Clinical Pearls

Abstract

Nurses often admire family caregivers of chronically critically ill patients. A study by Hwang and colleagues gives insight into the lives of caregivers of heart failure patients. Most primary caregivers were spouses or partners living in the same household as the patient. A total of 54% were employed outside the home, but 24% reported having to quit work or reduce hours. Caregivers provided a median of 20 hours of care per week; the mean duration of care was 4.5 years.Caregivers identified several areas that negatively affected their perceptions of the experience of providing care:This article raises awareness that caregivers’ needs should be addressed with each contact with the health care system. Information and support may reassure caregivers about their instrumental role in caring for loved ones with heart failure.—Kimberly Whiteman,rn, dnp, ccrnSee Article, pp 431–442When critically ill patients with comorbid conditions are taken from a general care unit to the radiology department for testing procedures, increased medical support may be needed.Ott and colleagues examined 64 emergencies that occurred in the radiology department. They found the following:Greater vigilance is needed when a patient is going to travel off the floor for testing or procedures. Slight variations in vital signs or mentation are important aspects to convey to the care providers.— Helen Miley,rn, phd, ccrn, acnp, gnpSee Article, pp 461–469Communication is important for patient care, and nurses should seek to learn more about how to effectively communicate with patients who have an endotracheal tube in place.Khalaila and colleagues studied the experiences of 65 patients who had experienced mechanical ventilation. The results showed that participants had high scores for stress and moderate to high levels of psycho-emotional distress associated with being unable to speak during the procedure.Nurses may alleviate some of the stressful experiences patients have while using mechanical ventilation by the implementing the following:An average of 3 communication tools were used by each patient in the study, and it was noted that emotions of fear and anger were reduced with increases in communication methods. Also, psychological distress was lower with increased duration of analgesia and sedation.—Elisabeth George,rn, phdSee Article, pp 470–479