Interaction with potential donors’ families: The professionals’ community of concern—a phenomenological study

Abstract

The aim of this paper was to explore the health professionals' experiences and gain a deeper understanding of interaction with families of critically ill or traumatized patients with severe brain injuries. The methodological approach was qualitative and phenomenological. Data were collected through participant observation and in-depth interviews with nurses, physicians, and chaplains working in two ICUs in a Norwegian university hospital. A thematic analysis was used for analyzing data. Two main themes emerged from analysis: Patient oriented even when present and Family oriented even when absent. Each main theme is divided into two sub-themes. The themes appeared as phases in an interaction process. In the two first phases the interaction may be characterized as Alternating between being absent and present and Following up and withholding information and in the two last phases as Turning point and changing focus and Partly present when waiting for death. The findings are in the discussion illuminated by the phenomenological concept of concern. Concern is visible as care, and the distinction in care between “leaps in” and “leaps ahead” and “ready-to-hand” and “unready-to-hand” are topics in the discussion. Because of the complexity of caring for both patient and family, the situation demands efforts to relieve nurses in particular, during the most demanding phases of the process.

Do we treat individuals as patients or as potential donors? A phenomenological study of healthcare professionals’ experiences

“…Parallel with the shift from patient to organs, the HPs’ concerns also gradually shifted from the patient toward the family, 25 partly because they needed the family’s consent to access the patient’s organs. Thus, caring for the family may not be a goal in itself but rather a means of helping others.…”

“…This article is a part of a larger study that explored HPs’ experiences of interaction with families of critically ill or injured patients with severe brain injuries. 25,26 In most cases, the subject of OD was brought up with the family, and the aim of this part of the study was to gain a deeper understanding of the ethical challenges related to the treatment and care for patients and families in different stages of the OD process.…”

Familien in kritischen Situationen der klinischen Pflege

“…Erschwert wird dies, wenn Pflegende nicht offen mit der Familie kommunizieren können und Informationen zurückhalten müssen, weil ein ärztliches Aufklärungsgespräch noch nicht stattgefunden hat. Anders als in der Studie von Orøy et al (2011), in der Pflegende grundsätzlich am ärztlichen Aufklärungsgespräch beteiligt sind, sind gemeinsame Aufklärungsgespräche von Arzt und Pflegekraft in den Kliniken der Teilnehmenden an der vorliegenden Studie nicht die Regel. Um genau zu wissen, was der Arzt mit den Angehörigen besprochen hat, und um die Familie somit besser begleiten zu können, wünschen sich Pflegende jedoch eine geregelte Teilnahme und eine engere Zusammenarbeit mit den ärztlichen Kollegen.…”

Representing life as opposed to being: the bio-objectification process of the HeLa cells and its relation to personalized medicine

“…Focus is on experiences. As a method, it helps in identifying contextually bound clusters of themes, and it makes interpretation a key issue for scientific analysis as it is essential to understand phenomena as part of processes and context (17). The interpretative process is dynamic, and strives to go from the part to the whole, in a manner where critical reflection of the process is emphasized, aiming at achieving insights of general value.…”