title: Giving up and withdrawal by ventilator treated patients: nurses' experience.
abstract: If a patient on admission to the Intensive Care Unit (ICU) already seems to have given up and behaves in a withdrawn manner the nurses usually interpret it as an expression of the patient's personality. However the nursing care activities are more or less characterized by uncertainty and fear of misjudgements due to difficulties in interpreting the patient's wishes and needs. If this syndrome of giving up and withdrawal develops during ventilator treatment in the ICU nurses interpret the patient's behaviour as a sign of depression caused by exhaustion, awareness of severe illness, injuries or disabilities or loss of hope, meaning and will to live. The nurses' reactions are either to wait for spontaneous changes in the patient's behaviour or to make more active interventions, trying to support the patient and alleviate his/her condition. Most nurses feel helpless and powerless not knowing how to lessen and relieve the patient's suffering. Caring for these patients is often frustrating, stress-evoking and tiring for the nurses, especially if this syndrome is present for a long period. It is therefore important to do further studies to increase knowledge about the syndrome and its effects.
authors.forename: I B
authors.initials: IB
authors.lastname: Engberg
mesh_terms: D001293:Attitude to Death; D003142:Communication; D016638:Critical Illness / Q000451:nursing / Q000523:psychology* / Q000628:therapy; D006801:Humans; D009730:Nursing Assessment; D012121:Respiration, Artificial / Q000451:nursing / Q000523:psychology