Inability to communicate with the patient can also cause frustration. Nurses may feel incompetent because their patients cannot communicate seemingly important messages to them (Bergbom-EDgberg.. aDd H.,a.lja., 1993).

Talking with relatives is a skill usually learned from experience rather than training. At times this can be stressful since the ICU staff have to remain calm and objective even when relatives or patients are rude, abusive, or aggressive. Death and dying are a common fate of many patients on the ICU. It has been shown to be 'an emotionally charged, highly stressful situation demanding all the skills of the staff'. Difficulties arise with the breaking of bad news to the relatives, in the care of the dying patient, and in supporting the family of the patient and dealing with any reactions that might ensue.

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