Unrecognized contributions of families in the intensive care unit.

OBJECTIVE: To describe the contributions to care that family members perform while their loved one is at high risk of dying in the intensive care unit.
DESIGN: Exploratory, descriptive analysis.
SETTING: Two intensive care units at a tertiary medical center in the western United States. PARTICIPANTS: Through purposive sampling, 25 family members of 24 ICU patients at high risk of dying participated in the study.
INTERVENTIONS: None. MEASUREMENTS AND
RESULTS: A qualitative, descriptive technique was used for data analysis. Three independent raters coded transcripts of audiotaped interviews with family members about their experiences in the ICU. Recurring themes were categorized into roles that family members take on while their loved one is in the ICU. These work roles consisted of active presence, patient protector, facilitator, historian, coach, and voluntary caregiver.
CONCLUSIONS: Family members are important to patient care in the ICU. They perform multiple roles that are often not valued or go unrecognized by ICU health care providers. More support and appreciation of family members' contributions to care may provide families opportunities for intimacy and promote a sense of belonging in the highly technical environment of an ICU.