A difficult path to walk: Critical Care Nurses’ lived experience of crucial conversations: perspectives from one Australian team

Abstract

This practice inquiry reports the lived experience of Crucial Conversations by a small group of critical care nurses in a South Australian quaternary hospital’s critical care unit. Crucial Conversations are high stakes, highly emotional dialogues, where opinions and understanding greatly differ. Executed well, these discourses result in increased collaboration, meaningful solutions to challenging issues and improved team performance. Literature reveals other systems in place for quality improvements in unit performance that include TeamSTEPPS and Safety Learning System (SLS) reporting, however, the unique conflict resolution strategies with reflective events has not been adequately covered. Crucial Conversations are one form of a structured resolution process, which addresses this gap. Research regarding the lived experience of Crucial Conversations is an important piece missing from the literature. Using van Manen’s hermeneutic phenomenological methods, ‘Too hot to handle’, ‘Anticipatory responding’ and ‘Moving from who is right to what is right’ emerged as themes of the critical care nurses’ lived experience of Crucial Conversations. The inquiry findings give complementary views to previous research, add to the body of knowledge related to Crucial Conversations and bring attention to the importance of improving professional relationships on all levels. The study findings lend themselves to a process of implementing Crucial Conversations into the critical care setting. The value of this research lies in the implementation of multidisciplinary strategies for effective ongoing working relationships.