Objective: Family caregiver involvement may improve patient and family outcomes in the intensive care unit. This study describes critical care nurses' approaches to involving family caregivers in direct patient care.; Research Methodology& Design: This is a qualitative content analysis of text captured through an electronic survey.; Setting: A convenience sample of 374 critical care nurses in the United States who were subscribers to one of the American Association of Critical Care Nurses social media sites or electronic newsletters.; Main Outcome Measure: Critical care nurses' responses to five open-ended questions about their approaches to family involvement in direct patient care.; Findings: Nurse, patient and family caregiver factors intersected in the context of the professional practice environment and the available resources for family care. Two main themes were identified: "Involving family caregivers in patient care in the intensive care unit requires careful assessment" and "There are barriers and facilitators to caregiver involvement in patient care in the intensive care unit."; Conclusion: Patient care demands, the professional practice environment and a lack of resources for families hindered nursing family caregiver involvement. Greater attention to these barriers as they relate to family caregiver involvement and clinical outcomes should be a priority in future research.; Copyright © 2017 Elsevier Ltd. All rights reserved.