Experiences of surgical nurses in providing end-of-life care in an acute care setting: a qualitative study
The number of deaths occurring in hospitals is rising, and many occur in settings other than specialist palliative care, oncology or critical care. Nurses working outside these specialist environments report end-of-life (EoL) care as a source of stress. This research aimed to explore these experiences.
Aims and methods:
This qualitative study, using semi-structured interviews as a research technique, aimed to investigate the experiences of surgical nurses caring for dying patients.
Five themes emerged: understanding of and preference for EoL care; perceived barriers while providing EoL care; robust support from the team as a facilitator while providing EoL care; symptom management; future training and support.
Participants considered providing EoL care as part of their professional role and reported that they were able to provide appropriate physical care. Participants identified challenges in providing emotional and psychological support to dying patients and their families in an acute surgical setting.
It is estimated that the number of older adults in the world will more than double by the year 2050, which is expected to increase demand on every aspect of health care, including end-of-life (EoL) care (United Nations, 2017). This will present a challenge to nursing care in hospitals (Gill and Duffy, 2010; United Nations, 2017; Hunter and Orlovic, 2018). Although increasing numbers of people express a preference for receiving EoL care at home, the proportion of deaths occurring in hospitals is rising (Wee et al, 2018; Public Health England, 2019). Most adult hospital wards and specialist units are therefore expected to provide EoL care (Quill and Abernethy, 2013).
Nurses working in non-specialist wards report limits to knowledge and skills in providing EoL care (Gill and Duffy, 2010; Udo et al, 2011; McCourt et al, 2013). Many express the view that terminally ill patients should ideally be cared for in palliative care units where increased time, dedicated communication skills and scope to provide psychosocial care are more readily available (McCourt et al, 2013).
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