Nurses Caring for ICU Patients With Intellectual Developmental Disabilities in the United States: An Interpretivist Narrative Analysis Using Western Story Arcs

Understanding ICU nurses' experiences in caring for patients with intellectual developmental disabilities is crucial. Insights can inform supportive measures and training programs to enhance nurse well-being and patient population-specific outcomes. The primary objective of this study was to explore and understand the lived experiences of nurses caring for patients with intellectual developmental disabilities. This narrative study employed a research design focusing on ICU nurse storytelling. Registered nurses from ICU settings (n = 49) in the United States participated. Data were collected from January 2024 through April 2024 via semi-structured interviews over an online audiovisual recorded platform. Transcripts were analysed using Christopher Booker's theory of the seven basic plots (Overcoming the Monster, Rags to Riches, The Quest, Voyage and Return, Comedy, Tragedy, and Rebirth) to identify emerging themes in the data. Story arcs revealed each type of narrative arc apart from comedy, suggesting that ICU nurse experiences of caring for patients with IDD are widely varied and encompass a full range of human expression and experience. Themes spanning these arcs included (1) The Journey of Revisioning ICU Care and (2) Finding Strength to Champion Patient Rights. Findings suggest that ICU nurses consistently experienced the key elements in Finding Strength to Champion Patient Rights but that the key elements of The Journey of Revisioning ICU Care were less widely experienced. Tailored support and training programs can enhance nurses' ability to provide effective care to this patient population. Insights hold practical implications for nursing education, clinical practice, and policy development. Findings suggest additional training for nurses will benefit patient outcomes and nurse satisfaction. Through exploring unique challenges and emotional burdens faced by nurses, healthcare organisations can develop supportive measures that foster a more caring and effective healing environment. Policy changes can lead to improved patient outcomes, greater nurse satisfaction, and a more inclusive healthcare system that recognises and addresses the needs of vulnerable populations. No patient or public contribution. This study focused on the lived experiences of ICU nurses rather than direct patient or public involvement. The research design and data collection were centred on professional narratives from nursing staff, which did not necessitate input from patients or