Caring and technology in an intensive care unit: an ethnographic study

Journal article

Price, A. M. 2013. Caring and technology in an intensive care unit: an ethnographic study. Nursing In Critical Care. 18 (6), pp. 278-288. https://doi.org/10.1111/nicc.12032
AuthorsPrice, A. M.
Abstract

Background
Critical care practice is a mixture of caring and technological activities. There is debate about whether the balance between these two elements is correct and a concern that critical care units can dehumanise the patient. This research wanted to examine aspects that might affect this balance between the caring and technology within the critical care setting.
Aim
What aspects affect registered health care professionals’ ability to care for patients within the technological environment of a critical care unit?
Methodology
A qualitative approach using ethnography was utilised as this methodology focuses on the cultural elements within a situation. Data collection involved participant observation, document review and semi-structured interviews to triangulate methods as this aids rigour for this approach. A purposeful sample to examine registered health care professionals currently working within the study area was used. A total of 19 participants took part in the study; 8 nurses were observed and 16 health care professionals were interviewed, including nurses, a doctor and 2 physiotherapists. The study took place on a District General Hospital intensive care unit and ethical approval was gained.
Findings
An overarching theme of the ‘Crafting process’ was developed with sub themes of ‘vigilance’, ‘focus of attention, ‘being present’ and ‘expectations’ with the ultimate goal of achieving the best interests for the individual patient.
Conclusion
The areas reflected in this study coincide with the care, compassion, competency, commitment, communication and courage ideas detailed by the Department of Health (2012). Thus, further research to detail more specifically how these areas are measured within critical care may be useful.
Relevance to practice
Caring is a complex concept that is difficult to outline but this article can inform practitioners about the aspects that help and hinder caring in the technical setting to inform training.

KeywordsAdult intensive care;Critical care nursing;Fieldwork;Person-centered nursing;Qualitative research;Technology
Year2013
JournalNursing In Critical Care
Journal citation18 (6), pp. 278-288
PublisherBlackwell
ISSN1362-1017
Digital Object Identifier (DOI)https://doi.org/10.1111/nicc.12032
Publication dates
PrintNov 2013
Publication process dates
Deposited24 Feb 2015
Output statusPublished
Permalink -

https://repository.canterbury.ac.uk/item/8726y/caring-and-technology-in-an-intensive-care-unit-an-ethnographic-study

