Intensive and Critical Care Nursing
Volume 26, Issue 1 , Pages 33-43, February 2010

More than nothing: The lived experience of tracheostomy while acutely ill

Critical Care Outreach Team, 4th Floor, Princess Alexandra Hospital, Essex CM20 1QX, United Kingdom

Accepted 23 September 2009.

Summary 

While the physical sensations surrounding tracheostomy tube insertion have been reported within nursing and allied healthcare literature, the lived experience of these sensations is poorly described. This appears relevant given the imminent results of the Tracman study (2008).

A purposive sample of three participants who had tracheostomy tubes previously within a critical care area or still in situ were recruited. They described their experiences in a face-to-face semi-structured interview that were audio taped. The interviews were transcribed verbatim and analysed using Giorgi's 5 concrete steps of the human scientific phenomenological method (1997).

Findings revealed themes that drew attention to the fundamental aspects of the experience. These were:

1.Necessity of communication

2.Retaining normality

3.Psychosocial discomfort

4.Painful procedures

5.Fear of the unknown

6.Relationships with staff

Practical recommendations draw attention to the organisational support required for staff expected to care for these patients in the ward environment. This involves the introduction of evidence based guidelines and competency based care to promote the acquisition of skills required to perform those essential tasks such as suction and stoma care to a high standard. Protected, formalised skills based teaching is seen as fundamental in this process. Patients’ felt confident in nursing staff that were able to demonstrate proficiency with such tasks and this is seen as crucial when one considers that the tracheostomy tube is a new experience for patients.

Keywords: Tracheostomy, Lived experience, Acute illness, Critical care

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PII: S0964-3397(09)00088-3

doi:10.1016/j.iccn.2009.09.004

Intensive and Critical Care Nursing
Volume 26, Issue 1 , Pages 33-43, February 2010