Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study Prospective studies using video-recordings of patients during mechanical ventilator treatment (MVT) while conscious have not previously been published. The aim was to describe patients' statements, communication and facial expressions during a video-recorded interview while undergoing MVT. Content analysis and hermeneutics inspired by the philosophy of Gadamer were used. The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients' conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.

Aim: The aim of this study was to illuminate the lived experience of patients who were conscious during mechanical ventilation in an intensive care unit (ICU).Method: Interviews with 12 patients assessed as being conscious during mechanical ventilation were conducted approximately one week after discharge from an ICU. The text was analyse dusing a phenomenological-hermeneutic method inspired by Ricoeur. Results: Apart from breathlessness, voicelessness was considered the worst experience. The discomfort and pain caused by the tracheal tube was considerable. A feeling of being helpless,deserted and powerless because of their serious physical condition and inability to talk prompted the patients to strive for independence and recovery and made them willing to 'flowwith' the treatment and care. Comments from the patients suggest that their suffering can be alleviated by communication, participation in care activities and companionship. Conclusion: A patient's endurance whilst conscious during mechanical ventilation seems to be facilitated by the presence of nurses, who mediate hope and belief in recovery, strengthening the patient's will to fight for recovery and survival.

Aim: The aim of this study was to observe, interpret and describe nurses' communication with conscious patients receiving mechanical ventilation treatment (MVT) in an intensive care unit(ICU), and to examine if such communication could be interpreted as caring. Design: Hermeneutic observational study inspired by the philosophy of Gadamer. Method: Nineteen patients were observed on several occasions for a total of 66 hours, when conscious during MVT. Findings: A form of caring communication was identified and interpreted as comprising seven themes: being attentive and watchful, being inclusive and involving, being connected, remaining close, being reassuring and providing security, keeping company and using humour and using a friendly approach. Communication that mediated a non-caring approach was also identified and described under two thematic headings, i.e. being neglectful and being absent. Conclusions: Caring is communicated by the caring act of ''standing-by'' the patient. Caring or non-caring is communicated in non-verbal and verbal communication, in the words used, the tone of voice and behaviour, as well as in the performance of nursing care activities.

Background

In recent years, light or no sedation has become a common approach to invasive mechanical ventilation in patients with respiratory distress. The experience of visiting a conscious patient receiving mechanical ventilation in the ICU has to our knowledge not yet been investigated.

Aim

The aim of the study was to describe the meaning attributed by relatives to their experiences of meeting, seeing and communicating with a patient cared for on a mechanical ventilator while conscious.

Method

This study used a prospective, exploratory design comprising interviews with ten relatives conducted on two occasions; in connection with their visits to a patient cared for on a ventilator while conscious and approximately a week after the end of intensive care. The data were analysed by means of hermeneutic interpretation to obtain a deeper understanding of relatives' experiences.

Results

Striving to achieve contact with the patient was the most important aspect of being a close relative of a patient receiving ventilator treatment while conscious and was described by four main themes: feeling ambivalent towards consciousness; feeling ambivalent towards sedation; feeling dependent on the carer and being disappointed; and suppressing own suffering and sadness.

Conclusion

The patients' consciousness enabled the relatives to judge their condition for themselves and enter into contact. This resulted in a sense of being in control but also efforts to suppress own suffering.