  • 87
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month

Export as

Related outputs

A global examination of nurse practices to engage families in the intensive care unit
McAndrew, N., Clisbee, D., Brysiewicz, P., Eggenberger, S., Richardson, A., Richardson, S., Price, A., de Beer, J., Towell-Barnard, M., Honda, J. and Chiang, V. 2023. A global examination of nurse practices to engage families in the intensive care unit.
Family experiences and trajectory of care received during and after a relative’s admission to ICU: A scoping review
Burns, M., De Goumoens, V., Naef, R., Brysiewicz, P., McAndrew, N., Eggenberger, S., MacPhail, K., Kiwanuka, F., Luttik, M., Nagl-Cupal, M. and Price, A. 2023. Family experiences and trajectory of care received during and after a relative’s admission to ICU: A scoping review.
Factors affecting critical care nurses engagement with families
Price, A. 2023. Factors affecting critical care nurses engagement with families.
Factors influencing critical care nurses' family engagement practices: An international perspective
Price, A., McAndrew, N., Thaqi, Qendresa, Kirk, M., Brysiewicz, P., Eggenberger, S. and Naef, R. 2022. Factors influencing critical care nurses' family engagement practices: An international perspective. Nursing In Critical Care. 28 (6), pp. 1031-1044. https://doi.org/10.1111/nicc.12824
EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries
Hatzidimitriadou, E., Wright, T., Stirrup, V., Kuzbit, P., Thompson, T., DeBraal, P, Burton, C., Price, A., Stein, M., Wells, G., Manship, S., Martin, A. and Chung, P. 2022. EMPOWERing older people and their communities to manage their own CARE (EMPOWERCARE): Evaluation study of a social innovation initiative across four European countries. International Journal of Integrated Care. https://doi.org/10.5334/ijic.ICIC22333
Staff perceptions of spiritual care in intensive care: A preliminary survey.
Price, Ann M. 2022. Staff perceptions of spiritual care in intensive care: A preliminary survey. Intensive and Critical Care Nursing. https://doi.org/10.1016/j.iccn.2022.103341
‘Doing the best we can’: Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID-19
Stayt L., Merriman, Clair, Bench, Suzanne, Price, A., Vollam, Sarah, Walthall, Helen, Credland, Niki, Gerber, Karin and Calovski, Vid 2022. ‘Doing the best we can’: Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID-19. Journal of Advanced Nursing. 78 (10), pp. 3371-3384. https://doi.org/10.1111/jan.15419
Intensive care nurse-family engagement from a global perspective: A qualitative multi-site exploration.
Naef, Rahel, Brysiewicz, Petra, Mc Andrew, Natalie S, Beierwaltes, Patricia, Chiang, Vico, Clisbee, David, de Beer, Jennifer, Honda, Junko, Kakazu, Shota, Nagl-Cupal, Martin, Price, A., Richardson, Sandra, Richardson, Anna, Tehan, Tara, Towell-Barnard, Amanda and Eggenberger, Sandra 2021. Intensive care nurse-family engagement from a global perspective: A qualitative multi-site exploration. Intensive and Critical Care Nursing. https://doi.org/S0964-3397(21)00070-7
Reflections on international research collaborations: decolonising our research approach
Price, A. M. and Southgate, A. 2021. Reflections on international research collaborations: decolonising our research approach. Council of Deans of Health
Ethics in critical care research: scratching the surface
Price, A. M. 2021. Ethics in critical care research: scratching the surface . Intensive and Critical Care Nursing. https://doi.org/10.1016/j.iccn.2021.103013
Nurses’ perspectives on spiritual care in ICU: results of a survey
Price, A. M. 2020. Nurses’ perspectives on spiritual care in ICU: results of a survey.
Comparing undergraduate student nurses understanding of sustainability in two countries: a mixed method study
Chen, M. and Price, A.M. 2020. Comparing undergraduate student nurses understanding of sustainability in two countries: a mixed method study. Nurse Education Today.
Innovative global family research: lessons learnt from the IFNA Acute Care Research Cluster
Brysiewicz, P., Naef, R., Eggenberger, S., Beierwaltes, P., Chiang, V., Clisbee, D., de Beer, J., Ewens, B., Honda, J., McAndrew, N., Meiers, S., Nagl-Cupal, M., Richardson, A., Richardson, S., Tehan, T., Towell-Barnard, A. and Price, A. M. 2019. Innovative global family research: lessons learnt from the IFNA Acute Care Research Cluster.
Engaging with families during critical illness: an international study of nurses’ descriptions and practices of family engagement in intensive care units
Naef, R., Brysiewicz, P., Eggenberger, S., Beierwaites, P., Chiang, V., Clisbee, D., Honda, J., McAndrew, N., Meiers, S., Nagl-Cupal, M., Ricardson, A., Richardson, S., Tehan, T., de Beer, J., Towell-Barnard, A., Ewens, B. and Price, A. M. 2019. Engaging with families during critical illness: an international study of nurses’ descriptions and practices of family engagement in intensive care units.
Engagement of families in ICU from the nursing staff perspective
Price, A. M., Brysiewicz, P., Eggenberger, S. and Naef, R. 2019. Engagement of families in ICU from the nursing staff perspective.
Spiritual intelligence as a method to improve spiritual care in nursing students
Price, A. M. 2019. Spiritual intelligence as a method to improve spiritual care in nursing students.
Editorial comment: Nursing in Critical Care journal survey 2018
Scholes, J., Albarran, J. and Price, A. M. 2018. Editorial comment: Nursing in Critical Care journal survey 2018. Nursing In Critical Care. https://doi.org/10.1111/nicc.12384
Spiritual care: can student nurses learning contribute to leading person-centred practice?
