The nurse's role in palliative care: A qualitative meta‐synthesis

Sekse, Ragnhild Johanne Tveit; Hunskår, Irene; Ellingsen, Sidsel

doi:10.1111/jocn.13912

Cited by 177 publications

(173 citation statements)

References 41 publications

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“…This role can be explained as that of a servant leader (who builds and serves a community; Greenleaf, ) in LTC settings. When providing palliative care in hospitals and home care, nurses—as the health professionals who spend the most time with such people—ensure their availability and coordinate care (Sekse, Hunskar, & Ellingsen, ). However, in the LTC settings examined in this study, nurses were not the health professionals who were closest to residents.…”

Section: Discussionmentioning

confidence: 99%

Rebuilding and guiding a care community: A grounded theory of end‐of‐life nursing care practice in long‐term care settings

Nasu

Sato

Fukahori

2020

Journal of Advanced Nursing

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Aims To investigate the end‐of‐life (EOL) nursing care practice process in long‐term care (LTC) settings for older adults in Japan. Design A qualitative study based on grounded theory developed by Corbin and Strauss. Methods Sampling, interviewing, and analysis were performed cyclically, with results for each stage used as the basis for data collection and next‐stage analysis decisions. Semi‐structured interviews were conducted from March 2015‐March 2019 with 22 nurses from eight LTC settings. Analysis was performed using coding, constant comparison, and emerging categories. Results The core category, “guiding the rebuilt care community to assist the dying resident” comprised five categories: “assessing the resident's stage,” “harmonizing care with the dying process,” “rebuilding a care community,“ “helping community members care for the resident,” and “encouraging community members to give meaning.” The participants were described as “traditional village elders“ who were the integral members of the care community, as well as guides who helped and encouraged the community. Conclusion Results revealed the holistic process of EOL nursing‐care practice in Japan. Nurses aimed to allow LTC residents to die as social human beings, surrounded by people, and not just responding physical and psychological distress. Such practice requires nursing expertise, healthcare skills, and leadership qualities to build and serve care communities. Nurses must also consider residents’ uncertainties and vulnerabilities as well as their cultural backgrounds. Impact This study showed that the nurses hold unique roles in providing dying people with care from a community. These findings can potentially be applied for developing a universal model for LTC nurses in many aging populations, to modify their EOL care practice, educate new LTC nurses, and collaborate with other healthcare professionals.

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Section: Discussionmentioning

confidence: 99%

Rebuilding and guiding a care community: A grounded theory of end‐of‐life nursing care practice in long‐term care settings

Nasu

Sato

Fukahori

2020

Journal of Advanced Nursing

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“…Advocating on behalf of residents (Dahlin, ) was found to be particularly important for nurses in LTC settings, where most residents' cognitive function is declining. This advocacy role is consistent with EOL care in other settings (Karbasi et al, ; Sekse et al, ). However, nurses also mentioned that the dignity of dying residents was disturbed by unnecessary treatment to keep them alive as per relatives' wishes but contrary to the residents' own.…”

Section: Discussionmentioning

confidence: 99%

“…Nurses were reflective on their practice but experienced contextual barriers including lack of space, time, and educational preparation for providing high‐quality EOL care. Sekse, Hunskar, and Ellingsen () did a qualitative meta‐synthesis of nurses' role in palliative care across health services and found that nurses' valued roles included “being available” to provide and coordinate care, for which they need knowledge and training, guidance, and support. Nurses' role for EOL care in LTC settings will and should differ from that in hospital and homecare settings along with differences of context including residents' length of stay, purpose of admission, physician placement, or nurse‐resident/nurse‐patient ratio.…”

Section: Introductionmentioning

confidence: 99%

End‐of‐life nursing care practice in long‐term care settings for older adults: A qualitative systematic review

