Reflecting on one's own death: The existential questions that nurses face during end-of-life care

Karlsson, Matts; Kasén, Anne; Wärnå-Furu, Carola

doi:10.1017/s1478951516000468

Cited by 25 publications

(17 citation statements)

References 19 publications

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“…For example, evidence from the primary literature showed that nurses were often burdened by the professional expectation to manage the emotions of the grief and loss of the dying patients and their families as well as their own. 23 Inconsistencies in the participants' expectations of each other's roles were also found in the current study. In some cases, the views of doctors as to what their roles were differed to what the nurses perceived to be the role of the doctor.…”

Section: Discussionsupporting

confidence: 69%

“…In line with the previous research, nurses in this study felt that they were professionally obliged to provide clinical care and, at the same time, to provide emotional support. For example, evidence from the primary literature showed that nurses were often burdened by the professional expectation to manage the emotions of the grief and loss of the dying patients and their families as well as their own 23 …”

Section: Discussionmentioning

confidence: 99%

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Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Omoya

Bellis

Breaden

2022

J Hosp Palliat Nurs

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There have been significant advancements in the fields of medicine, demography, and pathology. These disciplines have contributed to the classification and control of death and dying. People are now living longer with numerous comorbidities, and there is a significant aging population. Consequently, there have been increases in the numbers of people who present to emergency departments across Australia seeking access to care at the end of life. Emergency department staff must have the knowledge and skills required to provide end-of-life care in a setting that traditionally contradicts the goals of comfort care. With the increase in demand for end-of-life care in emergency departments, a gap exists in the experiences of how staff provide such care in this setting. As a result of this gap, it is important to understand the lived experiences of emergency department doctors and nurses who provide end-of-life care. The aim of this research is to understand the lived experiences of emergency department doctors and nurses concerning death, dying, and end-of-life care provision. Data were analyzed using Diekelmann's 7-step analysis to support Gadamer's phenomenological approach. Results indicate that challenges exist in the decision-making process of end-of-life care in emergency departments.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Omoya

Bellis

Breaden

2022

J Hosp Palliat Nurs

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“…This is partially because patients and families may be reluctant to make care transitions out of fear of losing the professional caregiver with whom they have developed a strong, trusting relationship (Sefcik et al, 2017) or from fear of being abandoned by their nurse (Back et al., 2009). Nurses, on the other hand, may also experience complex emotions or face existential questions about their personal identity, role as a professional caregiver and fellow human being, while caring for patients at the end‐of‐life (Karlsson et al., 2017). In prior research, assurances of non‐abandonment have been associated with expressions of satisfaction with clinician communication in serious illness (Sullivan et al., 2015).…”

Section: Discussionmentioning

confidence: 99%

Homecare nurses guide goals for care and care transitions in serious illness: A grounded theory of relationship‐based care

Sullivan

Mann

Mullen

et al. 2021

Journal of Advanced Nursing

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Aims To identify the process that homecare nurses use when recognizing serious illness, engaging patients and families in goals‐for‐care discussions and guiding transitions to comfort‐focused care. Design Constructivist grounded theory. Methods Semi‐structured focus group interviews of 31 homecare Registered Nurses were recorded and transcribed (June–August 2019). Line‐by‐line coding using the constant comparative method until saturation was achieved and a grounded theory was identified. Credibility, transferability, and confirmability establish study rigor. Results A grounded theory of relationship‐based care. Nurses cogitate and act when recognizing serious illness. They have difficult conversations and support care transitions with wisdom and knowing, by identifying changes in illness trajectories and being informed and alert to diminishing quality of life. Nurses are skilled at engaging patients, families, and the team and accommodate care in the home for as long as possible, while manoeuvring through complex systems of care; ultimately relinquishing and guiding care to other providers and settings. However, nurses feel inadequately prepared and frustrated with a fragmented healthcare system and lack of collaboration among the team. Conclusion This study identifies a grounded theory to support clinical decision‐making and position homecare nurses as leaders in guiding goal care discussions and transitions to comfort‐focused care. These findings reinforce the importance of developing health policy that ensures care continuity in serious illness. Further research is needed to improve relationships across care settings and enhance training for the delivery of comfort‐focused care in the home as changing needs emerge during serious illness management.

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“…Therefore, the study suggests that the technological obligations and moral/ethical concerns experienced by nurses regarding palliative care mostly cause them to suppress their actual feelings. In the previous studies, it was mentioned that nurses, who provided palliative care, learnt emotional management processes over time, recognized that acting as the institution expected of them (instead of actual emotions) might cause alienation of the self, tried to prevent grief by restricting the emotions, and this could conflict with their self-identities (29,33). In a study conducted on the factors affecting the emotional labor of the neonatal nurses, it was observed that the institutional support provided to nurses was not sufficient.…”

Section: Discussionmentioning

confidence: 99%

Yenidoğan yoğun bakım hemşirelerin duygusal emek düzeylerinin palyatif bakıma yönelik tutumlarına etkisi

EREL

Büyük

2021

Journal of Medicine and Palliative Care

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Reflecting on one's own death: The existential questions that nurses face during end-of-life care

Cited by 25 publications

References 19 publications

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Homecare nurses guide goals for care and care transitions in serious illness: A grounded theory of relationship‐based care

Yenidoğan yoğun bakım hemşirelerin duygusal emek düzeylerinin palyatif bakıma yönelik tutumlarına etkisi

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