Critical Care Nurses’ Experiences With Death and Dying: A South African Perspective

Abstract

The aim of this study was to explore experiences of South African critical care nurses regarding grief, death and dying in a critical care environment. Data was collected using semi-structured interviews and was analyzed using Giorgi’s thematic data analysis method. Available literature suggests that critical care nurses have varied experiences in relation to their experiences in relation to end-of -life patient care. However, few studies have examined the involvement of South African intensive care nurses’ in caring for the dying patient, their grief, their reactions to death in the workplace and the extent to which their nursing practice is based on shared beliefs, experiences and attitudes. Findings from this study revealed many predisposing factors and circumstantial occurrences shaping both, the nature of care of the dying and subsequent grief that, affected the nurse. Repeated exposure to grief, leads to occupational stress and burn out, causing emotional disengagement from caring for the dying, which ultimately affect the quality of care rendered for both the dying patient and their family. Issues, such as communication, multicultural diversity, education and coping mechanisms are essential in nursing education and practice and nurses caring for the critically ill or dying patient, need to have support networks and strategies put in place, not only to assist in providing care, but also for their own emotional support and well-being.

Grief Support and Coping Mechanism Mediate the Effect of Grief on Burnout Among Intensive Care Unit Nurses

“…The nurses' choice of coping mechanism varies based on their acceptance of patients' death 14 . The nurses transformed the negative coping mechanisms used at the initial stage of their first experience dealing with patients' death into positive coping mechanisms as their acceptance of patients' death progressed over time with the increase in their understanding of patients' death with the advance of medical and nursing knowledge 12,14 . This probably explains the preference for positive coping mechanisms among the majority of ICU nurses with the absence of grief in this study.…”

“…The nurses felt supported when their grief was acknowledged and understood by colleagues, family members, superiors, and friends who provided them with opportunities for debriefing; allowed them to attend workshops on managing their grief; and provided a quiet place for reflection following patients' death 37,41 . However, ICU nurses are often not supported well during their state of grievousness after the death of their patients 12 . This could probably explain the moderate to low level of grief support among most ICU RNs in this study.…”

“…Intensive care unit nurses cope with their grief using various temporary and lasting measures that vary among them. They use the most appropriate coping techniques based on each dying situation, as no single mechanism is feasible to help all nurses or nurses across all experiences of caring for dying patients 1,12 . Grieving nurses usually deal with their loss and pain by displaying negative and positive emotional reactions 4 .…”

Development of a training programme for professional nurses in South Africa – An educational response to the COVID‐19 pandemic

“…Nurses have witnessed healthcare providers making so‐called decisions pertaining to patient care but are unable or unwilling to step forward and be that patient's advocate in the way they ought to be or the way they were taught to be. Findings from a study revealed that many predisposing factors and circumstantial occurrences shaping both, the nature of care of the dying and subsequent grief that affected the nurse (Naidoo & Sibiya, 2019 ). Repeated exposure to grief leads to occupational stress and burn out, causing emotional disengagement from caring for the dying, which ultimately affects the quality of care rendered for both the dying patient and their family.…”

“…Issues, such as communication, multicultural diversity, education and coping mechanisms are essential in nursing education and practice. Nurses caring for the critically ill or dying patient need to have support networks and strategies put in place, not only to assist in providing care, but also for their own emotional support and well‐being (Naidoo & Sibiya, 2019 ).…”