Jeff Brown and Dr. Renea Beckstrand, College of Nursing

In an intensive care center, one sees many patients suffering and staff rushing about, caring for patients’ needs. The most important thing about working in the area of intensive care is efficiency. Dr. Renea Beckstrand of the Brigham Young University College of Nursing has been researching the best way to organize and run Intensive Care Units in the United States for several years. She has discovered many ways to improve patient care and resolve nurse burnout issues by asking nurses what they believe helps or impedes nursing care.

As an ORCA project, I chose to extend this previously researched topic to a greater population. The project is a survey of the perception of nurses in the critical care setting concerning end-of-life care. Before beginning, I translated this survey into German for use among all German-speaking nurses. It was intended mainly for nurses in Germany and Austria, but pertained to many nurses in neighboring countries with large German-speaking populations. I could not actually get to all of these places, so I used the internet as my main source of communication with nurses in these countries. I created a survey on qualtrics.com and planned to distribute the link to as many nurses as possible.

The survey was intended to find out what hindered or helped intensive care nurses perform their jobs most efficiently and with the fewest complications. As a tool I used a survey created by Dr. Beckstrand. Her survey is entitled Survey of the Perception of Nurses in the Critical Care Setting Concerning End-of-Life Care. It contains situations and problems that nurses would rate as being helpful or unhelpful or hindering or not hindering. Each item would also be rated as to how often it occurs in the area that the nurse works. By verifying what makes for efficient nursing care and what hinders it, administrations around the world can begin to implement changes so that patient care is the best that it can be.

At the outset of the project I was very optimistic. I had been to Austria previously and had visited with hospital administrators who were sure to help in the distribution of this survey. But when it came time to distribute I was met with a problem: It was nearly impossible to contact nursing organizations in Europe. The main organization with which I would have like to collaborate, OEBAI (Austrian Association of Intensive Care Nurses and Anesthetists), never responded to my emails or phone calls. I moved to other organizations in Liechtenstein, German, Switzerland, and even the whole of Europe. I had the same problem with them all. I finally received an email back from an organization in Italy, but it was criticizing my techniques and nothing more. It gave no hint as to what I should do, and after replying with a plea for enlightenment, I never received an answer. This was very discouraging, but I did not give in.

I looked for ways that I might find individual nurses instead of organizations. Facebook, internet forums, and personal contacts in the area were helpful as I attempted to send out my link. I knew already several people in Austria, two of whom were nurses. I sent the link to them and asked that they distribute it amongst their co-workers and friends. I also created an event on Facebook that had instructions and the link; this I asked that my friends join and invite others from Europe to do the same. Lastly (and I believe the most effective), I posted to an internet forum of German nurses.

Using this secondary method, I gained 33 responses to the survey. It was not as many as I had hoped, but it was a start; it was unfortunately also an end. 33 people had looked at my survey, and it appears that they found it too long or inapplicable to themselves because only two people finished it. Unfortunately these two responses yielded no information about how critical care units can be improved.

I have seen the error of my ways and it lies in incentive. I knew from the beginning that Dr. Beckstrand had given money or some other incentive to nurses so that they would fill out this survey, but I decided against it. It would be too expensive to provide every person with monetary compensation, and it would be infeasible as well. But in the last month I took a survey that used a compensation that I know would have also worked for my situation. I filled out the survey because at the end I had the opportunity to win something in a drawing. I know now that when I perform a survey again, people will fill it out if there is the chance to win an item at the end. I could have purchased any number of prizes and offered them as incentive to fill out this survey.

This research will be continued in the future and I understand through this failure how it can succeed later. Although to be a nurse is an altruistic decision, I will rely upon the materialistic desires to get things done. Also, it will be important to speak directly with my population if possible. That way, individuals will know how important this work is to their wellbeing and that of their patients. Patient care is the ultimate end of nursing research. It goes to all those we care for and my hope is that this research will contribute to healthier, happier patients.