Fathers’ experience of starting family life with an infant born prematurely due to mothers’ severe illness.

Objective: To describe fathers’ experiences of starting family life with an infant delivered prematurely out of necessity of saving the mother’s and infant’s lives due to the mother’s severe preeclampsia. Methods: A descriptive, qualitative design was used. Six fathers were interviewed twice: from 6 to 24 days and from 4 to 22 weeks after delivery. Data were transcribed verbatim and analyzed using a reflective lifeworld research approach. Results: The essence of the fathers’ experiences of establishing a family with a seriously ill mother and a premature infant can be described as a process of becoming a family through reflection on life and death in a context of separation. The essence specifically comprised the following constituents: (1) starting fatherhood facing existential issues, (2) connecting the family, (3) becoming familiar with your infant, and (4) becoming a father in a public area. Conclusions: The fathers were able to develop their relationship to their infants; this emphasizes the importance of the fathers being able to spend their time in the NICU. The privacy of the fathers were more or less challenged, health professionals should be aware of individualize their approach to the fathers. The study reveals that family life started with separation. Health professionals should try to ensure that the family should be together. Mutual guidelines between the wards that treats mother and child should be implemented. When new mother and child-centers are planned a family friendly environment should be prioritized.acceptedVersio

Evidensbasert sykepleie i møte med praksis

Evidence-based practice is a discussed issue, also in critical care nursing. The purpose of this study has been to examine to what extent medical evidence accounts for nursing to the patients that are weaning from ventilator. I have used qualitative method and have interviewed intensive care nurses about their experience with the weaning protocol. The interviews were examined by using a structural analysis. In the discussion of data the statements of the intensive care nurses were discussed with different evidence- and knowledge concepts. Theories of Katie Eriksson, Kari Martinsen, Herdis Alvsvåg and Patricia Benner have also been significant. The findings show that the weaning protocol is useful as a mutual strategy for weaning, but it accounts only to some extent for nursing to the actual group of patients. Informants describe nursing as concrete nursing interventions, for instance estimations of respiration and mobilization. Moral aspects of nursing are described as sensibility, communication with the patient and to express protection. Nursing that goes beyond what the protocol describes is learned by experience and in the collective of colleges. The findings in this study suggest that theory about clinical wisdom / judgement to a greater extent than the evidence-based weaning protocol accounts for nursing to the weaning patients. A concept of evidence that describes more aspects of nursing than medical evidence will also give a better description. Evidence-based knowledge, as the weaning protocol is an example of, is a part of the knowledge base of the intensive care nurses. If the focus is on this kind of knowledge only, other parts of the knowledge within intensive care nursing can be invisible or can vanish

The function of ritualized acts of memory making after death in the neonatal intensive care unit

(1) Background: Some infants die shortly after birth, leaving both parents and nurses in grief. In the specific setting where the data were collected, the bereaved parents receive a scrapbook made by the nursing staff in the NICU, and a box made by a local parent support group. Making a scrapbook and a box when an infant dies in the NICU can be regarded as ritualized acts. The aim of this study is to explore the functions of these ritualized acts of making a scrapbook and memory box when an infant dies in the NICU. (2) Methods: Focus group interviews were performed with experienced nurses in the NICU, and with members of a parent support group. Reflexive thematic analysis was used to interpret the data. (3) Three main themes were constructed: “Making memories”, “showing evidence of the infant’s life and of the parenthood”, and “controlling chaos”. (4) Conclusions: Through the ritualized acts of making scrapbooks and boxes, nurses and members of the parent support group collect and create memories and ascribe the infant with personhood, and the parents with the status of parenthood. In addition, the ritualizing functions to construct meaning, repair loss, relieve sorrow, and offer a sense of closure for the makers of these items.publishedVersio