Nurses’ and patients’ perceptions of expert palliative nursing care

Johnston, Bridget; Smith, Lawrence D.

doi:10.1111/j.1365-2648.2006.03857.x

Cited by 119 publications

(139 citation statements)

References 35 publications

(59 reference statements)

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“…In a review of the literature concerning the ability of staff to alleviate existential distress, it was found that although clinicians are sometimes aware of their lack of knowing what to say and or do when patients experience existential distress, they are often aware of existential distress or spiritual meaning as being part of their work (Leung and Esplen, 2010). In order to meet patients' needs to express existential concerns, nurses have been found to develop relationships of trust through effective communication skills (Mok and Chiu, 2004;Johnston and Smith, 2006). Alternatively, assistant nurses find it unnatural to talk about death with patients or their relatives and report that caring for dying patients provokes negative emotions (Beck et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

Browall

Henoch

Melin‐Johansson

et al. 2014

European Journal of Oncology Nursing

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a b s t r a c tNurses working with cancer patients in end of life care need to be prepared to encounter patients' psychosocial and spiritual distress. Aim: The aim of this study was to describe nurses' experiences of existential situations when caring for patients severely affected by cancer. Methods and sample: Nurses (registered and enrolled) from three urban in-patient hospices, an oncology clinic and a surgery clinic and a palliative homecare team were, prior to the start of a training program, invited to write down their experiences of a critical incident (CI), in which existential issues were featured. Results: Eighty-eight CIs were written by 83 nurses. The CIs were analyzed with qualitative content analysis. Two main themes were found: Encounters with existential pain experiences, which concerned facing death and facing losses; and Encountering experiences of hope, which concerned balancing honesty, and desire to live. Conclusions: This study points out that health care professionals need to be aware of patients' feelings of abandonment in exposed situations such as patients' feelings of existential loneliness. That there are some patients that express a desire to die and this makes the nurses feel uncomfortable and difficult to confront these occurrences and its therefore important to listen to patients' stories, regardless of care organization, in order to gain access to patients' inner existential needs.

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Section: Introductionmentioning

confidence: 99%

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

Browall

Henoch

Melin‐Johansson

et al. 2014

European Journal of Oncology Nursing

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“…Shortcomings and barriers have been reported in communication at the end of life between patients and healthcare professionals, and among the staff [40,[41][42][43]. Nurses consider communication at the end of life, although difficult, to be part of their responsibility; education has been found to contribute to increased confidence in interdisciplinary communication and communication with dying patients [29][30][31]37,41,[44][45][46]. In our study, increased attention in the intervention wards to palliative care and to physician end-of-life communication might also have contributed to the improved end-of-life communication by nurses.…”

Section: Discussionmentioning

confidence: 99%

Effect of a Palliative Care Nurse Champion Program on Nursing Care of Dying Patients in the Hospital: A Controlled before and after Study

FE¹,

A²,

CCD³

et al. 2017

J Nurs Health Stud

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Objective: Hospitals increasingly appoint nurse champions to improve quality of care. This study investigated the effect of palliative care nurse champions on nursing end-of-life care. Methods:Imbedded in a controlled before-after study (June 2009-July 2012) on care for the dying patient in the hospital, nurses completed questionnaires on end-of-life care within two weeks after the patient's death. Halfway the study, seven out of 18 participating wards appointed two palliative care nurse champions. Characteristics of end-of-life care were compared for patients who died before and after the introduction of the nurse champion program and with outcomes in 11 control wards. Results:In the intervention wards, data were collected on 81 patients in the pre-intervention period and on 93 patients in the post-intervention period; in control wards these numbers were 114 and 121, respectively (response 54%). After the introduction of the nurse champion program, nurses in the intervention wards more frequently discussed imminent death with patients (35% pre-intervention vs 50% post-intervention, p=0.05), were more frequently aware of psychological symptoms (57% vs 71%, p=0.04), and performed less futile interventions during the final hours (on average 0.8 vs 0.4 out of 4 interventions, p<0.01). These differences were not found in the control wards. No effect was found on nurses' awareness of patients' imminent death. Nurses' median score for quality of dying was lower in the postintervention period (7.5 vs 7.0 on a 0-10 scale; p=0.02). Conclusion:Nurse Champions had a beneficial effect on end-of-life nursing care in hospital. We found increased communication and more awareness of patients' palliative care needs. Increased awareness seems to have made nurses more critical about the quality of dying.

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“…Death often occurs in a centralised location which is set aside by the society for the work of dying. In many jurisdictions this is a hospital, although it is uncommon for there to be a discrete space for this purpose; for example, in Australia, of 729 public acute hospitals Death in these settings is controlled and supervised by the health professions (physicians, nurses and others allied to medicine, typically under the direction of a medical practitioner (Johnston & Smith, 2006). Recipients of this care (patients, carers and families) report varied levels of engagement in the functioning of these places as they go about the business of caring (Johnson & Smith, 2006), but the structural elements of place are largely solid.…”

Section: Dying In Modern Timesmentioning

confidence: 99%

Solid and liquid modernity: A comparison of the social geography of places to die in the UK and Australia

2016

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LIQUIDITY AND THE SOCIAL GEOGRAPHIES OF DYING2 | P a g e Solid and liquid modernity: A comparison of the social geography of places to die in the UK and Australia. AbstractPreferred place of care and death is a widely used quality measure for palliative and end of life care services. In this paper we explore the use of Zygmunt Bauman's ideas on solid and liquid modernity to understand the complexity of the social geographical contexts of delivering and receiving care. While solid ways of dying offer certainty and standardised care, more liquid ways allow for individualised care connected to family and communities.Understanding the complex tensions between solid and liquid aspects of palliative care may allow practitioners to help dying people to die in the ways and places they prefer.

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Nurses’ and patients’ perceptions of expert palliative nursing care

Abstract: Although the study was conducted in the United Kingdom, the findings have relevance for palliative care practice globally in terms of dependence, issues of patient choice, nurses being interpersonally skilled and building therapeutic relationships with patients.

Cited by 119 publications

References 35 publications

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

Effect of a Palliative Care Nurse Champion Program on Nursing Care of Dying Patients in the Hospital: A Controlled before and after Study

Solid and liquid modernity: A comparison of the social geography of places to die in the UK and Australia

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