2026 Volume 46 Pages 584-592
Purpose: This study aimed to elucidate the nature of invisible nursing practices by examining situations in which intensive care unit (ICU) nurses intentionally refrained from touching patients.
Methods: A comparative case study design was employed using data from participant observations and semi-structured interviews were conducted between May 2018 and March 2019. Among the 13 cases collected, 5 cases (10 scenes) in which periods of non-touching (approximately 60 minutes) were observed were selected for analysis. These cases were compared to explore how nurses perceived patients’ conditions and decided whether to intervene in situations in which direct care was intentionally withheld.
Results: The Case-based Meaning Construction (CMC) approach was used to identify three underlying intentions and six key practical points were identified as components of invisible nursing practices. These practices protected patients by regulating external stimuli through adjustments in timing and interpersonal distance, including avoiding unnecessary movements, limiting informational input, and maintaining personal space. Rather than representing an absence of care, these practices reflected deliberate clinical judgments aimed at stabilizing the patients’ physiological and psychological states while preventing unnecessary stimulation.
Conclusion: Three conditions were identified as necessary for these practices to function: continuous patient, readiness to adjust interventions based on the patient’s response, and a clear intention to minimize the burden (stimuli) placed on the patient. This study contributes to the articulation of critical care nursing practices that were previously been difficult to recognize as nursing actions.
