THE EXPERIENCES OF CRITICAL CARE NURSES WITH REGARD TO END-OF-LIFE ISSUES IN THE INTENSIVE CARE UNIT
DOI:
https://doi.org/10.25159/2520-5293/35Abstract
Nurses in the intensive care unit might be faced with emotional conflict, stress and anxiety when dealing with end-of-life issues and thus need to be supported. In understanding the experiences of nurses, enhanced support can be given in order to assist nurses to deal better with end-of life issues in the intensive care unit. The purpose of the study was to explore and describe the experiences of nurses’ with regard to end-of-life issues in the intensive care unit. A qualitative, explorative, descriptive and contextual research design using a semi-structured interview approach was used. The target population for the study comprise twenty registered nurses in the intensive care unit. Of the twenty nurses, only nine were willing to participate in the study. Purposive sampling method was used to interview nine nurses in a private intensive care unit. Data collected was thematically analysed, using Tesch’s method. Four major themes were identified, namely: (1) conflicting emotions; (2) family relations; (3) multi-disciplinary team relations; and (4) supportive strategies when dealing with end-of-life issues. The study concluded that nurses experienced different emotions, conflict and stress when dealing with end-of-life issues in the intensive care unit. A need for supportive relations with family members, the multi-disciplinary team and support from management were reported. Immediate debriefing, enhancing communication amongst multi-disciplinary team members, having a permanent counsellor or pastoral counselling, an ethics committee and training programmes in place to address end-of-life issues are a few of the support strategies that can assist critical care nurses in dealing with end-of-life issues in the intensive care unit.Â
Metrics
References
Adams, J.A., Bailey, D.E., Anderson, R.A., Docherty, S.L. 2011. Nursing roles and strategies in end-of-life decision making in acute care: a systematic review of the literature. Nursing Research and Practice, 2011(527834):1-15. DOI: https://doi.org/10.1155/2011/527834
Calvin, A.O., Lindy, C.M., Clingon, S.L. 2009.The cardiovascular intensive care unit nurse’s experience with end-of-life care: A qualitative descriptive study. Intensive and Critical Care Nursing, 25(4):214-220. DOI: https://doi.org/10.1016/j.iccn.2009.05.001
Campbell M, Guzman JA. 2003. Impact of a proactive approach to end-of life care in a medical ICU. Chest, 123(1):266-271. DOI: https://doi.org/10.1378/chest.123.1.266
Carlet J, Thijs LJ, Antonelli M, Cassel J, Cox P, Hill N, Hinds C, Pimentel JM, Reinhart K, Thompson. 2003. Challenges in end-of life care in the ICU. Statement of the 5th International Consensus Conference in Critical Care, Brussels, Belgium. Intensive Care Medicine, 30(1):770-784. DOI: https://doi.org/10.1007/s00134-004-2241-5
Coffey, R., Everett, S., Miller, S., Brown, J. 2011. End of life in the burn/trauma unit: a nursing perspective. International Journal of Critical Illness and Injury Science, 1(2):129-131. DOI: https://doi.org/10.4103/2229-5151.84799
Creswell, JW. 2013. Qualitative inquiry and research design: choosing among five approaches. 3rd Edition. California: SAGE publications.
Epsinosa, L., Yound, A., Symes, L., Haile, B., Walsh, T.. 2010. ICU nurses’ experiences in providing terminal care. Critical Care Nurse Quarterly, 33(3):273-281. DOI: https://doi.org/10.1097/CNQ.0b013e3181d91424
Festic, E., Grewal, R., Rabatin, J.T., Divertie, G.D., Shannon, R.P., Johnson, M.M. 2010. End-of-life care in the intensive care unit: the perceived barriers, supports, and changes needed. Journal of Department of Medical Sciences of Academy of Sciences and Arts of Bosnia and Herzegovina, 39(2):150-158.
Fumis RRL and Deheinzelin D. 2010. Respiratory support withdrawal in intensive care units: families, physician and nurses views on two hypothetical clinical scenarios. Critical Care,14:R235. DOI: https://doi.org/10.1186/cc9390
Hampson LA and Emaneul EJ. 2005. The prognosis for changes in end-of life care after Schiavo: national consensus evolves. Health Affairs,24(4):972-975. DOI: https://doi.org/10.1377/hlthaff.24.4.972
Hansen, L., Goodell, T.T., DeHaven, J., Smith, M.D. 2009. Nurses’ perceptions of end-of-life care after multiple interventions for improvement. American Journal of Intensive Care, 18(3):263-271. DOI: https://doi.org/10.4037/ajcc2009727
Hebert, K., Moore, H., Rooney, J. 2011. The nurse advocate in end-of-life care. The Ochsner Journal, 11(4):325-329.
Kuschner, W.G., Gruenewald, D.A., Clum, N., Beal, A., Ezeji-Okoye, S.C. 2009. Implementation of ICU palliative care guidelines and procedures: a quality improvement initiative following an investigation of alleged euthanasia. American College of Chest Physicians,135(1):26-32. DOI: https://doi.org/10.1378/chest.08-1685
Langley, G., Schmollgruber, S. 2006. End-of-life care in intensive care units. South African Journal of Critical Care, 22(2):58-65. DOI: https://doi.org/10.1016/j.iccn.2005.03.001
Langley G, Schmollgruber S, Fulbrook P, Albarran JW and Latour JM. 2013. South African critical care nurses’ views on end-of life decision-making and practices. Nursing in Critical Care, 19(1):9-17. DOI: https://doi.org/10.1111/nicc.12026
McGowan CM. 2011. Legal aspects of End-of Life Care. Critical Care Nurse, 31(5):64-69. DOI: https://doi.org/10.4037/ccn2011550
Morton, P.G., Fontaine, D.K. Critical care nursing: a holistic approach. 2013. 10th edition. Philadelphia: Lippincott Williams & Wilkins.
Ranse, K., Yates, P., Coyer, F.. 2010. End-of-life care in the intensive care setting: a descriptive exploratory qualitative study of nurses’ beliefs and practices. Australian Critical Care Journal, 25(1):4-12. DOI: https://doi.org/10.1016/j.aucc.2011.04.004
Scherer Y, Jezewski MA, Graves B, WU YB and Bu X. 2006. Advanced Directives and End-of Life Decision making: survey of critical care nurses’ knowledge, attitude and experience. Critical Care Nurse,26(4):30-40. DOI: https://doi.org/10.4037/ccn2006.26.4.30
South African Nursing Council. Nursing Act, 2005, Act No. 33 of 2005. 30 (1), 25.
Thelen M. 2005. End-of Life Decision making in Intensive Care. Critical Care Nurse, 25(6):28-37. DOI: https://doi.org/10.4037/ccn2005.25.6.28
Urden, L.D., Stacy, K.M. & Lough, M.E. 2014. Thelan’s Critical Care Nursing. 7th edition. Missouri: Elsevier.
Downloads
Published
How to Cite
Issue
Section
Accepted 2015-01-21
Published 2015-01-21
