Family members also known as guardians are willingly involved in caring for inpatients in acute care wards due to cultural expectations, shortage of staff, and dissatisfaction with care rendered by nurses. This practice is adopted from Family Centered Care (FCC) approach. Nurses offer little or no support to guardians when they are involved in caring for inpatients due to a lack of policy that regulates the practice in adult acute care wards. This leads to inconsistent implementation of FCC principles when involving guardians. The abrupt acquisition of the caring role by the guardians disrupts the normal functioning of the entire family because they take up the role without any preparation. This leads to physical, psychosocial, and economic implications for the guardian and the family.

We used a focused ethnographic approach to explore the perspectives of nurses and guardians on the implications of the caring role on the guardian and how they adapt to the burden of the caring role. We recruited twelve guardians and eight nurses who met the inclusion criteria, using the purposive sampling method. Data collection was done using participant observation and in-depth interviews. We used N-Vivo 12 to code and categorize data which later emerged into themes. Spradley’s Developmental Research Sequence was used to analyze the findings. Three cultural themes emerged from the findings of this study: roles of the guardian, burden of the caring role, and coping with the burden of the caring role. Nurses should facilitate guardians’ ability to adapt to the caring role by creating effective partnerships and collaboration when involving them in acute care wards.

Elizabeth Gwaza is a Ph.D. in Nursing candidate at Kamuzu University of Health Sciences in Malawi. She is a Registered Nurse and Midwife and is currently working as Managing Director of Good Hope Private Clinic Ltd and Good Hope Medical Centre Ltd in Malawi. She has three publications from her Ph.D. work. She has worked in various levels of nursing management in poorly resourced healthcare institutions in Malawi. She has more than 12 years of experience in leading and managing healthcare institutions. She is passionate about providing quality healthcare service in poorly resourced healthcare facilities.