Male ICU nurses' experiences of taking care of dying patients and their families: a gender analysis

Nurses' Caring Experiences for Dying Patients: A Meta-Synthesis Review

Nurses play an important role in caring for dying patients. The ability to face a dying patient is a vital necessity and skill for nurses. Nurses' experiences in dealing with dying patients help to identify the factors affecting nursing care. Therefore, this meta-synthesis explains nurses caring experiences for dying patients. In this meta-synthesis review, English qualitative articles related to nurses' caring experiences with dying patients that were published in Google Scholar, PubMed, Web of Science, Scopus, and CINAHL databases were selected. The results presented in 4 themes and 4 sub-themes, including (i) dual parallel nursing care (patient care and family care), (ii) conflict between nurses' beliefs and care duties, (iii) care reflections on the nurse (positive and negative care reflection, and (iv) coping strategies of nurses. This study shows that nurses provide diverse care to dying patients and their families, which has had positive and negative reflections on their personal and professional lives. Nurses sometimes had a conflict with their beliefs and treatment protocols, which hesitate to perform the treatment. Although nurses use various coping strategies when caring for dying patients and their families, they need more strategies to cope with multi-faceted physical, mental, spiritual, educational, and management issues.

Assessment of a medical student mentoring programme to improve attitudes related to grief and coping with death

Objectives

To evaluate the impact of a mentoring programme for medical students doing a palliative care rotation, aimed at improving coping with death and attitudes towards the suffering produced by illness.

Methods

A quasi-experimental study without a control group was carried out on second-year medical students. Five 1-h group sessions were conducted. Attitudes towards grief and coping with death were assessed before the mentoring programme began and afterwards, using the Brief Humanizar Scale and the Bugen's Coping with Death Scale, respectively.

Results

In terms of the sense of grieving as measured by the Brief Humanizar Scale, the mean score for the 'Burden' factor was 7 points and for the 'Change' factor it was 28.6, indicating that suffering makes more sense as a lever for positive change than as a burden. Regarding Bugen's Coping with Death Scale, the mean score was 127.8 points before the mentoring programme and 139.2 afterwards. Hence, the score after the mentoring programme increased by 11.4 points, improving strategies to cope with death.

Conclusion

Medical professionals must cope with death and end-of-life patients. In addition to scientific knowledge, students need to acquire competencies for better coping with the death of patients, with mentoring programmes helping to enhance this process of learning.

"Time and life is fragile": An integrative review of nurses' experiences after patient death in adult critical care

INTRODUCTION

Providing bereavement support and care to families is an aspect of critical care nursing practice that can be rewarding, yet emotionally and psychologically challenging. Whilst significant research has focused on end-of-life care in critical care, less is known about nurses' experiences after patient death.

AIM

The aim of this study was to synthesise research evidence on the experience of registered nurses after patient death in adult critical care.

DESIGN

A structured integrative review of the empirical literature was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across the Cumulative Index Nursing and Allied Health Literature (CINAHL) Complete, Ovid Medline, PsycInfo, Embase, and Emcare databases. Records were independently assessed against inclusion and exclusion criteria. A process of forward and backward chaining was used to identify additional papers. All papers were assessed for quality. Narrative synthesis was used to analyse and present the findings.

RESULTS

From the 4643 records eligible for screening, 36 papers reporting 35 studies were included in this review, representing the voices of 1687 nurses from more than 20 countries. Narrative synthesis revealed three themes: (i) postmortem care, which encompassed demonstrating respect and dignity for the deceased, preparation of the deceased, and the concurrent death rituals performed by nurses; (ii) critical care nurses' support of bereaved families, including families of potential organ donors and the system pressures that impeded family support; and (iii) nurses' emotional response to patient death including coping mechanisms.

CONCLUSIONS

Whilst a focus on the provision of high-quality end-of-life care should always remain a priority in critical care nursing, recognising the importance of after-death care for the patient, family and self is equally important. Acknowledging their experience, access to formal education and experiential learning and formal and informal supports to aid self-care are imperative.

Emotion management and stereotypes about emotions among male nurses: a qualitative study

BACKGROUND

Nursing requires a high load of emotional labour. The link between nursing, emotional labour and the female sex, complicates the figure of the male nurse, because masculinity is associated with physical or technical (rather than emotional) and moreover is defined in contrast to femininity. Our objective was to understand how emotion management is described by male nurses who work in the paediatrics department of a Spanish tertiary hospital.

