Critical Care Nurses on Duty: Information-Rich but Time-Poor

Suzanne Lewis

Abstract


Objective – To describe critical care nurses’ on-duty information-seeking behavior.

Design – Participatory action research using ethnographic methods.

Setting – A twenty-bed critical care unit in a 275-bed community (non-teaching) hospital.

Subjects – A purposive sample of six registered nurses (RNs) working shifts in the critical care unit.

Methods – The researcher accompanied six RNs on various shifts (weekdays and weekends, day and night shifts) in the critical care unit and used participant observation and in-context interviews to record fifty hours of the subjects’ information-seeking behavior. Transcripts were written up and checked by the subjects for accuracy and validity. The resulting rich data was analyzed using open coding (concepts which emerged during data gathering, for example “nurse’s personal notes”); in vivo coding (participant-supplied concepts, for example “reading on duty”); and axial coding (hierarchical, researcher-developed concepts such as “information behaviors, information sources, information uses, and information kinds”) (147).

Main results – The critical care nurses constantly sought information from people (patients, family members, other health care workers), patient records, monitors, and other computer systems and noticeboards, but very rarely from published sources such as books or online databases. Barriers to information acquisition included equipment failure, illegible handwriting, unavailable people, social protocols (for example physician – nurse interaction), difficult navigation of computer systems, and mistakes caused by simultaneously using multiple complex systems.

Conclusion – Critical care nurses’ information behavior is strongly patient-centric. Knowledge-based information sources are rarely consulted on duty due to time constraints and the perception that this would take time away from patient care. In seeking to meet the knowledge-based information needs of this group, librarians should be wary of traditional, academic models of information delivery. Instead, they should consider a tailored ready reference service incorporating quality and quantity filtering.

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