An exploration of nurse experience in caring for end of life care client and family in critical care setting in Indonesian context

Abstract

The need of society toward end-of-life care is increasing, especially for the client being cared in the ICU setting, where nursing role is critical in this context. Some studies have indicated that nurses often feel distressed in caring for those clients. The nursing knowledge related to caring for the client in the end-of-life phase is, therefore, important for improving the nurse's insights. This study employed qualitative phenomenological approach, focused on exploring the experience of nurses in providing end-of-life care to the clients and their families in ICU setting. Seven participants have participated in this study. Data collection was undertaken through in-depth interview and analyzed using Colizzi approach. The results of the study have described this phenomenon on four themes: the life and death is God's secret; the dilemma between doing the best for the client and terminating life support; Supporting the clients and families; Re lecting on the experience. The results of this study have a potential to expand the nursing knowledge related to end-of-life care as well as have the potential of improving the quality of care services provided to the clients in end-of-life phase.

Withdrawing life supports therapy in human rights perspective

“…(6) In case there was incompatibility between the request of the patient's family and the recommendation of the team appointed by the Medical Committee or Ethic Commiittee and the family remained requesting to withdraw or postpone the life support therapy, the responsibility was in the side of the patient's family. Article 15 paragraph (5) and paragraph (6) as provisions on the legal standing of terminally illed patient state: a. a terminally illed patient remained to be the main legal subject so that hehad the right to decide his own will -see Article 15 Paragraph (5) and paragraph (6). b. in case the patient could not declare his or her own will, his legal standing was then replaced by his family's member having the rights.…”

“…It will be even more complicated if it is arequest of the patient's family because of socio-economic reasons so that the family forces to bring the patient home. In this case it is clear that the one having authority to remove all the devices is the doctor in duty [5,6]. Case examples of appeals for the release of life aids often occur in the ield of health services, especially hospital services.…”

Meta analysis: The relationship of mother's hand washing behavior, clean water supply and availability of latrines with the incidence of diarrhea in toddlers

“…Based on the Basic Human Servicer (BHS) study in Indonesia in 2006, people's behavior in washing their hands is 12% after defecating, after cleaning the feces of infants and toddlers 9%, before eating 14%, before feeding the baby 7%, before preparing food 6%. So that hand washing behavior is one of the factors that cause diarrhea [7,8]. In another BHS study on the behavior of household drinking water management, it showed that 99.20% boiled water to get drinking water, but 47.50% of the water still contained Eschericia coli.…”