communicate with the family members in order to make informed decisions on whether to terminate the life of a patient (Schaefer & Block, 2009). Involving family members in making such decisions instills a feeling of inclusion in the decision-making process. This move makes the family members feel as part of the decision, and thus they are not affected by the outcome thereafter (Olsen et al., 2009). ICU healthcare professionals have the ability to tell if their efforts in treatment will help to save the life of the patient in question (McAdam & Puntillo, 2009). When it becomes apparent that the patient will pass on, family involvement is crucial at this point. The decision at this point involves withholding or withdrawal of the life supporting mechanism. At this point, palliative care is afforded to the patient. Palliative care involves providing comfort to the patient prior to his/her death. Family members often demand assurance that their patient is not going to suffer after the withdrawal of the life supporting machines (Høye & Severinsson, 2010). Nurses also reassure the family members that the decision is in the best interest of the patient (Kentish-Barnes et al., 2009). Nurses provide this assurance and it is effective in reducing stress and anxiety amongst family members.
Spiritual interventions
Spirituality and culture are two important human traits and they have to be respected especially when involving ICU patients (Schaefer & Block, 2009). People have different religious and cultural beliefs that influence their decisions on certain issues. Most people belief in spiritual intervention during the hard times. Through regular interaction amongst nurses, patients, and the family members, nurses are in a position to determine when such interventions are necessary. In the event that the family members are emotionally affected by their patient’s illness, the nurses may invite religious leaders to do counseling to supplement the nursing efforts (McAdam & Puntillo, 2009). Nurses use informal means to determine when such interventions are required and make them available. Research indicates that such interventions are necessary and they produce effective results to believers (Olsen et al., 2009). Research also indicates that spiritual interventions encourage contribution in decision-making. Additionally, through such interventions, most people are in a position to make critical contributions after consultation with their respective spiritual leaders. Such spiritual consultations are most helpful when done in the last days of the patient’s life (Høye & Severinsson, 2010). Therefore, the role of nurses in providing professional and spiritual counseling cannot be ignored.
Family conferences
Family conferences organized by nurses in the course of treatment also work effectively in reducing stress and anxiety amongst family members (Schaefer & Block, 2009). The conferences bring together family members and clinicians to deliberate on the course of events. Nurses usually preside over the conference due to their close involvement in the provision of care to patients and their professional understanding acquired throughout the treatment period (Olsen et al., 2009). Nurses are in a position to measure family members’ understanding on their patients’ progress and advise them accordingly (McAdam & Puntillo, 2009). Family members are at liberty to pose any relevant question and express themselves to the clinicians at the conference. Relatives are also given an opportunity to contribute to the decision making process. Such contributions are necessary since they prepare the members of any outcome.
Interactions with family members
Most patients admitted in the ICU are in critical conditions and some even cannot speak for themselves (Kentish-Barnes et al., 2009). Information about a patient’s feelings is important to the nurses if the correct treatment is to be achieved. History of the patient’s health is important and it becomes quite tasking to acquire such information if the patient cannot express himself/herself. This scenario necessitates the need to interact with the family members to get the patient’s history and any other relevant information. Nurses have to rely on the information provided by the patient’s relatives and in the process of such interactions, the nurse can detect physiological issues in the family members and respond appropriately to mitigate the situation. Nurses may at times acquire information regarding a patient through viewing photographs provided by the patient’s relatives (Schaefer & Block, 2009). The interaction between nurses and family members results in good relationship between the two parties in the end (Olsen et al., 2009). This aspect ensures that family members keep informed of all the developments. Research indicates that good relations between the two parties help in fighting stress and anxiety amongst family members. The available literature indicates that good interaction with the healthcare providers leads to reduction of stress among family members by about 25% (Høye & Severinsson, 2010).
Breaking death news
ICU nurses often face death cases in the course of their work (Kentish-Barnes et al., 2009). In most cases, ICU nurses only prolong the patients’ lives through life supporting machines (Schaefer & Block, 2009). Breaking news to the patients’ family members can be an uncomfortable task especially news on death. Therefore, nurses must do it professionally and exercise due care. Research indicates that keeping family members updated of all the developments of their patient’s health is necessary and it helps in reducing anxiety and fear amongst them. Therefore, the role of nurses in delivering news to family members and relatives of the ill patients cannot be ignored and it can be regarded as the major role played by nurses towards containing fear and anxiety. Breaking death news to relatives is heartrending and nurses have to be careful when delivering such messages. Nurses also comfort the family members during the hard moments especially after the death of a patient.
Conclusion
ICU nurses have the responsibility of saving lives (McAdam & Puntillo, 2009). Family members of the ill patients are at a risk of suffering from stress and anxiety. Nurses’ role in the ICU is twofold. On one hand, nurses have the responsibility of providing healthcare to the ill patients. On the other hand, they have an added responsibility of ensuring that family members are not affected psychologically. In a bid to accomplish this mission, they ensure that proper communication is maintained throughout the process of treatment. Communication and involvement of the family members in making key decisions helps in reducing stress and anxiety. The patient’s relatives are relieved of stress in case of death since the demise is said to have come from their own decisions as opposed to a scenario where the ICU healthcare providers make the decision themselves. Nurses are placed strategically to establish good communication between patients and family members and inform them of all the developments. In addition to communication, nurses also give professional counseling to the family and relatives of the ill patient. Therefore, nurses’ role in the ICU is paramount and it is effective in reducing fear and anxiety among the relatives.
References
Høye, S., & Severinsson, E. (2010). Multicultural family members’ experiences with nurses and the intensive care context: A hermeneutic study. Intensive and Critical Care Nursing, 26(1), 24-32.
Kentish-Barnes, N., Lemiale, V., Chaize, M., Pochard, F., & Azoulay, É. (2009). Assessing burden in families of critical care patients. Critical care medicine, 37(10), 448-456.
McAdam, L., & Puntillo, K. (2009). Symptoms experienced by family members of patients in intensive care units. American Journal of Critical Care, 18(3), 200-209.
Olsen, D., Dysvik, E., & Hansen, B. (2009). The meaning of family members’ presence during intensive care stay: A qualitative study. Intensive and Critical Care Nursing, 25(4), 190-198.
Schaefer, K., & Block, S. (2009). Physician communication with families in the ICU: evidence-based strategies for improvement. Current opinion in critical care, 15(6), 569-577.