Price, A. M. 2018. Spiritual care: can student nurses learning contribute to leading person-centred practice?
First year nursing students use of social media within education: results of a survey
Price, A. M., Devis, K., Le Moine, G., Crouch, S., South, N. and hossain, R. 2017. First year nursing students use of social media within education: results of a survey. Nurse Education Today. https://doi.org/10.1016/j.nedt.2017.10.013
Using phenomenology to explore student nurses experiences of spiritual care
Price, A. M. 2017. Using phenomenology to explore student nurses experiences of spiritual care.
Exploring spiritual care in nurse education: is phenomenology the right tool for the job?
Price, A. M. 2017. Exploring spiritual care in nurse education: is phenomenology the right tool for the job?
The National Competency Framework for Registered Nurses in Adult Critical Care: an overview
Deacon, K., Baldwin, A., Donnelly, K., Freeman, P., Himsworth, A., Kinoulty, S., Kynaston, M., Platten, J., Price, A. M., Rumsby, N., Witton, N. and on behalf of the Critical Care Nurse Education Review Forum (CCNERF) 2017. The National Competency Framework for Registered Nurses in Adult Critical Care: an overview. Journal of the Intensive Care Society.
The significance of Personal Learning Environments (PLEs) in nursing education: extending current conceptualizations’
Patterson, C., Stephens, M., Chiang, V., Price, A. M., Work, F. and Snelgrove-Clarke, E. 2017. The significance of Personal Learning Environments (PLEs) in nursing education: extending current conceptualizations’. Nurse Education Today. 48, pp. 99-105. https://doi.org/10.1016/j.nedt.2016.09.010
Oesophageal varices
Canavan, R. and Price, A. 2016. Oesophageal varices. in: Price, A., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 229-236
Understanding the ecology of the Personally Significant Learning Environment (PSLE): one year on
Stephens, M., Patterson, C., Price, A. M., Snelgrove-Clarke, E., Work, F. and Chiang, V. 2016. Understanding the ecology of the Personally Significant Learning Environment (PSLE): one year on.
Using creative writing to explore facilitation skills in practice
Price, A. M., Hirter, K., Lippiatt, C. and O'Neill, K. 2016. Using creative writing to explore facilitation skills in practice. International Practice Development Journal. 6 (1). https://doi.org/10.19043/ipdj.61.011
Acute abdomen
Canavan, R. and Price, A. M. 2016. Acute abdomen. in: Price, A., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 223-228
Compartment syndrome
Price, A. M. 2016. Compartment syndrome. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 335-338
Neurogenic shock
Price, A. M. 2016. Neurogenic shock. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 297-300
Diabetic ketoacidosis
Price, A. M. and Canavan, R. 2016. Diabetic ketoacidosis. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 289-296w
Assessing and managing aspects of consciousness and disability
Price, A. M. 2016. Assessing and managing aspects of consciousness and disability. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 271-282
Anaphylactic shock
Price, A. M. 2016. Anaphylactic shock. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 193-196
Sepsis
Price, A. M. and Smith, S. 2016. Sepsis. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 169-176
Assessing and managing the cardiovascular system
Price, A. M. 2016. Assessing and managing the cardiovascular system. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 161-168
Asthma
Price, A. M. and Merritt, S. 2016. Asthma. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 121-130
Chronic obstructive pulmonary disease
Price, A. M. and Merritt, S. 2016. Chronic obstructive pulmonary disease. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 109-120
Obtaining and interpreting arterial blood gases
Price, A. M. and Smith, S. 2016. Obtaining and interpreting arterial blood gases. in: Price, A. M., Smith, S. and Challiner, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Cumbria M & K Publishing. pp. 79-86
What are the patterns of personal learning environments (PLE) for undergraduate students undertaking degrees in nursing.
Price, A. M., Stephens, M., Patterson, C., Snelgrove-Clarke, E., Work, F. and Chiang, V. 2015. What are the patterns of personal learning environments (PLE) for undergraduate students undertaking degrees in nursing.
Implementing an e-learning Masters programme for Practice Development
Price, A. M., Howatson-Jones, L. and Dewing, J. 2014. Implementing an e-learning Masters programme for Practice Development.
Is spirituality evident as part of the caring activity of nurses within a intensive care unit?
Price, A. M. 2012. Is spirituality evident as part of the caring activity of nurses within a intensive care unit?
The complex architecture of critical care practice
Price, A. M. 2010. The complex architecture of critical care practice.
Undertaking a Glasgow Coma Score properly
Price, A. M. 2010. Undertaking a Glasgow Coma Score properly. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 357-360
Meeting nutritional requirements (MUST)
Price, A. M. 2010. Meeting nutritional requirements (MUST). in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 353-356
Interpretation of blood gases
Price, A. M. 2010. Interpretation of blood gases. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 333-340
Neurogenic shock
Price, A. M. 2010. Neurogenic shock. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 241-246
Altered level of consciousness and confusion
