Causes of futile care from the perspective of intensive care unit nurses (I.C.U): qualitative content analysis

Abstract

Background Medical care that has therapeutic effects without significant benefits for the patient is called futile care. Intensive Care Units are the most important units in which nurses provide futile care. This study aimed to explain the causes of futile care from the perspective of nurses working in Intensive Care Units are. Method The study was conducted using a qualitative approach. Qualitative content analysis was used to analyze the data. Study participants were 17 nurses who were working in the Intensive Care Units are of hospitals in the north of Iran. They were recruited through a purposeful sampling method. Data was gathered using in-depth, semi-structured interviews from March to June 2021. Recruitment was continued until data saturation was reached. Results Two main themes, four categories, and thirteen subcategories emerged from the data analysis. The main themes were principlism and caring swamp. The categories were moral foundation, professionalism, compulsory care, and patient’s characteristics. Conclusion In general, futile care has challenged nursing staff with complex conflicts. By identifying some of these conflicts, nurses will be able to control such situations and plan for better management strategies. Also, using the findings of this study, nursing managers can adopt supportive strategies to reduce the amount of futile care and thus solve the specific problems of nurses in intensive care units such as burnout, moral stress, and intention to leave.

Becoming futile: the emotional pain of treating COVID-19 patients

“…While medical futility is inherently ambiguous and contextdependent, hinging on probabilistic determinations of whether a treatment would benefit a patients' quality of life or offer a chance of recovery balanced against the risk of harm, it is also one of the primary drivers of moral distress among intensive care unit workers (Palda et al, 2005;Asayesh et al, 2018;Rakhshan et al, 2022). In the case of COVID-19 presented here, futility took on a somewhat different character.…”

“…Medical futility is an inherently ambiguous, multidimensional, and context-dependent concept that nevertheless generally describes a situation when a patients' physician has determined that a treatment offers no reasonable likelihood of benefit to the patients' quality of life or chance of recovery, and therefore providing such treatment would be not justified given the potential risk of harm (Palda et al, 2005;Asayesh et al, 2018;Rakhshan et al, 2022). Although futility is a concept as old as Hippocrates, the ethical dilemmas in making futility determinations endure and may even be amplified as new treatments emerge that extend a patients' life long after they otherwise would have died (Whitmer et al, 2009).…”

The nurses’ perception of the factors influencing professional misconduct: A qualitative study

“…The patient's age is a characteristic that leads nurses even to provide futile care. 37 A study reported the age discrimination experience in healthcare centers in 30% of the elderly and 47% of the students. 38 In another study, the prioritization of medical care and treatment based on the patient's age was reported.…”

Para Medicine Students’ Experiences of Virtual Education: A Qualitative Study

“…The present study was conducted in 2022 using a qualitative research design with a conventional content analysis approach to examine Para medicine students' experiences of virtual education. This approach is a systematic and purposeful way to describe a phenomenon (19). This study was conducted on various fields of medical sciences (nursing, anesthesiology, operating room, midwifery, laboratory sciences) studying at universities in the north of Iran.…”