Interaction with family-members of critically ill patients : which difficulties exist?

Background: When the patient is critically ill the family is in a vulnerable position. The nurse's role is to support and help the family to find meaning in the difficult situation and to provide realistic hope. Balancing between the patient's and the family's needs is difficult. Knowledge about how nurses experience difficulties in the interaction with family is required in order to grant good care too critically ill patients and their family-members. Aim: To describe nurses' perceived difficulties in the interaction with family-members of critically ill patients. Method: The study is a qualitative literature-based study based on qualitative research. Results: The analysis resulted in four main themes; difficult disunion, environmental constraints, interpersonal difficulties and communicative difficulties. Conflicts, disagreement and expectations in the interaction with family-members are difficult. There are environmental constraints in the form of family's presence, lack of space and time constraints. Nurses find it difficult to manage their emotions, family who get to close and to support the family. Information, comprehension, knowledge, language barriers and cultural differences represents communicative difficulties. Conclusion: There is a lack of knowledge among nurses about how to handle difficult situations where family is involved. Doctors and nurses need to collaborate more. Conflicts, disagreements and expectations can put severe pressure on the nurse. It is difficult for the nurse to strike a balance between being professional and being personal. Environmental constraints are an organizational problem which creates difficulties for the nurse in the interaction with family