Thought processes of mid-career nurses in postoperative respiratory observation in a gastrointestinal surgical ward

Abstract

This study aims to identify how and what mid-career nurses in charge of postoperative management think about postoperative respiratory observations, through semi-structured interviews with five nurses working in gastrointestinal surgery wards of three hospitals. The analysis of the interview data yielded 5 categories from 75 codes and 13 subcategories. The interviewees stated that they were “concerned about changes in the patient condition due to the invasiveness of the surgery and anesthesia before the respiratory observation”, “prepared for respiratory observation based on the manuals of their department prior to surgery”. Regarding countermeasures for respiratory observation results, nurses stated that they “determine the respiratory observation method based on the patient’s physical condition.” They also responded that, within the limited time and circumstances available for observation, “when the patient’s physical condition changes suddenly, they determine the respiratory observation method based on priority. Further, from the narratives of the nurses, we identified “perspectives on respiratory observations based on empirical rules.” These manifest the importance of manuals for nurses to observe respiration at appropriate intervals, and knowledge acquired by them. This work also suggests that the thoughts about respiratory observations are affected by the experiences accumulated as the mid-career nurses. This study revealed that nurses predicted changes in breathing before starting observation utilizing department manuals, and determined breathing observation methods considering priorities. These thought processes were based on the experience of mid-level nurses.