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  • 1. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Växjö University.
    Beleuguered by technology: Care in technologically intense environments2008Inngår i: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 9, nr 1, s. 55-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients’ lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.

  • 2. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Caught in an Artificial Split: A Phenomenological Study of Being a Caregiver in the Technologically Intense Environment2007Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, nr 2, s. 130-136Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle ‘moments’ of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs.

  • 3. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Växjö University.
    Of vigilance and invisibility: being a patient in technologically intense environments2007Inngår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 12, nr 3, s. 151-158Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Equipment and procedures developed during the past several decades have made the modern intensive care unit (ICU) the hospital’s most technologically advanced environment. In terms of patient care, are these advances unmitigated gains? This study aimed to develop a knowledge base of what it means to be critically ill or injured and cared for in technologically intense environments. A lifeworld perspective guided the investigation. Nine unstructured interviews with intensive care patients comprise its data. The qualitative picture uncovered by a phenomenological analysis shows that contradiction and ambivalence characterized the entire care episode. The threat of death overshadows everything and perforates the patient’s existence. Four inter-related constituents further elucidated the patients’ experiences: the confrontation with death, the encounter with forced dependency, an incomprehensible environment and the ambiguity of being an object of clinical vigilance but invisible at the personal level. Neglect of these issues lead to alienating ‘moments’ that compromised care. Fixed at the end of a one-eyed clinical gaze, patients described feeling marginalized, subjected to rituals of power, a stranger cared for by a stranger. The roar of technology silences the shifting needs of ill people, muffles the whispers of death and compromises the competence of the caregivers. This study challenges today’s caregiving system to develop double vision that would balance clinical competence with a holistic, integrated and comprehensive approach to care. Under such vision, subjectivity and objectivity would be equally honoured, and the broken bonds re-forged between techne, ‘the act of nursing’, and poesis, ‘the art of nursing’.

  • 4. Elmqvist, C.
    et al.
    Brunt, D.
    Fridlund, Bengt
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Ekebergh, Margaretha
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Being first on the scene of an accident: experiences of "doing" prehospital emergency care2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 2, s. 266-273Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Prehospital emergency care includes the care and treatment of patients prior to them reaching hospital. This is generally a field for the ambulance services, but in many cases firemen or police can be the ones to provide the first responses. The aim of this study was to describe and understand experiences of being the first responder on the scene of an accident, as described by policemen, firemen and ambulance staff. A lifeworld perspective was used in four different traumatic situations from southern Sweden. The data consisted of 13 unstructured interviews with first responders. The phenomenological analysis showed that experiences of being the first responder on the scene of an accident is expectations of doing a systematic course of action, dressed in the role of a hero, and at the same time being genuine in an interpersonal encounter. This entails a continuous movement between ‘being’ and ‘doing’. It is not a question of either – or, instead everything is to be understood in relation to each other at the same time. Five constituents further described the variations of the phenomenon; a feeling of security in the uncertainty, a distanced closeness to the injured person, one moment in an eternity, cross-border cooperation within distinct borders and a need to make the implicit explicit. This finding highlights the importance of using policemen and firemen in doing life support measures while waiting for the ambulance staff, and would in turn increase the importance of the relationship between the different professionals on the scene of an accident.

  • 5. Elmqvist, C
    et al.
    Fridlund, Bengt
    Ekebergh, Margaretha
    More than medical treatment: The patient’s first encounter with prehospital emergency care2008Inngår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 16, nr 3, s. 185-192Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A common feature of emergency care services is the short, fragmented encounters with great demands for rapid treatment and efficiency. The aim of this study was to describe and understand the patient’s first encounter with prehospital emergency care as experienced by the patient and the first responders. A lifeworld perspective was used in four different traumatic situations. The data consisted of 18 unstructured interviews with patients and first responders. The phenomenological analysis showed that the concept of lifesaving means more than just upholding vital functions. The patient needs to retain his/her identity by means of a communicative contact, to be confirmed in the lived encounter and to recapitulate the elapsed time of the unexpected event in order to regain a state of equilibrium. Five constituents further described the variations of the patients’ first encounter; the encounter with the helpless injured body, the confirming existential encounter, the encounter while waiting, the lived encounter and the recapitulated encounter. This finding highlights the importance of a new understanding about empowering the patient with narratives throughout the whole caring process. There are also implications for educating personnel and students in emergency care about the first encounter with the patient in emergency care where the senses, the time and the narrative are essential elements that are unique for each person.

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