Dying Patient and Family Contributions to Nurse Distress in the ICU

Lief, Lindsay; Berlin, David; Maciejewski, R; Westman, Li; Su, Amanda; Cooper, Zara; Ouyang, Daniel; Epping, Geraldine; Derry, Heather M.; Russell, David; Gentzler, Eliza; Maciejewski, Paul K.; Prigerson, Holly G.

doi:10.1513/annalsats.201804-284oc

Cited by 21 publications

(22 citation statements)

References 40 publications

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“…Therefore, it was not surprising that removing family members from the bedside improved nursing workflow. Additionally, nurses provide a great deal of emotional support to distressed families in the ICU, which can, in turn, lead to heightened nursing distress ( Leung et al, 2019 , Lief et al, 2018 , Stayt, 2009 ). With the visitor restriction, nurses have had more time to focus on direct patient care without the added responsibility of providing information and support to family members at the bedside throughout the day.…”

Section: Discussionmentioning

confidence: 99%

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

Wendlandt

Kime

Carson

2022

Intensive and Critical Care Nursing

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Purpose To obtain information on how family visitor restriction during the COVID-19 pandemic has impacted the workplace experience of physicians and nurses in the medical intensive care unit, and to assess differences by profession. Materials and methods We developed a survey containing closed- and open-ended questions, applying both quantitative and qualitative analyses to our results. Results Of the 74 respondents, 29 (38%) were nurses and 45 (62%) were physicians. Nurses reported positive changes to daily workflow and the ability to provide medical care, while physicians reported negative changes in these areas. Both groups reported decreased comprehension and increased distress among families, and decreased ability to provide end-of-life care. For the qualitative analysis, eight themes were identified: the patient’s room as space, creation of a new space through virtual communication, time, increased complexity of care, challenges around the use of technology, adjustments to team roles and responsibilities, desire for families to return, and internal tension. Conclusion Intensive care physicians and nurses reported both positive and negative effects of family visitor restriction during the COVID-19 pandemic, with significant differences based on profession. Both groups expressed concern for an overall negative impact of visitor restriction on healthcare workers, patients, and their families.

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Section: Discussionmentioning

confidence: 99%

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

Wendlandt

Kime

Carson

2022

Intensive and Critical Care Nursing

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“…The importance of the various negative effects of work in the ICUs was significantly more prominent in discussions with nurses. Negative effects (emotional fatigue, moral distress, burnout) were most prominent in situations when nurses had the feeling that they needed to follow orders they were not at ease with, did not understand, or considered to be inappropriate (Flannery, Ramjan, and Peters 2016 ; St Ledger, et al 2012 ; van Mol, et al 2015 ; Shoorideh, et al 2015 ; Lief, et al 2018 ; Hua, et al 2016 ).…”

Section: Discussionmentioning

confidence: 99%

“…End-of-life decisions in ICUs include decisions about withholding or withdrawing potentially life-prolonging treatment and decisions about alleviation of pain and other symptoms with possible life-shortening effects (Sprung et al 2014 ; Joynt et al 2015 ; Downar et al 2016 ). However, although these issues are commonly faced in the ICU setting, it seems that healthcare professionals are not well equipped to deal with end-of-life decisions and their consequences (St Ledger, et al 2012 ; Deyaert, et al 2014 ; Latour, Fulbrook, and Albarran 2009 ; McMillen 2008 ; Forte, et al 2012 ; van Mol, et al 2015 ; Lief, et al 2018 .). Among the most often noted issues faced within end-of-life decision-making, physicians and nurses express poor communication, role ambiguity, and the lack of clear guidelines (Deyaert, et al 2014 ; Latour, Fulbrook, and Albarran 2009 ; Wilkinson, Truog, and Savulescu 2016 ).…”

Section: Introductionmentioning

confidence: 99%

End-of-Life Decisions in Intensive Care Units in Croatia—Pre COVID-19 Perspectives and Experiences From Nurses and Physicians

et al. 2021

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Healthcare professionals working in intensive care units (ICUs) are often involved in end-of-life decision-making. No research has been done so far about these processes taking place in Croatian ICUs. The aim of this study was to investigate the perceptions, experiences, and challenges healthcare professionals face when dealing with end-of-life decisions in ICUs in Croatia. A qualitative study was performed using professionally homogenous focus groups of ICU nurses and physicians (45 in total) of diverse professional and clinical backgrounds at three research sites (Zagreb, Rijeka, Split). In total, six institutions at the tertiary level of healthcare were included. The constant comparative analysis method was used in the analysis of the data. Differences were found between the perceptions and experiences of nurses and physicians in relation to end-of-life decisions. Nurses’ perceptions were more focused on the context and features of immediate care, while physicians’ perceptions also included the wider sociocultural context. However, the critical issues these specific professional groups face when dealing with end-of-life decisions seem to overlap. A high variability of practices, both between individual practitioners and between different organizational units, was omnipresent. The lack of adequate legal, professional, and clinical guidelines was commonly expressed as one of the most critical source of difficulties.

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“…More recent work has demonstrated that the quality of the patient's death, their suffering and loss of dignity, have been significantly associated with emotional distress in nurses (Lief, et al, 2018).…”

Section: Final Approved Versionmentioning

confidence: 99%

‘I cried too’ – Allowing ICU nurses to grieve when patients die

Endacott

2019

Intensive and Critical Care Nursing

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Dying Patient and Family Contributions to Nurse Distress in the ICU

Cited by 21 publications

References 40 publications

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

The impact of family visitor restrictions on healthcare workers in the ICU during the COVID-19 pandemic

End-of-Life Decisions in Intensive Care Units in Croatia—Pre COVID-19 Perspectives and Experiences From Nurses and Physicians

‘I cried too’ – Allowing ICU nurses to grieve when patients die

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