Aiken LH, Sloane DM, Cimiotti JP Implications of the California nurse staffing mandate for other states. Health Serv Res. 2010; 45:(4)904-921

Al-Qurainy R, Collis E, Feuer D. Dying in an acute hospital setting: the challenges and solutions. Int J Clin Pract. 2009; 63:(3)508-515

Bloomer MJ, Endacott R, O'Connor M, Cross W. The ‘dis-ease’ of dying: challenges in nursing care of the dying in the acute hospital setting. A qualitative observational study. Palliat Med. 2013; 27:(8)757-764

Bryman A. Social research methods, 5th edn. Oxford: Oxford University Press; 2016

Casey D, Murphy K, Ni Leime A Dying well: factors that influence the provision of good end-of-life care for older people in acute and long-stay care settings in Ireland. J Clin Nurs. 2011; 20:(13-14)1824-1833

Caswell G, Pollock K, Harwood R, Porock D. Communication between family carers and health professionals about end-of-life care for older people in the acute hospital setting: a qualitative study. BMC Palliat Care. 2015; 14:(1)

Cauldwell K, Stone P. The changing nature of end of life care. Indian J Med Paediatr Oncol. 2015; 36:(2)94-98

Clarke A, Ross H. Influences on nurses' communications with older people at the end of life: perceptions and experiences of nurses working in palliative care and general medicine. Int J Older People Nurs. 2006; 1:(1)34-43

Gagnon J, Duggleby W. The provision of end-of-life care by medical-surgical nurses working in acute care: a literature review. Palliat Support Care. 2014; 12:(5)393-408

Gill F, Duffy A. Caring for cancer patients on non-specialist wards. Br J Nurs. 2010; 19:(12)761-767

Hopkinson JB, Hallett CE, Luker KA. Caring for dying people in hospital. J Adv Nurs. 2003; 44:(5)525-533

Hospice UK. Hospice UK launches new programme to create more compassionate workplaces and better support employees. 2019. (accessed 6 September 2021)

End of life care in England. A briefing paper II. 2018. (accessed 6 September 2021)

Johansson K, Lindahl B. Moving between rooms—moving between life and death: nurses' experiences of caring for terminally ill patients in hospitals. J Clin Nurs. 2012; 21:(13-14)2034-2043

Mahtani-Chugani V, González-Castro I, de Ormijana-Hernández AS, Martín-Fernández R, de la Vega EF. How to provide care for patients suffering from terminal non-oncological diseases: barriers to a palliative care approach. Palliat Med. 2010; 24:(8)787-795

Mak YW, Lim Chiang VC, Chui WT. Experiences and perceptions of nurses caring for dying patients and families in the acute medical admission setting. Int J Palliat Nurs. 2013; 19:(9)423-431

McCaughan E, Parahoo K. Medical and surgical nurses' perceptions of their level of competence and educational needs in caring for patients with cancer. J Clin Nurs. 2000; 9:(3)420-428

McCourt R, Power JJ, Glackin M. General nurses' experiences of end-of-life care in the acute hospital setting: a literature review. Int J Palliat Nurs. 2013; 19:(10)510-516

National Institute for Health and Care Excellence. End of life care for adults: service delivery. NICE guideline NG142. 2019. (accessed 10 September 2021)

More care less pathway: a review of the Liverpool care pathway. 2013. (accessed 6 September 2021)

Perceptions of a ‘good death’ in acute hospitals. 2015. (accessed 7 September 2021)

Omar Daw Hussin E, Wong LP, Chong MC, Subramanian P. Nurses' perceptions of barriers and facilitators and their associations with the quality of end-of-life care. J Clin Nurs. 2018; 27:(3-4)e688-e702

Peters L, Cant R, Payne S How death anxiety impacts nurses' caring for patients at the end of life: a review of literature. Open Nurs J. 2013; 7:14-21

Peterson JL, Johnson MA, Halvorsen B Where do nurses go for help? A qualitative study of coping with death and dying. Int J Palliat Nurs. 2010; 16:(9)432-438

Polit D, Beck C. Resource manual to accompany nursing research. Generating and assessing evidence for nursing practice, 8th edn. Pennsylvania (PA): Wolters Kluwer; 2008

Public Health England. Older people who died in hospital: England 2017. 2019. (accessed 7 September 2021)

Quill TE, Abernethy AP. Generalist plus specialist palliative care—creating a more sustainable model. N Engl J Med. 2013; 368:(13)1173-1175

Raymond A, Lee SF, Bloomer MJ. Understanding the bereavement care roles of nurses within acute care: a systematic review. J Clin Nurs. 2017; 26:(13-14)1787-1800

Royal College of Nursing. Guidance on safe nurse staffing levels in the UK. 2011. (accessed 7 September 2021)

Royal College of Nursing. Getting it right every time. Fundamentals of nursing care at the end of life. 2015. (accessed 7 September 2021)

Sherman DW. Nurses' stress and burnout. How to care for yourself when caring for patients and their families experiencing life-threatening illness. Am J Nurs. 2004; 104:(5)48-57

Slatyer S, Pienaar C, Williams AM, Proctor K, Hewitt L. Finding privacy from a public death: a qualitative exploration of how a dedicated space for end-of-life care in an acute hospital impacts on dying patients and their families. J Clin Nurs. 2015; 24:(15-16)2164-2174

Thompson G, McClement S, Daeninck P. Nurses' perceptions of quality end-of-life care on an acute medical ward. J Adv Nurs. 2006; 53:(2)169-77

Udo C, Melin-Johansson C, Danielson E. Existential issues among health care staff in surgical cancer care – Discussions in supervision sessions. Eur J Oncol Nurs. 2011; 15:(5)447-453

United Nations. World population ageing 2017. Highlights. 2017. (accessed 7 September 2021)

Atlas of variation for palliative and end of life care in England. 2018. (accessed 10 September 2021)

Zheng R, Lee SF, Bloomer MJ. How nurses cope with patient death: A systematic review and qualitative meta-synthesis. J Clin Nurs. 2018; 27:(1-2)e39-e49

Experiences of surgical nurses in providing end-of-life care in an acute care setting: a qualitative study

14 October 2021
Volume 30 · Issue 18



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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