Nurses’ early experiences with patient death: The results of an on-line survey of Registered Nurses in New Zealand

To be involved - A qualitative study of nurses' experiences of caring for dying patients

OBJECTIVE

The aim of this study was to describe nurses' experiences (>two years) of caring for dying patients in surgical wards.

BACKGROUND

Palliative care is included in education for nurses. However, the training content varies, and nurse educators need to be committed to the curriculum regarding end-of-life situations. A lack of preparation among newly graduated nurses regarding dying and death could lead to anxiety, stress and burnout. Therefore, it is important to improve knowledge regarding end-of-life situations.

SETTING, PARTICIPANTS AND METHOD

A qualitative descriptive study was carried out in two surgical wards in the southern part of Sweden. The study comprised six interviews with registered nurses and was analysed using manifest qualitative content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nurses' perspectives and thoughts regarding dying patients.

RESULTS

The results formed one category (caring-to be involved) and three subcategories (being supportive, being frustrated and being sensitive in the caring processes). Nurses were personally affected and felt unprepared to face dying patients due to a lack of knowledge about the field of palliative care. Their experiences could be described as processes of transition from theory to practice by trial and error.

CONCLUSION

Supervision is a valuable tool for bridging the gap between theory and practice in nursing during the transition from novice to expert. Improved knowledge about palliative care during nursing education and committed nursing leadership at the ward level facilitate preparation for end-of-life situations.

Learning end-of-life care within a constructivist model: Undergraduate nursing students' experiences

BACKGROUND

Although nursing education aims to equip nursing students to provide care to dying patients and their families, nurses often feel ill-prepared to cope with the emotional labour involved in end-of-life care.

OBJECTIVES

The aim of the study was to explore and describe nursing students' experiences of end-of-life care through experiential learning within a constructivist educational model.

METHOD

A qualitative, descriptive design was used. As part of introducing experiential learning, innovative educational practices were initiated during a second year level undergraduate nursing module on end-of-life care. Qualitative data on second-year nursing students' experiences were collected through written reflections and analysed using open coding.

RESULTS

The themes that emerged revealed participants' sensory and emotional experiences during the learning opportunities. Participants reflected on what they learnt and clarified their values related to death and dying. They indicated how they would apply the new meanings constructed in clinical practice.

CONCLUSION

A constructivist educational model of experiential learning holds potential to enhance value clarification and nursing students' sensory and emotional awareness of death and dying. Experiential learning is recommended to develop nursing students' competency inproviding end-of-life care.

Terror management theory applied clinically: implications for existential-integrative psychotherapy

Existential psychotherapy and Terror Management Theory (TMT) offer explanations for the potential psychological effects of death awareness, although their respective literatures bases differ in clarity, research, and implications for treating psychopathology. Existential therapy is often opaque to many therapists, in part due to the lack of consensus on what constitutes its practice, limited published practical examples, and few empirical studies examining its efficacy. By contrast, TMT has an extensive empirical literature base, both within social psychology and spanning multiple disciplines, although previously unexplored within clinical and counseling psychology. This article explores the implications of a proposed TMT integrated existential therapy (TIE), bridging the gap between disciplines in order to meet the needs of the aging population and current challenges facing existential therapists.

Nurses' experiences with catastrophic upper gastrointestinal bleeding in patients with hepatocellular carcinoma: a qualitative study

PURPOSE

To explore how nurses experienced catastrophic upper gastrointestinal bleeding in hepatocellular carcinoma (HCC) patients.

METHODS

A qualitative descriptive method was used. Data were collected by semi- structured interviews. Twenty-one registered nurses who had taken care of HCC patients with catastrophic upper gastrointestinal bleeding were purposely recruited from the Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital located in mainland China.

RESULTS

Four themes explicated from the study were: feelings expressed during the process of rescuing the lives of patients, feelings expressed from succeeding or failing to save the lives of patients, feelings expressed from family members response to nurses' actions, the impact of the experience on the personal life, work and philosophy of life of the nurse subjects.

CONCLUSIONS

The findings of this study indicate that it is necessary for nursing leaders to take effective measures to improve nurses' nursing skills, to provide more education in care of the dying, to offer nurses services that address their psychosocial health and to provide them with emotional support.

Programa educativo sobre muerte y cuidados paliativos en los profesionales de la salud

Introducción: La relación existente entre el personal de salud y la muerte, tienen una inevitable implicación emocional, ya que se vive y convive cotidianamente con la muerte. Objetivo: Conocer el efecto de un Programa Educativo sobre Muerte y Cuidados Paliativos (PEMyCP), fundamentado a partir de la noción de enfermedad y muerte en México. Método: Estudio cuasiexperimental comparativo, muestreo no probabilístico por conveniencia, diseño pretest-postest de un solo grupo, con profesionales de la salud en México. Los instrumentos utilizados fueron: Escala de actitudes ante los cuidados paliativos, Cuestionario de competencias profesionales y Escala de ansiedad ante la muerte de Templer. A través de análisis de frecuencias, pruebas t para muestras relacionadas y análisis de varianza ANOVA. Resultados: El PEMyCP tuvo un impacto positivo en las actitudes ante los cuidados paliativos (t=-2,0050, p=0,44), en las capacidades profesionales (t=6.969, p<0.0001), y ansiedad ante la muerte (t=2,991, p=0,15). Se realizó un ANOVA, encontraron cambios significativos en conocimientos (F=8,5988, p <0,0001) y habilidades (F=6,1197, p<0,0001); sin embargo, no se identificaron cambios en actitudes (F=0,76131, p=0,63738). En la ansiedad ante la muerte, se aprecian diferencias estadísticamente significativas (F=4,0048, p=0,00919). Conclusiones: El PEMyCP tuvo un impacto favorable en conocimientos, habilidades y ansiedad ante la muerte, no siendo así en las actitudes ante la muerte y los cuidados paliativos, ya que se requiere de mayor tiempo para lograr modificarlas debido a que se adquieren no solo aspectos cognitivos, sino también afectivos y conductuales a través de la propia experiencia.