Maintaining emotional wellbeing in the intensive care unit: A grounded theory study from the perspective of experienced nurses

Abstract

Background: For ICU nurses, maintaining their own wellbeing is vital to health and their ability to remain in the ICU workforce. However, little is known about the emotional wellbeing of ICU nurses working with frequent exposure to distress. Objectives: The aim of this study was to develop a substantive theory to explore and explain the ICU nurse’s perspective of maintaining emotional wellbeing. Methods: Grounded Theory methodology was used to discover the processes nurses used to maintain their emotional wellbeing when working in the ICU. Results: Emotional wellbeing was described by the participants as feelings of satisfaction and happiness, derived from the delivery of best care to patients and their families. The core problem shared by ICU nurses was the ‘‘Inability to protect self from distress’’ when caring for patients who were critically ill and their families. Conditions were identified that impacted the nurses’ ability to protect self from distress, Best care; Autonomy; Teamwork; and Previous nursing and life experience. The Basic Social and Psychological Process used by nurses was called ‘‘Protecting Self from Distress’’. The process was described under three phases: Delivering best care in ICU; validating care episodes; and distancing from distress. The process included strategies to overcome or promote the conditions that impacted nurse wellbeing. Conclusion: Nurses maintain their emotional wellbeing through the delivery of best care. Best nursing care in the ICU was holistic and inclusive of the care of the family. Understanding the conditions that impacted nurse wellbeing provides valuable insight into factors that help or hinder the delivery of best nursing care. The substantive theory demonstrates processes that enable nurses to maintain their emotional wellbeing and provide best care to patients and families in the ICU.