The cognition of busyness and main busy scenes in intensive care unit nursing care: a qualitative study_West China Medical Journal

Authors：

ZOU Qian ¹ , LI Hongxia ² ,  ZHANG Mingji ¹

1. School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, P. R. China;
2. Human Resources Department, Shanghai Oriental Hospital, Shanghai 200120, P. R. China;

Corresponding?author：

ZHANG Mingji, Email: zhangmingji@sjtu.edu.cn

Keywords：

Intensive care units; Nurse; Busyness; Qualitative research; Cognition; Scenes

DOI：

10.7507/1002-0179.202107248

Video：

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Objective To explore the nurses’ cognition of busyness in intensive care unit (ICU), summarize the main busy scenes, and provide strategies for solving problems of busyness. Methods Nurses in three ICU departments of Shanghai Oriental Hospital were selected by purpose sampling method from September 2020 to January 2021. Face-to-face semi-structured in-depth interviews were conducted with nurses. The interview data were analyzed and thematically refined using the method of Colaizzi data analysis. Results A total of 10 nurses were interviewed, including 8 general nurses and 2 head nurses, all of whom were women. The cognition of busyness covered three elements: explosively increased workload, time pressure, and overwhelming information from multiple sources. Busy scenes included four themes: large amount of patients, critical conditions of patients, unstable conditions of patients, and frequent service transfer among different medical divisions. Conclusions According to the three elements of nurses’ cognition of busyness and scenes of it, nursing managers can put forward corresponding solutions. This can retain or attract more nurses to work in ICU and provide better services for patients.

Citation： ZOU Qian, LI Hongxia, ZHANG Mingji. The cognition of busyness and main busy scenes in intensive care unit nursing care: a qualitative study. West China Medical Journal, 2021, 36(12): 1669-1673. doi: 10.7507/1002-0179.202107248 Copy

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19.	徐曉霞, 蔡學聯, 裘文娟, 等. 以護士崗位為定位的協作搶救模式在心內科病房心跳驟停患者中的應用. 護士進修雜志, 2015, 30(10): 898-900.
20.	趙思佳, 姜金霞, 田梅梅. 新入職護士對急診科規范化培訓真實體驗的質性研究. 中國醫藥導報, 2020, 17(34): 83-86.
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22.	Asken MJ, Kochert E, Wyatt A, et al. Calm amidst storm: psychological skills and mindset training for maximizing performance in medical emergencies. Resuscitation, 2020, 146: 32-33.
23.	Ozekcin LR, Tuite P, Willner K, et al. Simulation education: early identification of patient physiologic deterioration by acute care nurses. Clin Nurse Spec, 2015, 29(3): 166-173.
24.	王泓, 葉文琴, 王偉智, 等. 心胸外科監護室護理工作量調查及人力資源的合理使用. 中華護理雜志, 2004, 39(8): 604-606.
25.	俞萍, 任國琴, 張婧婧, 等. 標準化溝通模式在術后轉入 ICU 患者交接中的應用. 中華現代護理雜志, 2017, 23(27): 3446-3449.
26.	俞萍, 李琴, 程曉紅. 病房護士參與 ICU 病人過渡期護理體驗的質性研究. 全科護理, 2019, 17(34): 4323-4328.

