Challenges encountered by intensive care nurses in meeting patients' families' needs in Malawi

Abstract

Critically ill patients may be incapable of making decisions, thus forcing their family members to make decisions on their behalf. Intensive care units (ICUs) are a new additions to hospitals in developing countries. The nurses' roles, in caring for ICU patients and supporting their families, have not been researched extensively in Malawi. The purpose of this study was to explore the challenges ICU nurses face in providing family support while delivering complex care to patients. The results provide insight, from a developing country, related to intensive care nursing of patients and their families. It also provides a nursing perspective to hospitals striving to improve their ICUs. A descriptive, exploratory, qualitative study was conducted at two hospitals in Blantyre, Malawi, during March and April 2008. Data collection involved interviewing ten ICU nurses. The following themes emerged from the data: lack of adequate ICU training; lack of written policies to manage ICU patients' families; and lack of preparedness to provide continued and persistent information to families; manage the continued presence of families; promote families' abilities to rest; and to deal with specific religious practices and competing demands for patient and family care. Recommendations include: creating an ICU information booklet; introducing the provision of family support care in ICUs; creating respectful, trusting, empathetic and collaborative relationships with families; providing waiting areas for ICU patients' families; educating hospital management regarding the stressful working situation of ICU nurses; and instituting a post registration programme in intensive care nursing in Blantyre.