Introduction
Critical care nurses working in the intensive care unit (ICU) possess specialized skills and knowledge that enable them to effectively assist individuals in life-threatening situations. They must constantly monitor the patients for subtle changes to ensure immediate medical interventions. The main problem is that intensive care nurses work with a team of other professionals, such as surgeons and cardiologists, which requires proper coordination and collaboration.
Without proper communication, there may be double work and medical errors, leading to prolonged stays in the ICU. The purpose of this paper is to critically appraise two qualitative research papers. The guiding research question is: For nurses working in a critical care setting (P), does effective communication with the multidisciplinary team (I), compared to lack of strategic communication (C), result in patients spending less time in the ICU (O) in three months (T)?
Background of the Studies
One of the studies is “A Focused Ethnography of the Culture of Inclusive Caring Practice in the Intensive Care Unit” by Hanan Subhi Al-Shamaly. Its research problem concerns the emergence of complex perspectives on what constitutes caring in nursing in the ICU (Al‐Shamaly, 2021). The study’s significance sheds light on the concept of caring for critical care nurses.
The purpose is to examine the multidimensional and inclusive nature of caring in a critical setting (Al‐Shamaly, 2021). Its primary aim is to understand the conjunction of humanistic and technological aspects of caring. Thus, the research question is: What culture do nurses working in multidimensional care have that leads to patient and family satisfaction?
Cindy Weatherburn and Melanie Greenwood’s article is titled “The Role of the Intensive Care Nurse in the Medical Emergency Team: A Constructivist Grounded Theory Study”. Their research problem is a paucity of qualitative studies that capture the functions of intensive care nurses during medical emergency calls (Weatherburn & Greenwood, 2023).
The purpose of this study is to discuss and explain the role of the ICU nurse in collaboration with the medical emergency team (MET) of a tertiary hospital (Weatherburn & Greenwood, 2023). The aims include developing an understanding of the functions of critical care nurses, their enactment, and their specific responsibilities within the team. The guiding research question is: What are the roles of intensive care nurses within MET?
Support of Selected Nursing Practice Problem
The nursing practice question concerns effective communication between nurses and multidisciplinary team members to reduce the time patients spend in the ICU. Both studies are relevant to the issue as they clarify the role of critical care nurses. One study reports that the major causes of serious adverse effects in ICU patients resulted from suboptimal monitoring of vital signs and subsequent care (Weatherburn & Greenwood, 2023).
Lack of effective communication leads to substandard care, which is often attributed to a lack of organizational skills, failure to appreciate the urgency of the situation, working without adequate support, and incompetence (Weatherburn & Greenwood, 2023). The statements provide sufficient support for the PICOT, as they identify the lack of effective communication in nursing care as a reason for adverse effects in people receiving critical care treatment. Moreover, when nurses are unaware of the specifics of their work demands, they may fail or make errors while on duty.
Similarly, the second research study is relevant to the selected practice problem as it explores the concept of caring within the ICU. In addition to caring for patients and supporting their family members, critical care nurses work with various medical technologies (Al-Shamaly, 2021). The implication is that they have broad functions and responsibilities compared to nurses in the general ward. Noteworthy is the failure to effectively communicate their actions to the multidisciplinary team, thereby ensuring coordinated care. Therefore, it is relevant that they receive specialty training to enhance their competencies.
Method of Studies
Although both studies employed qualitative methodology, the selected study design differed. One research study used focused ethnography, a method renowned in the study of social interactions and behavior (Al-Shamaly, 2021). The other study employed constructivist grounded theory, utilizing observation and semi-structured interviews as primary data collection tools (Weatherburn & Greenwood, 2023). The main difference is that grounded theory involves analyzing data to develop it into a theoretical framework. In contrast, ethnography involves observation and interaction with the culture under study.
One of the benefits of focused ethnography is that it helps researchers understand the complexity of behavior and interrelations within a group. However, the main disadvantage of the design is that it is time-consuming and requires a high level of skills and experience. Grounded theory can produce diverse data with rich information on the concept under study. However, its drawback is that it requires a more structured approach and involves collecting a large amount of data, which can be time-consuming.
Results of Studies
Weatherburn and Greenwood developed a substantive theory that the fundamental role of the critical care nurse in a multidisciplinary team is to ensure patient safety. They derived the theory from four primary concepts: a systematic decision-making framework, figuring it out, patient safety, and directing care (Weatherburn & Greenwood, 2023).
The study by Al-Shamaly identified various dimensions of nursing care in the ICU. Particularly, the concept of caring should integrate patients, nurses, family members, colleagues, and the ecological environment of the ICU (Al-Shamaly, 2021). Overall, the findings suggest that caring is not limited to critically ill patients, as those connected to the ICU must be in their ideal state of wellness to achieve the desired results.
Ethical Consideration
Researchers must go through the institutional review board to ensure adherence to ethical standards. For instance, it is essential to obtain informed consent and ensure voluntary participation (Laurie et al., 2021). The other ethical requirement is not to harm the respondents. The hospital’s and university’s ethical committees approved the study after verifying that it did not pose a threat to the participants’ well-being (Al-Shamaly, 2021).
The implication is that no one was coerced into participating in the study. The other study obtained written informed consent from all nurses in the intensive care unit prior to sampling (Weatherburn & Greenwood, 2023). Therefore, respondents’ safety and willingness to participate were critical in ensuring that moral standards guided the study.
Conclusion
Nurses working in intensive care units need a strategic team with a multidisciplinary medical approach to enhance patient outcomes and minimize ICU stays. Proper communication ensures that the nurses are well-prepared to do their duties promptly. Qualitative research methodologies, including grounded theory and ethnography, are all crucial designs that help to understand social interactions and behaviors and advance theory. The studies were conducted ethically and established that it is essential to define the role of critical care nurses for the benefit of patients, their families, and the entire workforce.
References
Al‐Shamaly, H. S. (2021). A focused ethnography of the culture of inclusive caring practice in the intensive care unit. Nursing Open, 8(6), 2973-2985. Web.
Laurie, G., Dove, E., Ganguli-Mitra, A., McMillan, C., Emily Postan, Sethi, N., & Sorbie, A. (2021). The Cambridge handbook of health research regulation. Cambridge University Press.
Weatherburn, C., & Greenwood, M. (2023). The role of the intensive care nurse in the medical emergency team: A constructivist grounded theory study. Australian Critical Care, 36(1), 119-126. Web.