Ward nurses' experiences and perceptions of the critical care outreach service: A qualitative study undertaken in a large teaching hospital in the West of Ireland.

BACKGROUND: The critical care outreach service (CCOS) was established in a large teaching hospital in the West of Ireland in 2014 to provide an extension of CCOS between the intensive care unit (ICU) and the wards outside ICU. With the ever-increasing pressure on ICU resources, CCOS seems to offer an additional service to patients who are critically ill and deteriorating in hospital wards. AIM: The aim of this study is to explore ward nurses' experiences and perceptions of the CCOS. STUDY DESIGN: A qualitative descriptive methodology aimed to obtain a descriptive account of ward nurses' experiences of the CCOS. Data were collected using semi-structured interviews. Twelve nurses from the West of Ireland participated in the study. Braun and Clarke's six-step thematic analysis was used to analyse the data. RESULTS: Three core themes identified in this study included clinical support and decision-making; sharing knowledge and skills, and communication. All 12 nurses identified the positive impacts that they felt the current outreach service provided to them on a daily basis. CONCLUSIONS: Study findings indicate that nurses value the role of the CCOS in supporting the care of the critically ill and deteriorating patients at ward level. The CCOS has become invaluable to the ward nurses in their daily practice especially at a time when resources are lacking and patient acuity is on the rise.

Revisiting task orientated care: Oral histories of former student nurses in Ireland (1960-2001).

The apprenticeship model of nurse training was in place in Ireland up to the end of the twentieth century. Task orientated care was a feature of this model. It is important to examine task allocation from the student's perspective, in light of current and on-going debates regarding student nurses' supernumerary status. Both approaches influence the status of the student; as a worker with task allocation and as a learner with supernumerary status. Oral history interviews were undertaken with twelve former student nurses (1960-2001) to explore their experiences of clinical learning and task allocation. Task allocation consisted of household tasks and tasks involving patient care. Students' experiences were influenced more by issues surrounding the task, particularly the 'task-person', than the task itself. Therefore, a learning environment that is inclusive, supportive and understanding of students' learning is recommended, regardless of the model of nurse training or education that might be in place. These findings can inform current debate on supernumerary status and task allocation for the student nurse within their clinical learning environment, but also on the history of nurse education in Ireland in the twentieth century.

Nurses' role transition from the clinical ward environment to the critical care environment.

AIM: To explore the experiences of nurses moving from the ward environment to the critical care environment. BACKGROUND: Critical care areas are employing nurses with no critical care experience due to staff shortage. There is a paucity of literature focusing on the experiences of nurses moving from the ward environment to the critical care environment. METHODOLOGY: A Heideggerian phenomenology research approach was used in this study. In-depth semi structured interviews, supported with an interview guide, were conducted with nine critical care nurses. Data analysis was guided by Van Manen (1990) approach to phenomenological analysis. RESULTS: Four main themes emerged: The highs and lows, you need support, theory-practice gap, struggling with fear. The participants felt ill prepared and inexperienced to work within the stressful and technical environment of critical care due to insufficient education and support. CONCLUSION: The study findings indicated that a variety of feelings and emotions are experienced by ward nurses who move into the stressful and technical environment of critical care due to insufficient skills and knowledge. More education and support is required to improve this transition process.