METHODS

Qualitative descriptive study. The participants were selected through intentional sampling in the paediatrics department of a Spanish tertiary hospital. We conducted semi-structured interviews until reaching data saturation. We carried out a content analysis, using Lincoln and Guba's definition of scientific rigour.

RESULTS

We identified two key themes in the data: 1) Stereotypes related to the emotional aspects of care: Participants took for granted some gender stereotypes while questioning others and defended alternative ways of managing emotions related to care. 2) Emotion management strategies: Participants described keeping an emotional distance, setting boundaries, relativising problems and using distraction and humour.

DISCUSSION

Nursing care is conditioned by gender roles and stereotypes that present men as less capable than women of feeling and managing emotions. However, emotion management is necessary in nursing care-especially in paediatrics-and our participants reported using strategies for it. Although participants continued to interpret care in terms of traditional roles, they contradicted them in adapting to the emotional labour that their job requires.

CONCLUSIONS

New behaviours are emerging among male nurses, in which care and emotion management are not exclusively the purview of women. Our participants reproduced some gender stereotypes while disrupting others, and they tended to cling to the stereotypes that were favourable to them as male nurses. As we work towards a gender-neutral profession, these results represent a first step: male participants reported that they provide care and manage their emotions as well as (or better than) women. However, because they substantiated their claims by drawing on negative stereotypes of women, further progress must be made.

The interaction effect between gender and profession in posttraumatic growth among hospital personnel

Aim:

To explore if there is an interaction effect between gender (men and women) and profession (nurses and physicians) in posttraumatic growth (PTG).

Background:

PTG is defined as a positive psychological change experienced as a result of struggling with highly challenging life circumstances. It may take the form of improved self-image, a deeper understanding of self, increased spirituality, and/or enhanced interpersonal relationships. Gender and profession were found separately to be associated with PTG, but to date were not examined under interaction effect.

Methods:

We employed a cross-sectional study conducted in the tertiary medical center in Israel using a convenience sample. One hundred and twenty-eight nurses and seventy-eight physicians gave their consent and agreed to fill out self-report questionnaires regarding personal and professional data and PTG Inventory.

Findings:

The correlation matrix revealed that being a woman was associated with higher PTG total scale (r = 0.242; P ≤ 0.001) and its subscales except for spiritual change that showed no evidence of statistical effect. Similar pattern was found for being a nurse with PTG total scale (r = 0.223; P ≤0.001) and its subscales except for relating to others that showed no evidence of statistical effect. However, the interaction effect revealed that among men, there was no difference in the level of PTG and its subscales based on profession (Physicians men = 62.54 (20.82) versus Nurses men = 60.26 (22.39); F = 9.618; P = 0.002). Among women, nurses had a significantly higher scores in PTG (Physicians women = 61.81 (18.51) versus Nurses women = 73.87 (12.36); F = 9.618; P = 0.002) and its subscales in comparison to physicians except for subscale relating to other.

Conclusions:

Our findings suggest implications for research and practice namely exploring PTG among nurses and physicians would benefit from applying interaction effect of gender and profession. For practice, advocating PTG within the health care organization is needed to be tailored with gender and professional sensitivity.

Work environment factors in coping with patient death among Spanish nurses: a cross-sectional survey

Objective:

to explore self-perception competence among Spanish nurses dealing with patient death and its relationship with work environment, evidence-based practice, and occupational stress.

Method:

a cross-sectional web-based survey collected information from a convenience sample of 534 nurses from professional Spanish Colleges who answered four validated questionnaires: Coping with Death Scale, Practice Environment Scale of the Nursing Work Index, Perception of Evidence-Based Practice (EBP) and Nursing Stress Scale.

Results:

a total of 79% of the participants were women, the average age was 40 years old, 38% had a postgraduate degree and 77% worked in public health settings. Many nurses evaluated their work environment as unfavorable (66%), reported high occupational stress (83.5±14.9), and had high scores on knowledge/skills in EBP (47.9±11.3). However, 61.2% of them perceived an optimal coping (>157 score). The multivariate logistic model indicated positive associations with work environment and EBP characteristics (OR: 1.30, p=0.054; OR: 1.04, p=0.007; OR: 1.13, p<0.001, respectively) but negative associations with occupational stress and short work experience (OR: 0.98, p=0.0043; OR: 0.74, p<0.002, respectively). These factors explained 23.1% of the coping variance (p<0.001).