1. Bing-Jonsson PC, Foss C, Bj?rk IT. The competence gap in community care: imbalance between expected and actual nursing staff competence. Nord J Nurs Res, 2015, 36(1): 27-37.
2. Bontemps-Hommen CMML, Baart A, Vosman FTH. Practical wisdom in complex medical practices: a critical proposal. Med Health Care Philos, 2019, 22(1): 95-105.
3. 李長鴿, 田曉華, 馮麗娜, 等. 重癥監護病房護士工作壓力及應對方式與職業倦怠的相關性研究. 護理研究, 2014, 28(9B): 3236-3237.
4. Norman RM, Sjetne IS. Measuring nurses’ perception of work environment: a scoping review of questionnaires. BMC Nurs, 2017, 16: 66.
5. Aiken LH, Sermeus W, Van den Heede K, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 2012, 344: e1717.
6. Nagington M, Luker K, Walshe C. ‘Busyness’ and the preclusion of quality palliative district nursing care. Nurs Ethics, 2013, 20(8): 893-903.
7. Kerfoot K. Beyond busyness: creating slack in the organization. Medsurg Nurs, 2007, 16(1): 61-63.
8. Thompson DS, O’ Leary K, Jensen E, et al. The relationship between busyness and research utilization: it is about time. J Clin Nurs, 2008, 17(4): 539-548.
9. 王勵飛, 米元元, 金晶, 等. ICU 護士工作壓力體驗與應對質性研究的系統評價. 中華護理雜志, 2019, 54(10): 1566-1571.
10. Buerhaus PI, Staiger DO, Auerbach DI. Implications of an aging registered nurse workforce. JAMA, 2000, 283(22): 2948-2954.
11. 花蕓, 胡曉燕. 兒科重癥監護病房護理質量影響因素分析及對策. 護理學雜志, 2013, 28(17): 13-15.
12. Govasli L, Solvoll BA. Nurses’ experiences of busyness in their daily work. Nurs Inq, 2020, 27(3): e12350.
13. 劉明. Colaizzi 七個步驟在現象學研究資料分析中的應用. 護理學雜志, 2019, 34(11): 90-92.
14. Campbell CM, Prapanjaroensin A, Anusiewicz CV, et al. Variables associated with missed nursing care in Alabama: a cross-sectional analysis. J Nurs Manag, 2020, 28(8): 2174-2184.
15. McIntosh B, Sheppy B. Effects of stress on nursing integrity. Nurs Stand, 2013, 27(25): 35-39.
16. Ericson-Lidman E, ?hlin J. Assessments of stress of conscience, perceptions of conscience, burnout, and social support before and after implementation of a participatory action-research-based intervention. Clin Nurs Res, 2017, 26(2): 205-223.
17. 孫明貴. 工作密度和工作深度對組織繁忙感的影響機理. 創新與創業管理, 2017(1): 100-111.
18. Tarabay R, Abou-Zeid M. Assessing the effects of auditory-vocal distraction on driving performance and physiological measures using a driving simulator. Transp Res Part F Traffic Psychol Behav, 2018, 58: 351-364.
19. 徐曉霞, 蔡學聯, 裘文娟, 等. 以護士崗位為定位的協作搶救模式在心內科病房心跳驟停患者中的應用. 護士進修雜志, 2015, 30(10): 898-900.
20. 趙思佳, 姜金霞, 田梅梅. 新入職護士對急診科規范化培訓真實體驗的質性研究. 中國醫藥導報, 2020, 17(34): 83-86.
21. Kowitlawakul Y, Chow YL, Salam ZH, et al. Exploring the use of standardized patients for simulation-based learning in preparing advanced practice nurses. Nurse Educ Today, 2015, 35(7): 894-899.
22. Asken MJ, Kochert E, Wyatt A, et al. Calm amidst storm: psychological skills and mindset training for maximizing performance in medical emergencies. Resuscitation, 2020, 146: 32-33.
23. Ozekcin LR, Tuite P, Willner K, et al. Simulation education: early identification of patient physiologic deterioration by acute care nurses. Clin Nurse Spec, 2015, 29(3): 166-173.
24. 王泓, 葉文琴, 王偉智, 等. 心胸外科監護室護理工作量調查及人力資源的合理使用. 中華護理雜志, 2004, 39(8): 604-606.
25. 俞萍, 任國琴, 張婧婧, 等. 標準化溝通模式在術后轉入 ICU 患者交接中的應用. 中華現代護理雜志, 2017, 23(27): 3446-3449.
26. 俞萍, 李琴, 程曉紅. 病房護士參與 ICU 病人過渡期護理體驗的質性研究. 全科護理, 2019, 17(34): 4323-4328.

West China Medical Journal

The cognition of busyness and main busy scenes in intensive care unit nursing care: a qualitative study

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