Price, A. M. 2010. Altered level of consciousness and confusion. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 233-240
Compartment syndrome
Price, A. M. 2010. Compartment syndrome. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 229-232
Acute abdomen
Canavan, R. and Price, A. M. 2010. Acute abdomen. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 163-170
Chest pain
Budack, K. and Price, A. M. 2010. Chest pain. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 157-162
Sepsis
Price, A. M. and Smith, S. 2010. Sepsis. in: Smith, S., Price, A. M. and Challinor, A. (ed.) Ward-Based Critical Care: A Guide for Health Professionals Keswick M&K Update. pp. 113-120
Participant observation: how useful is it in an acute hospital setting?
Price, A. M. 2009. Participant observation: how useful is it in an acute hospital setting?
Caring and technology: can we separate them in ITU?
Price, A. M. 2009. Caring and technology: can we separate them in ITU?
Measuring cardiac output using the PiCCO system
King, D. and Price, A. M. 2008. Measuring cardiac output using the PiCCO system. British Journal of Cardiac Nursing. 3 (11), pp. 512-518. https://doi.org/10.12968/bjca.2008.3.11.31555
Developing a high dependency unit from a ward
Price, A. M. 2008. Developing a high dependency unit from a ward.
Applying interprofessional learning to a pre-registration health professions programme: the challenges for adult nursing
Felstead, I., Levine, A. and Price, A. M. 2008. Applying interprofessional learning to a pre-registration health professions programme: the challenges for adult nursing.
Exploring caring practice within the technological setting of a critical care unit
Price, A. M. 2008. Exploring caring practice within the technological setting of a critical care unit.
Using a high-flow respiratory system (Vapotherm) within a high dependency setting
Price, A. M., Plowright, C., Makowski, A. and Misztal, B. 2008. Using a high-flow respiratory system (Vapotherm) within a high dependency setting. Nursing In Critical Care. 13 (6), pp. 298-304.
Vascular surgery
Price, A. M. 2007. Vascular surgery. in: McArthur-Rouse, F. and Prosser, S. (ed.) Assessing and Managing the Acutely Ill Adult Surgical Patient Oxford Wiley-Blackwell. pp. 107-120
The joys and frustrations of being a part-time nursing student
Price, A. M. 2006. The joys and frustrations of being a part-time nursing student.
Pre-registration education: making a difference to critical care?
Collins, T., Price, A. M. and Angrave, P. 2006. Pre-registration education: making a difference to critical care? Nursing In Critical Care. 11 (1), pp. 52-57.
Implementing an adult nursing pathway within an inter-professional framework
Price, A. M. 2005. Implementing an adult nursing pathway within an inter-professional framework.
Caring and technology: time to redress the balance?
Price, A. M. 2005. Caring and technology: time to redress the balance?
Pre-registration education: making a difference to critical care?
Price, A. M. 2004. Pre-registration education: making a difference to critical care?
Intensive care nurses' experiences of assessing and dealing with patients' psychological needs
Price, A. M. 2004. Intensive care nurses' experiences of assessing and dealing with patients' psychological needs. Nursing In Critical Care. 9 (3), pp. 134-142. https://doi.org/10.1111/j.1362-1017.2004.00055.x
The reality of critical incident technique in small scale research
Price, A. M. 2003. The reality of critical incident technique in small scale research.
To high flow or not high flow CVVH
Price, A. M. 2003. To high flow or not high flow CVVH.
Using information technology to enhance critical care education
Price, A. M. 2003. Using information technology to enhance critical care education.
Nursing care of the acute head injury: a review of the evidence
Price, A. M., Collins, T. and Gallagher, A. 2003. Nursing care of the acute head injury: a review of the evidence. Nursing In Critical Care. 8 (3), pp. 126-133. https://doi.org/10.1046/j.1478-5153.2003.00019.x
The nurses' perspective of psychological care given to patients in ITU: what helps or hinders
Price, A. M. 2002. The nurses' perspective of psychological care given to patients in ITU: what helps or hinders.
Implementing a nurse-led ventilatory weaning protocol for long-term patients
Price, A. M. 2001. Implementing a nurse-led ventilatory weaning protocol for long-term patients.
Psychological care in intensive care: the nurses' view
Price, A. M. 2001. Psychological care in intensive care: the nurses' view.
Nurse-led weaning from mechanical ventilation: where's the evidence?
Price, A. M. 2001. Nurse-led weaning from mechanical ventilation: where's the evidence? Intensive and Critical Care Nursing. 17 (3), pp. 167-176. https://doi.org/10.1054/iccn.2001.1557
Alteration in cardiovascular function: care of the patient with septic shock
Price, A. M. and Kavanagh, D. 2001. Alteration in cardiovascular function: care of the patient with septic shock. in: Cox, C. and Reyes-Hughes, A. (ed.) Clinical Effectiveness in Practice Basingstoke Palgrave Macmillan. pp. 59-68
Nurse-led weaning from mechanical ventilation: where's the evidence?
Price, A. M. 2000. Nurse-led weaning from mechanical ventilation: where's the evidence?
Our journey with clinical supervision in an intensive care unit
Price, A. M. and Chalker, M. 2000. Our journey with clinical supervision in an intensive care unit. Intensive and Critical Care Nursing. 16 (1), pp. 51-56. https://doi.org/10.1054/iccn.1999.1475
Implementing clinical supervision in a district general hospital
Price, A. M. 1999. Implementing clinical supervision in a district general hospital.