This qualitative study explored the retrospective perceptions of the anticipatory mourning experience of caregivers who had not received hospice services. Data revealed five major processes that were consistently described by informants: realization; caretaking; presence; finding meaning; and transitioning. Characteristics of each of these processes are described. Study informants provided information about what was helpful to them. The implications for health care providers include: an awareness of changed family roles and relationship attachments that can cause strain on family systems; familiarity with the complex demands on caregivers and their need for accurate information, anticipatory guidance and support resources; professional expertise especially in regard to education about what to expect; a caring presence; and pain and symptom management.

The massive destruction caused by Hurricanes Katrina and Rita in 2005 provided an opportunity for many volunteers to be involved with disaster relief work. Exposure to devastation and personal trauma can have long-lasting and sometimes detrimental effects on people providing help. This qualitative study explored the experience of volunteer relief workers who provided disaster relief services after the hurricanes. Three major themes emerged: emotional reactions that included feelings of shock, fatigue, anger and grief as well as sleep disturbances; frustration with leadership; and life-changing personal transformation. Stress reactions were noted but appeared to be mitigated by feelings of compassion for the victims and personal satisfaction in being able to provide assistance. Suggestions are provided for further research.

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Background The perceptions of patients who are restrained and sedated while being treated with mechanical ventilation in the intensive care unit are not well understood. The effectiveness of sedation used to aid in recovery and enhance comfort during intubation is unknown. Objective To explore the perceptions of patients who were intubated and receiving pain medication while sedated and restrained in the intensive care unit, in particular, their experience and their memories of the experience. Methods In a phenomenological study, 14 patients who were intubated and receiving pain medication while sedated and restrained were interviewed at the bedside. A semistructured interview guide was used. Data were analyzed by using an inductive method consistent with qualitative research. Results Three major themes were identified from the data: lack of memory of being restrained; a perception of being intubated as horrific; nursing behaviors that were helpful and comforting. An unexpected discovery was that sedation may be interfering with pain assessment and management. Conclusion Being intubated can be painful and traumatic despite administration of sedatives and analgesics. Sedation may mask uncontrolled pain for intubated patients and prevent them from communicating this condition to a nurse. Nurses may need to evaluate current interventions in order to provide maximum comfort and promote optimal positive outcomes for intensive care patients who are intubated.

When patients and family members are asked directly about their experience, valuable insight is gained into what they perceive as caring and what contributes to recovery as perceived by those in crisis and in high-intensity medical settings. Capturing these data is elemental to designing high-quality, safe environments that facilitate healing.