Voices from the intensive care unit: A qualitative study on communication between family members and nurses

Appl Nurs Res. 2025 Oct:85:151991. doi: 10.1016/j.apnr.2025.151991. Epub 2025 Jul 22.

Abstract

Background: Effective communication between ICU nurses and patients' families is essential in ensuring optimal care, reducing anxiety, and enhancing decision-making. However, communication difficulties persist globally, particularly in intensive care units (ICUs) where patients are in critical condition and their families are distressed. Aim To explore the lived experiences of ICU nurses and family members in Jordan to understand how nurse workload, emotional stress, and cultural expectations influence the quality, clarity, and emotional tone of communication in intensive care settings.

Study design: A qualitative exploratory design was used. Individual face-to-face semi-structured interviews were done with 15 ICU nurses and 15 family members in two tertiary hospitals in Jordan. Braun and Clark's thematic analysis was utilized to generate the main themes and subthemes.

Results: The study identified three major themes: (1) communication disconnect and information gaps, including inadequate or inconsistent updates across shifts; (2) emotional load and its impact on communication, driven by family emotional overload and nurse burnout; and (3) balancing families' needs with nurses' workload, involving tensions between frequent updates, transparency, emotional support, and professional boundaries.

Conclusions: The study shows that ICU nurses in Jordanian hospitals face barriers to communicating with family members owing to irregular information distribution, emotional turmoil within families, and nurse exhaustion. These problems overlap with time pressure and workload stress, creating gaps in information flow, trust erosion, and emotional overload. Families' experiences could be improved through an improved ICU structure, easier communication pathways, enhanced nurse education and support, and improved family satisfaction.

Keywords: Communication; Critical care; Family members; ICU; Jordan; Nurses; Qualitative.

MeSH terms

  • Adult
  • Communication*
  • Critical Care Nursing*
  • Family* / psychology
  • Female
  • Humans
  • Intensive Care Units*
  • Jordan
  • Male
  • Middle Aged
  • Nursing Staff, Hospital* / psychology
  • Professional-Family Relations*
  • Qualitative Research