Nasu

Konno

Fukahori

2019

Int J of Nursing Practice

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Aim To synthesize qualitative evidence on nurses' end‐of‐life care practices in long‐term care settings for older adults. Background Qualitative evidence on how nurses describe their own end‐of‐life care practice has not been reviewed systematically. Design Qualitative systematic review. Data Sources Databases MEDLINE, CINAHL, PsycINFO, EMBASE, Mednar, Google Scholar, and Ichushi were searched for published and unpublished studies in English or Japanese. Methods The review followed the Joanna Briggs Institute approach to qualitative systematic reviews. Each study was assessed by two independent reviewers for methodological quality. The qualitative findings were pooled to produce categories and synthesized through meta‐aggregation. Results Twenty studies met all inclusion criteria. Their 137 findings were grouped into 10 categories and then aggregated into three synthesized findings: playing multidimensional roles to help residents die with dignity, needing resources and support for professional commitment, and feeling mismatch between responsibilities and power, affecting multidisciplinary teamwork. Conclusion Nurses play multidimensional roles as the health care professionals most versed in residents' complex needs. Managers and policymakers should empower nurses to resolve the mismatch and help nurses obtain needed resources for end‐of‐life care that ensures residents die with dignity.

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“…Nurses play vital roles in caring for patients during their end‐of‐life process. Nurses contribute expertise in palliative care and symptom management across a wide variety of practice settings, and they provide emotional, mental and psychological support to those navigating life‐limiting illness and death (Sekse, Hunskår, & Ellingsen, ). A lack of clarity in the professional contributions that registered nurses are permitted to make during a MAiD process can potentially disrupt and disconnect nurses during this complex and emotionally charged time.…”

Section: Political Ramifications and Professional Tensionsmentioning

confidence: 99%

“…Nurses play vital roles in caring for patients during their end-of-life process. Nurses contribute expertise in palliative care and symptom management across a wide variety of practice settings, and they provide emotional, mental and psychological support to those navigating life-limiting illness and death (Sekse, Hunskår, & Ellingsen, 2018).…”

Section: Professional Considerationsmentioning

confidence: 99%

Medical assistance in dying: A political issue for nurses and nursing in Canada

2019

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Death and dying are natural phenomena embedded within complex political, cultural and social systems. Nurses often practice at the forefront of this process and have a fundamental role in caring for both patients and those close to them during the process of dying and following death. While nursing has a rich tradition in advancing the palliative and end‐of‐life care movement, new modes of care for patients with serious and irremediable medical conditions arise when assisted death is legalized in a particular jurisdiction. In early 2015, the Supreme Court of Canada released its landmark decision Carter v. Canada (Attorney General) (‘Carter’), which legalized physician‐assisted suicide in particular clinical situations. The new law provided the broad national framework for Medical Assistance in Dying (MAiD) in Canada but, once the law was passed, provincial and territorial governments and health professional regulatory bodies each had to undertake a process of developing policies, procedures and processes to guide MAiD‐related practice specific to their jurisdiction. In this paper, we begin to examine the political ramifications and professional tensions arising from MAiD for nurses and nursing, focusing specifically upon the impacts for registered nurses. We identify how variations in the provincial and territorial literature and regulatory guidelines across Canada have given rise to role confusion and uncertainty among some registered nurses and how this may potentially impact patient care. We then continue to highlight the need for greater political activism among nurses to foster greater clarity in nursing roles in MAiD and to advocate for improved supports for patients and those close to them.

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The nurse's role in palliative care: A qualitative meta‐synthesis

Abstract: Aims and objectives: To explore how nurses, across various health systems, describe their role in providing palliative care for patients with life-threatening illnesses.Background: Despite the fact that nurses make up the largest group of healthcare

Cited by 177 publications

References 41 publications

Rebuilding and guiding a care community: A grounded theory of end‐of‐life nursing care practice in long‐term care settings

Rebuilding and guiding a care community: A grounded theory of end‐of‐life nursing care practice in long‐term care settings

End‐of‐life nursing care practice in long‐term care settings for older adults: A qualitative systematic review

Medical assistance in dying: A political issue for nurses and nursing in Canada

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