Background The Evidence that NIV is an effective treatment for patients with COPD who present in Acute Type 2 Respiratory Failure is well documented. Yet despite NIV being considered the gold standard for treating patients with this life threatening condition, no published research could be found on how individuals experienced NIV in the acute setting. The Respiratory Team has led the NIV service for the last 7 years and our knowledge has grown with every patient we have treated with NIV. However during the follow-up of patients who had undergone NIV it became apparent that some of them had strange tales to tell. They told of dreams and images that they associated with their episode on NIV. Some refused having NIV again due to their dislike of the treatment. This was not something which had been discussed whilst in hospital and warranted investigation.

The Study This phenomenological study aimed to explore the experiences of 8 patients with COPD who underwent NIV for Acute Type 2 RF. To gain access to the rich data, in-depth unstructured interviews were conducted. The data were analysed using a framework by Deikelman.

The Outcomes Some themes which emerged from the data were expected however, the main theme of delirium was not. This unpredicted finding raised issues about mental capacity and decision making. This new understanding of delirium and its possible consequences has far reaching implications for how we care for this vulnerable group especially when it comes to nursing them on ward areas rather than the HDU setting. The findings from this study have proved fascinating and set the scene for further exploration.