Objective Care in the emergency department focuses significantly on delivering lifesaving/ life-sustaining clinical actions, often with limited attention to health-related suffering even at the end-of-life. How healthcare staff experience and navigate through the end-of-life phase remains minimally explored. Thus, this study aimed to uncover the lived experiences of emergency department staff at the end-of-life. Methods van Manen’s hermeneutic phenomenological approach was used. Nineteen healthcare staff were purposively recruited and interviewed. Interviews were audio-taped, transcribed verbatim, and thematic categories formulated. The existential lifeworld themes (corporeality, relationality, spatiality, and temporality) were used as heuristic guides for reflecting and organizing the lived experiences of participants. Results The overarching category, ‘ resuscitate and push’, was captured as corporeality (resisting death and dying); relationality (connectedness to the body of the patient; and lacking support for family and self); spatiality (navigating through a liminal space and lack of privacy for patients); and temporality (having limited to no time for end-of-life care and grieving). The end-of-life space was unpleasant. Although participants experienced helplessness and feelings of failure, support systems to help them to navigate through these emotions were lacking. Grief was experienced covertly and concealed by the entry of a new patient. Conclusion End-of-life in the emergency department is poorly defined. In addition to shifting from the traditional emergency care model to support the streamlining of palliative care in the department, staff will require support with navigating through the liminal space, managing their grief, and developing a better working relationship with patients/ families.
Background: Nurses working in various patient care departments are exposed to different traumatic situations, patient suffering, and death in their routine care. This study investigated grief and coping experiences amongst registered nurses working in various care departments of a major government health facility in the Ashanti region of Ghana. Methods: A descriptive cross-sectional survey amongst nurses was conducted. A quota-sampling technique was applied to yield a representative sample of 79 nurses working in different wards of Konongo-Odumasi Government Hospital in Konong, Ghana. A structured self-administered questionnaire was used for data collection. Standard descriptive statistics (e.g. frequency and proportions) were used to summarize the survey data. The data were analyzed using SPSS software, v. 20. Results: The majority of nurses (63%) reported feelings of grief following the death of patients they had cared for. Most respondents (89%) who did not acknowledge a grief experience did not grieve out of fear or as a show of professionalism. Some reported impacts of grief included insomnia (39%), loss of appetite (51%), tiredness (8%), feeling of depression (24%), and reduced functionality at work and home (27%). Common coping strategies for dealing with grief following patient death included physical exercise (67%), engaging in spiritual practices (51%), listening to music (47%), and discussing with other colleagues (42%). Only 47% of nurses reported access to professional counseling. Conclusion: Regular training on effective grief coping strategies and emotional support for nurses caring for the dying may positively affect the health and well-being of nurses and improve the quality of care for both the dying patient and their families. Providing professional counseling for nurses is also suggested.
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