Culture of Interpersonal Communication in ICU Nurses: An Ethnographic Study

Abstract

Introduction: Interpersonal Nurses Communication (IPC) in Intensive Care Unit (ICU) is known to be important due to the critical situation of patients and the nurses’ experience with moral distress. Nurses interpersonal relationships and ways of resolving conflicts are influenced by the culture of this sector. Aim: To specify the culture of IPC among nurses in ICU. Materials and Methods: This was a qualitative multi-site ethnographic study conducted from May 2017 to September 2019 at Kermanshah University of Medical Sciences. Data were collected through participatory observation and formal and informal semi-structured interviews. The study environment included four ICUs in two hospitals. Data were obtained from an uninterrupted observation for five months, intermittent observation for six months, 15 formal interviews and 31 informal interviews. The process stems from the research evolutionary cycle model and Spradley's Steps. In order to discover the meaning of the patterns from the obtained themes, the findings were interpreted after analysis. In this study, Spradley method was used to analyse the data. Results: In this study, 66.7% of the nurses were female, the mean age was 38.66±9.1 years, and mean work experience was 14.43±8.4 years. The three main themes of the high-level code consensus emerged as follows: Grouping which included the formation of groups, cooperation and competition between groups, and demarcation and characteristics of groups. The governing organisational relationships include managerial strategies and nature of the wards. And the individual characteristics that included top-down look, work discipline and experience. Conclusion: The IPC among the ICU nurses is a dynamic and inevitable process and influenced by factors such as nurses’ membership in the groups established in the ICU, nurses’ cooperation, management strategies, physical and emotional nature of critical care units, work experience and former communications, discipline, and features such as a top-down attitude.

Keywords

• centralised ethnography
• communication
• confrontation
• intensive care unit nurse
• moral distress
• multi-site ethnography