Emotional burden of nurses in palliative sedation therapy

Abstract

A significant number of nurses felt serious emotional burden related to sedation. To relieve nurses' emotional burden, we encourage 1) management efforts to reduce work overload, 2) a team approach to resolving conflicting opinions, especially between physicians and nurses, 3) co-ordination of early patient-family meetings to clarify their preferred end-of-life care, 4) education and training about sedation specifically focused on interpersonal skills, systematic approaches to diagnosing refractory symptoms, minimum life-threatening potency in sedation, and ethical principals differentiating sedation from euthanasia, and 5) exploring nurses' personal values through the patient-centered principle.

Nurses' Attitudes and Experiences Surrounding Palliative Sedation: Components for Developing Policy for Nursing Professionals

“…11,[15][16][17]22,23 Similar to other studies, nurses reported PS as an important therapy to improve the care of dying patients with refractory symptoms. Nurses overwhelmingly agreed PS was salient for the management of refractory physical symptoms; however, differences in opinions emerged on whether PS was appropriate for nonphysical symptoms such as depression and existential suffering.…”

“…22 In a nationwide study of Japanese nurses, the lack of understanding surrounding sedation was one of the most frequently cited reasons for emotional burden by nurses. 17 These findings were echoed in our study as nurses cited the importance of clarifying patient eligibility and how PS differed from other treatments.…”

“…11,17 Nurses reported working within a team as a key skill and process for decisions surrounding PS. This includes a nurse-physician relationship that fosters ''collaborative decision making.''…”

“…10,11,[14][15][16][17][18][19][20] In fact, we could only identify seven publications that addressed this question-two from North America, one from Japan, and four from Europe. The purpose of the current study was to elicit nurses' perspectives and conceptualizations of knowledge and skills needed to administer PS in order to inform developing a hospital policy that addresses identified concerns.…”

La sédation palliative pour soulager la souffrance existentielle en fin de vie : regard sur une pratique controversée

“…Implications pour la pratique infirmière L'initiation d'une sédation continue et profonde peut être une expérience difficile pour l'infirmière (Morita, Miyashita, Kimura, Adachi, & Shima, 2004b). L'infirmière joue un rôle central de porteparole auprès du patient à travers le système de santé (Bruce & Boston, 2012).…”