The Trial-and-Error Process of Emergency and Intensive Care Nurses to Calm the Agitation of Delirious Patients

Abstract

The purpose of this study was to clarify the cognitive and technical processes that occur when emergency and intensive care nurses work with delirious patients to reduce their delirium symptoms. We conducted semi-structured interviews with seven nurses of four hospitals using a modified grounded theory approach. Then, seven categories and 11 concepts were generated from the analysis. It was found out that the cognitive and technical processes in which emergency and intensive care nurses attempted to reduce patients’ symptoms were a process of trial-and-error engagement in an attempt to calm their agitation in order to protect their bodies and safety. When the nurses “detected suspicious signs” in the patients, they felt a desire to “calm their agitation,” and they used this desire as the basis for their involvement. First, they provided care to “remove the suffering derived from the body,” and then they intervened in “trying to bring the patients back to themselves by correcting the errors” of cognition. They evaluated these interventions as “not so good,” but they still repeated the same interventions. However, some nurses shifted to engaging in “accepting the impaired awareness.” These series of involvement processes were practiced by nurses using “intuition cultivated through experience.”