Community nurses' experiences of ethical problems in end‐of‐life care in the patient's own home

Abstract

The nurses exhibited commitment and a desire to do good when caring for patients in the end-of-life phase, even if they sometimes experienced feelings of lack of control. This implies that, when confronted with care-related issues, they have the power to both act and react. This study aimed to increase understanding of ethical problems that arise in end-of-life care in the patient's own home and revealed the need to take the patients', relatives' and nurses' perspectives on health and suffering into consideration to ensure good end-of-life home care.

Ideas of home in palliative care research: A concept analysis

“…“The patient's home is the place where her/his identity is protected from the outside of the world and where her/his identity is confirmed”, (p. 832)…”

“…“The home can be seen as an inner room (private space) where the person is at home with her/himself”, (p. 832)…”

“…The use of verbs in statements about home is significant for this attribute. Examples of verbs used, inflected in various ways, are “contribute,” “increase,” “give,” “demand,” “create,” “help,” “carry,” “confirm,” “protect,” “lodge,” and “support.”…”

“…This is noticed in studies by Vankatasalu et al . and Karlsson et al . (p. 832) when home is described as the space where a person is “at home with her/himself.” The difference between the attributes home as space and home as place is constituted by the chosen spatial terms themselves, more than the actual statements.…”

Palliative care nurses’ strategies when working in private homes—A photo‐elicitation study

“…Nurses may experience unsanitary conditions, demanding care activities, the need to perform heavy lifts and time-consuming travel between patients (Leiss, 2012;Markkanen et al, 2007). Further, nurses have reported that working in private homes can include having insufficient medical and collegial support, contributing to feelings of discomfort, insecurity and loneliness during work (Carlson, Ramgard, Bolmsjo, & Bengtsson, 2014;Karlsson, Karlsson, da Silva, Berggren, & Soderlund, 2013;Tunnah & Johnstone 2012). However, positive aspects are more frequently described and it has been suggested that the home environment promotes opportunities to create caring relationships which can, however, be emotionally challenging for the nurse when the patient dies (Markkanen et al, 2007).…”