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Concept development

I work in the ICU, where I am responsible for critically ill patients. Specifically, I am in charge of those who need artificial ventilation. I am to ensure the patients get better, and not contracting more diseases in the course of their admission in the ICU. One of the most dangerous risks that ICU patients on artificial air are exposed to is the Ventilator-Associated Pneumonia (VAP). Its prevention involves a 5-steps process, called the VAP bundle. Of the five steps, interruption of the sedation to introduce extubation to the patient is the most critical step, also called, “weaning from mechanical ventilation.” Previously, the physicians attending to patients in critical situations attempted to reduce the length of time of mechanical ventilation by manipulating ventilator modes and gradually decreasing the ventilator support. Nonetheless, research today has shown that sedation can have a bigger impact on the length of time of mechanical ventilation, and other patient outcomes than can manipulating ventilator modes (Eber, Laximinarayan, Perencevich, Malani, 2010). Patients respond differently to sedation, depending on their ability to cope. One major incidence that comes to my mind when sedation is mentioned is one I experienced with a post renal transplant patient, who was admitted to the ICU for 12 hours’ observation. ...
After successful surgery, the patient was put on mechanical ventilation and later sedated so that she does not fight the mechanical ventilation equipment. After she stabilized, the weaning process from mechanical ventilation took effect. This is in accordance with the VAP bundle protocol of preventing the occurrence of VAP. On receiving the physician’s order, I adhered by holding the sedation to assess if the patient was ready for extubation. However, after successful extubation, the patient grew violent. She felt this was a mean act as it dehumanized her. My attempts to explain the importance of the process were not welcome by the patient, as she could not understand. The Phenomenon of Interest The phenomenon of interest related to my story and her first action after weaning her from mechanical ventilator, is best described as “Waking up to breath.” This was termed during a discussion with my colleagues while doing our assignment for statistics course. We stopped for a while and discussed our concept development. Thus, each one of us presented her story and then we helped each other the come up with a concept. The phenomenon exhibits the high level of patient’s anxiety. Theoretical Lens for Viewing the Phenomenon The theoretical lens used to view this phenomenon shapes the meaning of this phenomenon. The phenomenon in this research is ‘waking up to breath,” which is accompanied with patient anxiety. This describes reactions of patient after she was weaned from the mechanical ventilator. She reacted rather violently. Various theories can be used to bring this phenomenon into perspective. However, I choose to choose one of the middle range theories. The theory of self-efficacy is one that will bring a deeper meaning and understanding to this phenomenon. In ...Show more

Summary

Concept Analysis 27th, November 2012 Introduction This research paper analyzes the concept of anxiety in relation to medical treatment and healing process. The structure of the paper, including theory development bases on the concept analysis framework of Liehr & Smith (2008)…
Author : raymundo19
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