The experiences of intensive care nurses caring for patients with delirium

Abstract

Background: Delirium is a prevalent and serious condition in ITU patients, often leading to prolonged hospital stays, adverse patient outcomes, and increased healthcare costs. ITU nurses are instrumental in the early recognition, prevention, and management of delirium. However, the experiences and challenges nurses face remain underexplored. Aim: This study aimed to explore the experiences of ITU nurses when caring for patients with delirium. It also aimed to explore the barriers and facilitators that influence clinical practice and to explore the strategies nurses adopt when caring for patients with delirium Design and Methods: An exploratory qualitative design was adopted. Semi-structured interviews were conducted with a purposive sample of six ITU nurses. Data were analysed thematically. Lazarus and Folkman’s (1984) transactional model of stress and coping was adopted to support the interpretation of nurses’ appraisal and coping responses. Findings: Four key themes emerged: (i) Emotional and Psychological Resilience highlighted the emotional impact of delirium care and the importance of peer support and coping strategies (ii) Ethical Decision-Making reflected challenges in balancing patient autonomy with safety and navigating clinical uncertainty (iii) Interdisciplinary Collaboration enhanced nurses’ confidence through strong teamwork support and communication; and (iv) Personal and Professional Development such as inadequate training, communication issues, and staffing constraints, while enhancing skills and knowledge for effective delirium care. Conclusion: The study emphasised the importance of improved organisational support, peer support and collaboration. A structured approach, characterised by formal, consistent, and coordinated strategies to enhance resilience in managing emotional and ethical responsibilities is required. Formal education and standardised, evidence-based clinical guidelines were identified as important strategies to mitigate clinical challenges, enhance nurse well-being, and optimise patient outcome.