Routines within the clinic
When the nurses’ and the physicians’ answers were compared, the importance of the tradition and routines within the clinic appeared. In NICU fever was related only to infection or cerebral injury and associated with a negative process. Temperature > 38° Cwas routinely treated irrespective of the presence of increasing intracranial pressure or not: «If the temperature is more than 38°C of course you give antipyretics». In the ICU fever was related to a sign of warning in the first place. Temperature of more than 39°C was associated with risk of physiological complications. The patients were assessed individually and the necessity of avoiding shivering was stressed: «If they (patients) do not feel badly I do not usually give them anything». In the SC fever was regarded as a normal reaction which increases the body defence against alien substances: «So we do not treat them in any special way.... give them an extra blanket if they want to». Antipyresis was of interest if the temperature increased to about 40° – 41° C, or if circulatory complications arose. In GR both physicians and nurses considered 38° C as borderline but adjusted assessment and actions to elderly people’s reactions. The patient’s personal experience was more important than the degree of fever when considering investigation and actions: «Generally you can say that the patients feelings are more important for my decision about actions».