This hermeneutic phenomenological inquiry reveals the meaning in critical care nurses' lived experiences of making a difference in practice with a view to deepening our understanding of nursing in pursuing nursing excellence. It serves to show how critical care nurses make a difference and what difference they make to critically ill patients in a manner that more fully captures nursing practice as enacted in the critical care setting. The authors subjected transcripts of the conversations with 16 critical care nurse participants to a thematic analysis and reflective process from which the following themes emerged: making the inhumane humane, making the unbearable bearable, making the life threatening life sustaining, and making the unlivable livable. Guided by the lifeworld existentials, these themes became the threads around which an interpretive—descriptive text was written. The authors wove other relevant sources of lived-experience material into the evolving text to assist with the explication of meaning.
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