Death, empathy and self preservation: the emotional labour of caring for families of the critically ill in adult intensive care

AIM AND OBJECTIVE: The purpose of this phenomenological study is to explore the emotional labour nurses' face when caring for relatives of the critically ill in intensive care unit. BACKGROUND: The admission of a critically ill patient into adult intensive care is a crisis for both patients and their families. Family members of the critically ill may experience extreme levels of stress and emotional turmoil throughout the course of the relative's illness. A central tenet of providing holistic nursing care in the intensive care unit is to care for both patients and their families, however, the emotional involvement required places considerable demands on those delivering care. The support health care providers require is frequently overlooked in these challenging environments. DESIGN: Heideggerian phenomenological approach was adopted. METHODS: A purposive sample of 12 registered nurses working in an adult intensive care unit were interviewed. Interview transcripts were analysed using Colaizzi's framework. Data were collected in autumn 2005. RESULTS: Analysis of the participants' interview transcripts revealed the following themes: significance of death, establishing trust, information giving, empathy, intimacy and self preservation. CONCLUSIONS: Emotional work forms an important part of the critical care nurses job. The significance of death, breaking bad news and interpersonal relationships are sources of emotional stress for the critical care nurse caring for the family of the critically ill. The impact of this stress on the nurse and the care they deliver requires further investigation. RELEVANCE TO CLINICAL PRACTICE: Registered nurses caring for families who have relatives in adult intensive care units expand considerable emotional labour. Potentially, unless appropriately supported and managed, emotional labour may lead to occupational stress and ultimately burnout.