Background <p>The intensive care unit (ICU) is a place where standardized procedures and advanced technology intersect with profound human vulnerability. Here, a person-centred approach to care becomes not only desirable but crucial, as it proposes an approach to safeguard personhood amidst life-saving routines. This study forms part of a broader investigation of Person-centred Practice in the ICU, drawing on McCance and McCormack’s framework and Levinas’s philosophy of the radical Other.</p> Methods <p>This qualitative study explored how ICU nurses understand and enact person-centred care. Data were collected from 16 nurses working in adult ICUs across three hospitals in Austria through focus groups, individual interviews, and accounts of person-centred moments in practice. The analysis process was informed by the philosophy of radical alterity and, derived from this, focused on uncovering two strategies that nurses use to shape the care environment; i) ‘creating the context’ (grounding values and beliefs to allow personhood to emerge) and ii) ‘breaking up the frames’ (how nurses respond to disruptions through the radical Other to ensure personhood can be valued and sustained).</p> Results <p>Findings address these two interrelated strategies. Nurses ‘create a context’ by adhering to inner credos - guiding values like recognising the person, taking responsibility and acting ethically - applied in shaping relationships and navigating the patient’s journey, balancing personal, clinical, and technological demands. They understand themselves as guardians of patients’ personhood. Person-centred moments emerged from challenging situations. Here, nurses were able to ‘break up the frames’ - routines, standard procedures, and even personal expectations - by opening to the situation and embracing the strangeness and disruption they faced. By going the extra mile, they created moments in which person-centred care could unfold, generating positive care experiences for patients, families, and nurses alike.</p> Conclusions <p>Person-centred care in the ICU means caring for the person behind tubes, wires, and machines. It cannot be reduced to checklists or protocols but depends on nurses’ ability to pause, notice, and respond, supported by organizational cultures that enable such care. In this way, ‘breaking up the frames’ is not about dismantling clinical care but expanding it to include the person.</p> Registration <p>Not registered. As part of a dissertation thesis the protocol for the study was approved by the Faculty board of Social Sciences of the University of Vienna, Vienna, Austria</p>