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

Registered Nurses' attitudes towards end-of-life care: A sequential explanatory mixed method study

AIMS

To examine registered nurses' attitudes about end-of-life care and explore the barriers and facilitators that influence the provision of high-quality end-of-life care.

DESIGN

A sequential explanatory mixed methods research design was used.

METHODS

An online cross-sectional survey was distributed to 1293 registered nurses working in five different hospitals in the Kingdom of Saudi Arabia. The Frommelt Attitudes Towards Care of the Dying Scale was used to assess nurses' attitudes towards end-of-life care. Following the survey, a subset of registered nurses were interviewed using individual semi-structured interviews.

RESULTS

Four hundred and thirty-one registered nurses completed the online survey, and 16 of them participated in individual interviews. Although nurses reported positive attitudes towards caring for dying patients and their families in most items, they identified negative attitudes towards talking with patients about death, their relationship with patients' families and controlling their emotions. The individual interview data identified the barriers and facilitators that registered nurses experience when providing end-of-life care. Barriers included a lack of communication skills and family and cultural and religious resistance to end-of-life care. The facilitators included gaining support from colleagues and patients' families.

CONCLUSION

This study has identified that while registered nurses hold generally favourable attitudes towards end-of-life care, they have negative attitudes towards talking with patients and families about death and managing their emotional feelings.

RELEVANCE TO CLINICAL PRACTICE

Education providers and leaders in healthcare settings should consider developing programmes for undergraduate nurses and nurses in clinical practice to raise awareness about the concept of death in a cross-section of cultures. Nurses' attitudes towards dying patients will be enhanced with culture-specific knowledge which will also enhance communication and coping methods.

REPORTING METHOD

This study used the Mixed Methods Article Reporting Standards (MMARS).

Surgical Nurses' Perceptions of Strategies to Enhance Pain Management Proficiency: A Qualitative Study

To describe surgical nurses' strategies for enhancing their pain management proficiency. A qualitative design was used to conduct the study. The participants were forty surgical nurses who had at least six years of nursing experience in caring for patients with pain. They responded to open-ended questions based on a review of the policy documents concerning the main elements of the pain management programme to be implemented by surgical nurses. Three key themes emerged from the surgical nurses' suggested strategies: partnering, disrupting, and becoming familiar with pain management competency concerns. Surgical nurses' strategies in acute and chronic pain management nursing units included solving patients' problems and promoting and enhancing pain strategies to address health challenges in organisations. The themes presented in the results include enhancing pain management in nursing competencies. State-of-the-art healthcare technologies are being applied to pain management. Surgical nurses' strategies should improve the quality of nursing care, especially post-surgery recovery time. It is recommended to engage patients, their families, and multidisciplinary care teams in other healthcare fields.

The Caring Mission - Nursing Personnel's Inner Driving Force in End-of-Life Care

Constantly facing human suffering and impending death can generate anxiety and insecurity in nursing personnel in end-of-life care. The aim of the study is to reveal nursing personnel's inner driving force in end-of-life care. A phenomenological hermeneutical method was used to search for meaning in the narrative data collected in this study. The structural analysis resulted in four themes: The appeal in the patient's vulnerability, The appeal in the patient's joy, Facing one's own existence in vulnerability, and Being at home with colleagues. Both vulnerability and joy motivated nursing personnel in caring. The care was often emotionally engaging and oscillated between grief and joy, which required a great deal from the nursing personnel both as professionals and fellow human beings. At the same time the emotionally engaging constituted an inner driving force, which gave them courage to do the best for the patients at the end of life.