Background: ICU discharges are challenging practices that carry risks for patients. Despite the existing body of knowledge, there are still difficulties in clinical practice concerning unplanned ICU discharges, specifically where there is no step-down unit.

Aim: The aim of this study was to explore general ward nurses´ experiences of caring for patients being discharged from an ICU.

Design and Methods: Data were collected from focus groups and in-depth interviews with a total of 16 nurses from three different hospitals in Sweden. An inductive qualitative design was chosen.

Findings: The analysis revealed three themes that reflect the challenges in nursing former ICU patients: a vulnerable patient, nurses’ powerlessness and organisational structure. The nurses described the challenge of nursing a fragile patient based on several aspects. They expressed feeling unrealistic demands when caring for a fragile former ICU patient. The demands were related to their own profession and knowledge regarding how to care for this group of patients. The organisational structure had an impact on how the nurses’ caring practice could be realised. This evoked ethical concerns that the nurses had to cope with, as the organisation’s care guidelines did not always favour the patients. 

Conclusions and Relevance to Clinical Practice: The structure of the organisation and its leadership seem to have a significant impact on the nurses´ ability to offer patients the care they need. Moreover, this study sheds light on the need for extended outreach services in order to meet the needs of patients after the intensive care period.