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Keywords:

  • Critical care;
  • Expertise;
  • Knowing the patient;
  • Mechanical ventilation;
  • Protocols;
  • Weaning

ABSTRACT

Aim: The aim of the research was to understand how nurses used technology to wean patients from mechanical ventilation.

Background: The literature concerned with the development of critical care centres on the role of technology with little emphasis on the nursing contribution.

Design: An ethnographic approach was used to understand how nurses used technology to wean patients from mechanical ventilation.

Methods: Data were gathered by participant observation and interviewing over a 6-month period. In total, 250 h of field notes were recorded.

Results: Data were analysed by the content analysis method. Knowing the patient was a central theme identified. Three sub-themes were identified: ways of knowing, continuity of care and the role of the patient in the weaning trajectory.

Conclusion: ‘Knowing the patient' was implied during the interviews as essential to the delivery of patient-centred care. There were two main factors that needed to be present in order for nurses to know their patients: continuity of care and expertise. ‘Ways of knowing’ was reliant on gaining information about the patient. The role of the patient was a passive recipient of treatment.

Implications for practice: Knowing the patient has been defined as a characteristic of expert nursing. To be truly patient-centred nursing needs to address the barriers that prevent nurses from getting to ‘know’ their patients.