An act of caring - patient diaries in Norwegian intensive care units

Aim: The aim of this study was to obtain more knowledge about the background, extent and implementation of diaries in Norwegian intensive care units (ICUs) providing mechanical ventilation to adult patients. Background: The growing understanding of long-term consequences of intensive care therapy has compelled nurses to introduce patient diaries to prevent problems after discharge from ICU. Research on this practice is limited. Design/method: The study had a qualitative descriptive design, and was conducted by means of semi-structured telephone interviews with 30 participants, all experienced intensive care nurses. The strategy of analysis was a template organizing style. Findings: The findings show that 31 out of 70 ICUs offer patient diaries, and many units have a long history of diary writing. Most of the units have some kind of guidelines, and the study has shown that diaries serve dual purposes; one of caring and another of therapy. Although these two dimensions seemingly present a paradox from a theoretical point of view, a combination appears to be at work in clinical practice. This may be explained by a tendency in nursing to regard caring as superior to therapy. The writing frequency varies, and the units that reported high activity provided follow-up programs in addition to diary writing. Diary writing as a nursing intervention is threatened by a lack of funding.