To have and to hold nutritional control: Balancing between individual and routine care:

Summary 

Objectives

Gaining insight into nutritional processes can help nurses and other staff in their work. The aim was to provide a theoretical understanding of the concerns and strategies of nutritional nursing care for patients with enteral nutrition in intensive care units.

Design

A grounded theory approach was used. Observations of patient's nutritional care and twelve interviews with eight registered nurses and four enrolled nurses were conducted.

Setting

The study was carried out in one intensive care unit at a medium sized hospital in Sweden.

Results

The substantive theory developed included the core category “To have and to hold nutritional control – balancing between individual care and routine care”. The core category was reflected in and related to the categories “knowing the patient”, “facilitating the patient's involvement”, “being a nurse in a team”, “having professional confidence” and “having a supportive organisation”. Finding a balance between individual care and routine care was a way of enhancing the patient's well-being, security and quality of care.

Conclusion

To have and to hold nutritional control over the patient's nutrition was found to be a balancing act between individual care and routine care. Organisation and teamwork are both challenging and supporting the provision, maintenance and development of nutritional care.

Keywords: Enteral nutrition, Enrolled nurses, Grounded theory, Intensive care and registered nurses