The experiences of rural and remote families involved in an inter-hospital transfer to a tertiary ICU: A hermeneutic study

Background: Inter-hospital transfers are necessary for critically ill patients to improve their chance of survival. Rural and remote families experience significant disruption to family life when critically ill patients are required to undergo a transfer to a tertiary hospital. What is not known is how ICU staff can assist these families who are involved in an inter-hospital transfer to a tertiary ICU. Purpose: To gain an understanding of rural and remote critical care families' experiences during an inter-hospital transfer to a tertiary ICU. Method: A hermeneutic phenomenological approach was adopted informed by the philosophical world views of Heidegger and Gadamer. Data collection occurred by in-depth conversational interviews from a purposeful sample of seven family members. Interview transcripts, field notes and diary entries formed the text which underwent hermeneutic analysis. Findings: Being confused, being engaged, being vulnerable and being resilient emerged as significant aspects of the rural and remote family members' experience during a transfer event. Conclusion: A better understanding of the experiences of rural and remote families during an inter-hospital transfer journey can inform the practice of ICU nurses. This study highlights the specific experiences of rural and remote families during an inter-hospital transfer journey to a tertiary ICU. It also informs nurses of the meaningful ways in which they can support these families with the uncertainty and chaos experienced as part of this journey. (C) 2014 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.