Caring for Adolescents in the Adult Intensive Care Unit

Kimberly, A Roehl

doi:10.4037/ccn2002.22.2.80

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…16 Staff had differing views about what adolescents are like, invariably reflecting their personal experiences of adolescents, as identified previously. 17 Throughout the interviews, the importance of assessing each adolescent as an individual was evident and this related to the themes of both the needs of critically ill adolescents and the implications for staff of caring for them. It also reflects existing guidance on caring for adolescents and for critically ill children.…”

Section: Discussionmentioning

confidence: 99%

Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units

Wood

Geoghegan

Ramnarayan

et al. 2019

J Intensive Care Med

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Purpose: In the UK, critically ill adolescents are treated in either adult or paediatric intensive care units (AICUs or PICUs). This study explores staff perspectives on where and how best to care for this distinct group. Materials and Methods:Semi-structured interviews were conducted with 12 members of staff (3 medical, 6 nursing and 3 allied-health professionals) working in 4 ICUs; 2 general hospital AICUs and 2 tertiary centre-based PICUs in England. Interviews were audio-recorded, transcribed and analysed using Framework Analysis.Findings: One overarching theme was identified, reflecting staff understanding of the term "adolescent", and this was linked to two further themes, each of which had several subthemes. "Needs of the critically ill adolescent" included medical needs, dignity and privacy; issues around consent; and the impact of intensive care admission."Implications for staff" included managing parental presence, and lack of familiarity with, and emotional impact of, dealing with this patient group. Some of these factors are currently better accommodated in adult settings. Conclusions:Decision-making about place of care should take into account the individual circumstances of the patient (e.g. nature of their medical condition and previous experiences, maturity, family preference) and not be based only on age at admission. We should work across disciplines to ensure we can discover, and consistently deliver, best practice to meet the needs of critically ill adolescents.

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Section: Discussionmentioning

confidence: 99%

Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units

Wood

Geoghegan

Ramnarayan

et al. 2019

J Intensive Care Med

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“…I raised questions of logic and substance to sharpen her own, growing sense of herself as a "qualitative" researcher. The end result is a sterling essay, "Caring for Adolescents in the Adult Intensive Care Unit" (Kimberly, 2002). In this case, it was she who suggested to me what I would be paid ($30/hour) that hourly figure matching precisely what she made as a nurse-practitioner, and the total figure matching just as precisely what she had accumulated to that point in her professional development fund.…”

Section: "Houston We Have a Problem"mentioning

confidence: 99%

Confessions Of A (Somewhat) Reluctant Consultant: Or, What Happens When Academic Dreams Go "Poof"

Hammar

2015

TQR

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“…Geanellos (1998, p.241) found "adolescents vacitfate between the thoughts, feelings and behaviours of a ch$d and those of an adult". They often display very challenging, refecting behaviour towards both their family and at times the nursingi staff (Kimberly, 2002). This can be described as similar to behavieu ~f a patient with borderline personality disorde12 Krawitz and Watson (3999, p-f7) state "having traits of this disorder is probably a normal feature of adolescence."…”

Section: Uursing Adolescentsmentioning

confidence: 99%

Pushing the Boundaries: Relationships With Adolescents

McLean¹

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<p>Therapeutic relationships are central to mental health nursing. The nurse's role in maintaining professional yet therapeutic boundaries within this relationship can be challenging. When therapeutic boundaries are breeched within the nurse adolescent relationship the adolescent's safety within this relationship is compromised. There is currently limited literature on how nurses are managing professional boundaries in relationships with adolescents in this setting. The adolescent's nature is to push boundaries; therefore the nurse needs to be acutely aware of this boundary pushing in everyday practice settings. For the safety of the adolescent and the nurse it is vital the nurse understands her role in managing the professional boundary. This thesis explores, through the use of narrative inquiry, four adolescent mental health nurses' experiences of assessing, understanding and maintaining therapeutic boundaries with adolescents in a mental health setting in New Zealand. The unique and specific implications for adolescent mental health nursing are discussed. Three key themes emerged from the analysis and findings: the importance of the nurse clarifying his/her role; the learning that occurs throughout the practice journey; and the role of the nurse in keeping the adolescent and the nurse safe. These findings highlight the importance of clinical supervision and open communication with senior nurses and mentors, which assist the nurse in monitoring practice. When nurses do not have sufficient knowledge of the fundamental principles of adolescent mental health nursing; such as knowledge and skills in both adolescent development and psychodynamic nursing, they are at risk of boundary crossings. Recommendations from this research include more emphasis on psychodynamic nursing principles in nursing education and nursing practice. There is a need for specialised education for nurses in child and adolescent mental health nursing. Nursing entry to practice programmes for new graduate nurses working in mental health, could assist in providing this. There is a call for further research into therapeutic relationships and professional boundaries in this complex nursing specialty.</p>

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Caring for Adolescents in the Adult Intensive Care Unit

Cited by 6 publications

References 12 publications

Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units

Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units

Confessions Of A (Somewhat) Reluctant Consultant: Or, What Happens When Academic Dreams Go "Poof"

Pushing the Boundaries: Relationships With Adolescents

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