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174 P R I N C I P L E S A N D P R A C T I C E O F C R I T I C A L C A R E

Case study
A 56-year-old woman, Mrs Supitayaporn, has been admitted to the 2. The family have specific requests that potentially impact on
critical care unit with a severe head injury, following being struck the critical care environment, and Mrs Supitayaporn’s process
by a car while she was out walking. She also has a fractured of care.
humerus and pelvis. A decision has been made for surgical inter- 3. The critical care nurse realises she knows little about the
vention to relieve her increasing intracranial pressure (ICP). Just as Buddhist faith.
the critical care nurse is preparing her for surgery, her family arrives.
It is explained that Mrs Supitayaporn needs urgent surgery to sta- Discussion
bilise her condition and prevent further deterioration. During this This critical care nurse has identified early the need for an
process it becomes clear that Mrs Supitayaporn’s husband does not interpreter in order for Mrs Supitayaporn’s husband to understand
understand what is happening.
the information about his wife’s condition and impending surgery.
The critical care nurse asks if any of the family members speak The son indicated he could speak English, and while in the short-
English, and a son steps forward. The critical care nurse also asks if term he could be used as an interpreter, in the long-term a
there are any important beliefs or practices Mrs Supitayaporn has professional interpreter should be sought. This removes the
that should be considered prior to going to surgery, and in the pressure from the son having to convey information between the
planning of her care. Mrs Supitayaporn belongs to the Buddhist critical care nurse and the Mrs Supitayaporn’s husband. It is clear
faith, and it is important that her family are present to ensure her that the nurse has engaged in genuine communication, and is
mind is put at peace, and to tell her about her merits. It is also working with the family – the beginnings of a partnership. A
important for her to be in an environment that is quiet and unhur- feature of this critical care nurse’s communication is her willingness
ried. The son informs the critical care nurse that they believe to listen and understand the information the son was sharing. In
strongly in the law of karma, and Mrs Supitayaporn should not be the course of this discussion the critical care nurse discovers
resuscitated. The critical care nurse realises she does not know information related to Mrs Supitayaporn’s religious faith, and at the
much about the Buddhist faith, and endeavours to find a local same time realises she knows little about the Buddhist faith.
Buddhist monk to help staff understand Mrs Supitayaporn’s faith. However, she has determined the need for a quiet environment,
As a first contact, the critical care nurse approaches the hospital the importance of the family being present, and the patient’s
chaplain for advice on how to contact a Buddhist monk. beliefs about karma and the potential impact this will have on
her treatment and intervention. This information should be
Major issues documented in Mrs Supitayaporn’s clinical file for continuity and
There are a number of potential issues in this case study: quality of care. The critical care nurse is also attempting to make
1. The critical care nurse was alerted to a problem with contact with a Buddhist monk to become better informed about
Mr Supitayaporn not understanding the explanations this faith. This case study demonstrates the beginning of delivering
being given about his wife’s condition, and the plan for culturally appropriate care to someone who is culturally and
treatment. linguistically different from the nurse, with specific religious needs.

Research vignette
Roberti SM, Fitzpatrick JJ. Assessing family satisfaction with care of units share a common waiting room with families of theatre
critically ill patients: a pilot study. Critical Care Nursing 2010 30: patients.
18–26.
Results
Introduction From the 31 survey responses received, the overall satisfaction was
This paper does not have a published abstract, however, it was a high with scores of 94 out of a possible 100. Satisfaction with the
pilot study designed to evaluate satisfaction with the overall care support received scored highest on the subscales (4.74) and
of critically ill patients by way of a patient proxy – the patient’s comfort the lowest score (4.62). The individual item that received
family. Patients in critical care areas are generally too ill to evaluate the highest score was satisfaction with the quality of care given to
their level of satisfaction with their care. The authors state that their the patient (4.87) and the lowest was the time families had to wait
aim is to use the results to identify areas for future research. for test results (4.48).
Methods
A survey method was used with a convenience sample. The Critical Conclusion
Care Family Satisfaction Scale (CCFSS) was selected to elicit fami- Families were satisfied with the care their relative received. Con-
lies’ satisfaction with care. It contains 20 items with five subscales: cerns of families need to be considered and potentially addressed
assurance, information, proximity, support and comfort. Two by the entire health care team as it is important to improve family
related sites were used – one a 10-bed surgical intensive care unit members’ satisfaction with the care their critically ill relative
and the other a 14-bed telementry/intermediate care unit. The receives.