Conclusion:

although most nurses perceived optimal coping, the situation could be enhanced by modifying several contextual factors. The identification of these factors would improve the quality of end-of-life care by facilitating nursing management.

Male nurses' views of gender in the nurse-family relationship in paediatric care

AIMS

(1) To learn how male nurses view and manage their relationships with families of hospitalized children, in contrast to how they view those established by female nurses. (2) To know if male nurses' relationships with families of hospitalized children are influenced by gender roles and stereotypes.

BACKGROUND

Relationships are essential in care. Prevailing gender stereotypes suggest that males have more difficulties with relationships than with technical aspects of nursing.

METHOD

Descriptive qualitative research in a public tertiary hospital September-December 2015. Participants were male nurses who worked in maternal and child health. Purposive sampling, based on criteria of homogeneity-regularity and heterogeneity-diversity. Semi-structured interviews and content analysis.

FINDINGS

Twelve male nurses participated. Two key themes emerged. (1) Establishment of professional-family relationship. Male nurses denied that male and female nurses established relationships with families differently, attributing any differences to personality rather than gender. (2) Management of relationships. Male nurses claimed that they set more limits on their relationships with families than female nurses.

DISCUSSION

Male nurses both disrupted and reproduced gendered stereotypes about relationships with families, revealing new models of masculinity.

CONCLUSION

Male nurses reject the stereotype that nursing is a women's profession, but they interpret their relationships with families in terms of gender roles and stereotypes.

IMPLICATIONS FOR NURSING AND NURSING POLICY

These findings contribute to understandings of the influence of gender stereotypes in nursing. They support the work of professional associations and labour unions in Spain and other countries to combat gender stereotypes and gender differences in nursing.

Exploring attitudes of acceptance of males in nursing among registered nurses

AIMS

To explore attitudes of acceptance of male nurses and examine correlations between female nurses' levels of acceptance and certain demographic variables.

BACKGROUND

Collaboration and teamwork are essential skills for the nursing profession and for successful health care environments. Attitudes of acceptance between male and female nurses can impact the ability to sustain these skills and influence nursing satisfaction.

METHODS

Female (n = 251) and male (n = 60) nurses from three medical centres in or near a large, Midwestern city participated. Data were collected via an anonymous online survey using the Sexist Attitude Inventory.

RESULTS

Male nurses' attitudes of acceptance of male nurses were greater than female nurses' attitudes of acceptance. A small, positive correlation was found between the female nurse's level of education and her acceptance of male nurses. Male and female nurses' responses were also significantly different on 35% of the inventory items-providing areas of focus for relationship improvement.

CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT

The significant difference between male and female nurses' acceptance of male nurses necessitates further investigation. Addressing male/female perspective differences on professional work issues may improve both groups' work experience, job satisfaction, and acceptance of all nursing colleagues, regardless of gender.

Professional male caregiving: A concept analysis

The number of men in professional caregiving roles has increased. While still a small percentage, the numbers of men in these roles continues to expand. Too often, the methods that professional male caregivers use to provide care differ from their female counterparts. There has not been much research conducted to understand how males in the professional role differ from their female counterparts in terms of caregiving characteristics.

A Comparative Study of Australian and New Zealand Male and Female Nurses' Health: A Sex Comparison and Gender Analysis

The aim of this research was to compare the health and lifestyle behaviors between male and female nursing professionals. Biological, workplace, and lifestyle factors as well as health behaviors and outcomes are reported as different between male and female nurses. Although male nurses show distinct health-related patterns and experience health disparities at work, few studies have investigated health differences by sex in a large cohort group of nursing professionals. This observation study of Australian and New Zealand nurses and midwives drew data from an eCohort survey. A cohort of 342 females was generated by SPSS randomization (total N=3625), to compare against 342 participating males. Measures for comparison include health markers and behaviors, cognitive well-being, workplace and leisure-time vitality, and functional capacity. Findings suggest that male nurses had a higher BMI, sat for longer, slept for less time, and were more likely to be a smoker than their female nurse counterparts. Men were more likely to report restrictions in bending, bathing, and dressing. In relation to disease, male nurses reported greater rates of respiratory disease and cardiovascular disease, including a three times greater incidence of myocardial infarction, and were more likely to have metabolic problems. In contrast, however, male nurses were more likely to report feeling calm and peaceful with less worries about their health. Important for nurse workforce administrators concerned about the well-being of their staff, the current study reveals significant sex differences and supports the need for gender-sensitive approaches to aid the well-being of male nurses.