Emotional knowing in nursing practice: In the encounter between life and death

Emotions and feelings in critical and emergency caring situations: a qualitative study

Background

Moral emotions are a key element of our human morals. Emotions play an important role in the caring process. Decision-making and assessment in emergency situations are complex and they frequently result in different emotions and feelings among health-care professionals.

Methods

The study had qualitative deductive design based on content analysis. Individual interviews and focus groups were conducted with sixteen participants.

Results

The emerging category “emotions and feelings in caring” has been analysed according to Haidt, considering that moral emotions include the subcategories of “Condemning emotions”, “Self-conscious emotions”, “Suffering emotions” and “Praising emotions”. Within these subcategories, we found that the feelings that nurses experienced when ethical conflicts arose in emergency situations were related to caring and decisions associated with it, even when they had experienced situations in which they believed they could have helped the patient differently, but the conditions at the time did not permit it and they felt that the ethical conflicts in clinical practice created a large degree of anxiety and moral stress. The nurses felt that caring, as seen from a nursing perspective, has a sensitive dimension that goes beyond the patient’s own healing and, when this dimension is in conflict with the environment, it has a dehumanising effect. Positive feelings and satisfaction are created when nurses feel that care has met its objectives and that there has been an appropriate response to the needs.

Conclusions

Moral emotions can help nurses to recognise situations that allow them to promote changes in the care of patients in extreme situations. They can also be the starting point for personal and professional growth and an evolution towards person-centred care.

Emotional distancing in nursing: A concept analysis

BACKGROUND

Emotional distancing was introduced as a means of coping with emotional labor. It safeguards healthcare workers from difficult emotional interactions with patients. It also provides caregivers with an escape from emotional exhaustion, compassion fatigue, and burnout.

AIM

This paper aims at defining emotional distancing by identifying its critical attributes and empirical use.

DESIGN/DATA SOURCE

A literature search was performed using applicable medical and health databases not merely restricted to the medical or nursing fields to understand the concept's true nature. "Emotional distance," "emotional distant," "emotional distancing," "emotionally distance," "emotionally distant," "emotionally distancing," "emotions [MeSH Terms] distance," "emotions distant," and "emotions distancing" were utilized as keywords and controlled vocabulary.

REVIEW METHODS

Walker and Avant's method was utilized as a comprehensive review of the literature to clarify the meaning of emotional distancing. Antecedents, characteristics, and consequences of emotional distancing were obtained systematically.

RESULTS

Based on the analysis, emotional distancing is a self-controlled defensive strategy involving emotional separation from patients to maintain neutrality.

CONCLUSION

Emotional distancing can enable health-related workers to protect the mental health of nurses while also providing best nursing care to patients. This helps reduce emotional labor and maintain nurses' professionalism. Further research is needed to develop a specific tool that can identify the circumstances and how healthcare workers can implement this strategy in practice. Emotional distancing is an important term that requires conceptual analysis as a coping strategy to protect the mental health of nurses while also serving the best nursing care to patients.

Discovering Humanoid Robot Consciousness Within Caring Science

Why would humanoid caring robots (HCRs) need consciousness? Because HCRs need to be gentle like human beings. In addition, HCRs need to be trusted by their patients, and have a shared understanding of patients' life experiences, their illnesses, and their treatments. HCRs need to express “competency as caring” to naturally convey their nursing as healing to patients and their families. HCRs should also have self-consciousness and express their emotions without needing inducement by persons' behaviors. Artificial “brains” and artificial consciousness are therefore necessary for HCRs. The purpose of this article was to explore humanoid consciousness and the possibilities of a technologically enhanced future with HCRs as participants in the care of human persons.

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.

Utilization of palliative care principles in nursing home care: Educational interventions

Objective:

This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.

Method:

Three different programs were developed by specialist staff from three local palliative care teams. In all, 852 staff at 37 nursing homes in the greater Stockholm area participated. Staff from 7 nursing homes participated in 11 focus-group discussions. Variation in size between the seven nursing homes initiated purposeful selection of staff to take part in the discussions, and descriptive content analysis was used.

Results:

The results suggest that staff reported positive experiences as they gained new knowledge and insight into palliative care. The experiences seemed to be similar independent of the educational program design. Our results also show that staff experienced difficulties in talking about death. Enrolled nurses and care assistants felt that they carried out advanced care without the necessary theoretical and practical knowledge. Further, the results also suggest that lack of support from ward managers and insufficient collaboration and of a common language between different professions caused tension in situations involved in caring for dying people.

Significance of results:

Nursing home staff experienced competence-building programs in palliative care as useful. Even so, further competence is needed, as is long-term implementation strategies and development of broader communication skills among all professions working in nursing homes.

Un-earthing emotions through art: facilitating reflective practice with poetry and photographic imagery

In this article, we comment upon and provide an arts-informed example of an emotive-focused reflection of a health care practitioner. Specifically, we use poetry and photographic imagery as tools to un-earth practitioners' emotions within agonizing and traumatic clinical encounters. In order to recognize one's own humanness and authentically engage in the art of medicine, we immerse ourselves in the first author's poetic and photographic self-reflection. The poem and image are intended to inspire interpretation and meaning based on the reader's own professional and/or personal context. The last line of the poem is "I take off the gloves. My hands are marked."

[The attitude among nursing professionals and students when facing death: a review of the scientific literature of the last decade]

Nursing professionals are integral members of the healthcare team and they maintain the most direct and prolonged contact with patients experiencing a terminal illness. This integrative review of the literature sought to investigate the attitude towards death among nursing professionals and students. Data were collected through searches in Lilacs, Medline, PsycINFO and CINAHL databases using the key words "nurses" and "attitude to death" in the period from 2000 to 2011. Of the 1376 articles identified, 262 were selected for data extraction and 35 were downloaded in full, constituting the corpus of research. The results showed a predominance of articles published in Brazilian journals. Studies indicate that the subject of death and dying has been neglected in training institutions, which causes hardship among professionals and nursing students when faced with the issue in practice, in addition to inappropriate conduct when dealing with patients who are experiencing the end of life process. In conclusion, the need for future research that may provide more detailed clarifications on the subject and seek strategies to address the lack of preparation and support of the nursing staff when they cope with death and dying was emphasized.

Ontological Security in Nursing Homes for Older Persons - Person-Centred Care is the Power of Balance

INTRODUCTION

The Swedish national guidelines for elderly care describe how older persons should be able to trust that their care is permeated with security. Different theoretical perspectives can be found that describe what creates security. Many studies have been done about security. However, few studies have explicitly asked older persons what security in nursing homes means to them.

AIM

The aim of the study was to describe how older persons in nursing homes talked and reflected about security in their daily lives.

METHOD

Nine older persons were interviewed in, in-depth interviews one to three times and the resulting data was analysed using content analysis.

RESULTS

The older persons adapted to having their own needs and those of the other older persons met and to the staff routines which created a sense of security. At the same time, they longed for security in which they could trust themselves and create their own daily life. Further to have a sense of belonging and of being liked for created an internal, interpersonal and external security. This can be linked to an ontological security which means having a sense of confidence in the continuity of self-identity and order in events, a being in the world.

CONCLUSION

Person-centred instead of institution- centred care can provide the balance of power that allows the older person to obtain ontological security in which the staff's ability to create a relationship with the older persons becomes crucial.