Emergence of a Constructivist Theory on Nurses’ Caring Decisions for Patients Being Withdrawn from Ventilatory Support

Abstract

This research is centered on developing a constructivist grounded theory that reflects how intensive care unit (ICU) nurses carry out their caring decisions for patients withdrawn from ventilatory support as captured from the Filipino context. To frame an exhaustive discussion, the researcher utilized Charmaz’s constructivist grounded theory approach with semi-structured interviews, observational field notes, and memos as data collection methods. Employing theoretical sampling, twenty senior ICU nurses, four doctors and ten patients’ family members provided data that formulated the theory. The formulated core category of Perspicacity in Caring Decisions is indicated by ICU nurses' ability to develop a deeper concept of wisdom and understanding gained through clinical and life experiences. This constructivist theory stands on a strong foundation built from five interlinked subcategories: Voicing Out, Establishing realities, Navigating transitions, Taking the time, and Serving a Good Death. This brings together and contextualizes what was happening throughout the processes of nurses’ end-of-life caring decisions. This research concludes that moving into a realm where death becomes an acceptable outcome, recognizing the Filipino cultural background, the patient made comfortable, and their family supported to understand the change of direction in approach are essential parts of the nurses’ caring decisions.