Background Although nurses are the primary clinicians in telemedicine intensive care units (tele-ICUs), their experiences remain underresearched. Objective To describe and interpret the lived experiences of tele-ICU nurses. Methods A qualitative, hermeneutical, phenomenological approach based on van Manen’s methodology was used to collect and interpret interview data. In-depth interviews were conducted with 11 tele-ICU nurses affiliated with a health system in the northeastern United States. The interviews were intended to elicit direct reports of specific incidents to capture the phenomenological experience. Field observations of the practice setting were conducted to enhance data richness. Results The participants were primarily female, aged 34 to 67 years, with 11 to 45 years of nursing experience. The following 4 major themes and 12 subthemes were identified: (1) watching intensively and panoptically, with subthemes (a) affirming unremitting diligence, (b) uncovering virtual knowing, and (c) easing perceptions of intrusion; (2) transcending complex boundaries, with subthemes (a) building trustful collaboration, (b) discerning vigilant interventions, and (c) exercising skillful investigation; (3) transforming nursing practice, with subthemes (a) mastering tact, (b) delineating the critical wholeness, and (c) augmenting safety and quality of care; and (4) developing an e-identity, with subthemes (a) tempering feelings of working in shadows, (b) evolving to the enhanced specialist role, and (c) achieving professional gratification. Conclusions Tele-ICU nurses play a transformative role in nursing practice. These findings have implications for nursing practice, education, health policy, enhancement of the current American Association of Critical-Care Nurses (AACN) Tele-ICU Nursing Practice Model, and future research on ICU telemedicine.

Annie George

American Journal of Critical Care

美国重症监护杂志 (AJCC) 的编辑邀请作者提交原始手稿，描述与重症和急性病患者护理相关的所有专业的调查、进展或观察。鼓励合作实践和研究的论文。稿件将被考虑，但前提是它们尚未在其他地方发表并且仅提交给 AJCC。

The editorial team of the American Journal of Critical Care invites authors to submit original manuscripts that describe investigations, advancements, or observations related to the care of critically ill and acutely ill patients. We encourage papers that promote collaborative practice and research. Manuscripts will be considered only if they have not been published elsewhere and are submitted exclusively to this journal.

美国重症监护杂志 (American Journal of Critical Care) 编辑诚邀作者提交原创手稿，内容涉及重症和急性病患者护理相关的各类研究、进展或观察。我们鼓励提交合作实践和研究的论文。所有稿件必须为未在其他地方发表且仅提交给本杂志。

Category	Quartile
医学	3
医学, 护理	3
医学, 危重病医学	4

The Lived Experiences of Telemedicine Intensive Care Unit Nurses

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