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Tschanz CL, Thoun DS. Feeling Pulled in Different Directions: A Parsesciencing Inquiry. Nurs Sci Q 2024; 37:237-248. [PMID: 38836483 DOI: 10.1177/08943184241246983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
The Parsesciencing mode of inquiry was used to advance understanding of a universal humanuniverse living experience of feeling pulled in different directions. Ten people engaged in dialogue to address the question, "What is your experience of feeling pulled in different directions?" The discerning extant moment of this inquiry was that feeling pulled in different directions is constrained vigor surfacing in wavering with cherished potentials.
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Affiliation(s)
- Coby L Tschanz
- Associate Teaching Professor, University of Victoria, Victoria, BC, Canada
| | - Deborah S Thoun
- Associate Professor (RTD), University of Victoria, Victoria, BC, Canada
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Hol H, Vatne S, Strømskag KE, Orøy A, Rokstad AMM. Norwegian nurses' perceptions of assisted dying requests from terminally ill patients-A qualitative interview study. Nurs Inq 2023; 30:e12517. [PMID: 35975335 PMCID: PMC10078436 DOI: 10.1111/nin.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
This study explores the perceptions of Norwegian nurses who have received assisted dying requests from terminally ill patients. Assisted dying is illegal in Norway, while in some countries, it is an option. Nurses caring for terminally ill patients may experience ethical challenges by receiving requests for euthanasia and assisted suicide. We applied a qualitative research design with a phenomenological hermeneutic approach using open individual interviews. A total of 15 registered nurses employed in pulmonary and oncology wards of three university hospitals and home care in one municipality were recruited. Four themes emerged from the analysis: (1) unprepared for the request; (2) meeting direct, indirect, and nonverbal requests; (3) working in a gray zone, and (4) feeling alone and powerless. The study found that nurses were unsure how to handle such requests due to professional uncertainty about assisted dying. Working in an environment where the topic is taboo made nurses morally uncertain, and some perceived this as moral distress. The hospital chaplain played a significant role in providing support to these nurses.
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Affiliation(s)
- Hege Hol
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
| | - Solfrid Vatne
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
| | | | - Aud Orøy
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
| | - Anne Marie Mork Rokstad
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway.,Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Boström K, Dojan T, Rosendahl C, Gehrke L, Voltz R, Kremeike K. How do trained palliative care providers experience open desire to die-conversations? An explorative thematic analysis. Palliat Support Care 2022:1-9. [PMID: 35942616 DOI: 10.1017/s1478951522001006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Despite the potential benefits of open communication about possible desires to die for patients receiving palliative care, health professionals tend to avoid such conversations and often interpret desires to die as requests for medical aid in dying. After implementing trainings to foster an open, proactive approach toward desire to die, we requested trained health professionals to lead and document desire to die-conversations with their patients. In this article, we explore how trained health professionals experience an open (proactive) approach to desire to die-conversations with their patients. METHODS Between April 2018 and March 2020, health professionals recorded their conversation-experiences on documentation sheets by answering seven open questions. A subsample was invited to offer deeper insights through semi-structured qualitative interviews. Interviews and documentation sheets were transcribed verbatim and analyzed thematically, then findings from both sources were compared and synthesized. RESULTS Overall, N = 29 trained health professionals documented N = 81 open desire to die-conversations. A subsample of n = 13 health professionals participated in qualitative interviews. Desire to die-conversations after the training were reported as a complex but overall enriching experience, illustrated in seven themes: (1) beneficial (e.g., establishing good rapport) and (2) hindering aspects (e.g., patients' emotional barriers) of desire to die-conversations, (3) follow-up measures, (4) ways of addressing desire to die, as well as (5) patient reactions to it. The interviews offered space for health professionals to talk about (6) content of desire to die-conversation and (7) (self-)reflection (e.g., on patients' biographies or own performance). SIGNIFICANCE OF RESULTS As part of an open (proactive) approach, desire to die-conversations hold potential for health professionals' (self-)reflection and a deeper understanding of patient background and needs. They may lead to a strengthened health professional-patient relationship and potentially prevent suicide.
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Affiliation(s)
- Kathleen Boström
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Thomas Dojan
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Carolin Rosendahl
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Leonie Gehrke
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital, Clinical Trials Center (ZKS), University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital, Center for Health Services Research, University of Cologne, Cologne, Germany
| | - Kerstin Kremeike
- Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
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Dholakia SY, Bagheri A, Simpson A. Emotional impact on healthcare providers involved in medical assistance in dying (MAiD): a systematic review and qualitative meta-synthesis. BMJ Open 2022; 12:e058523. [PMID: 35840304 PMCID: PMC9295670 DOI: 10.1136/bmjopen-2021-058523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Medical assistance in dying (MAiD) traverses challenging and emotionally overwhelming territories: healthcare providers (HCPs) across jurisdictions experience myriad of affective responses secondary to possible tensions between normative and interwoven values, such as sanctity of life, dignity in death and dying and duty to care. OBJECTIVE To determine the emotional impact on HCPs involved in MAiD. METHODS Inclusion restricted to English language qualitative research studies from four databases (OVID Medline, EMBASE, CINAHL and Scopus), from beginning until 30 April 2021, and grey literature up to August 2021 were searched. Key author, citation and reference searches were undertaken. We excluded studies without rigorous qualitative research methodology. Included studies were critically appraised using the Joanna Briggs Institute's critical appraisal tool. Analysis was conducted using thematic meta-synthesis. The cumulative evidence was assessed for confidence using the Confidence in the Evidence from Reviews of Qualitative Research approach. RESULTS The search identified 4522 papers. Data from 35 studies (393 physicians, 169 nurses, 53 social workers, 22 allied healthcare professionals) employing diverse qualitative research methodologies from five countries were coded and analysed. The thematic meta-synthesis showed three descriptive emotional themes: (1) polarised emotions including moral distress (n=153), (2) reflective emotions with MAiD as a 'sense-making process' (n=251), and (3) professional value-driven emotions (n=352). DISCUSSION This research attempts to answer the question, 'what it means at an emotional level', for a MAiD practitioner. Legislation allowing MAiD for terminal illness only influences the emotional impact: MAiD practitioners under this essential criterion experience more polarised emotions, whereas those practising in jurisdictions with greater emphasis on allaying intolerable suffering experience more reflective emotions. MAiD practitioner's professional values and their degree of engagement influence the emotional impact, which may help structure future support networks. English language literature restriction and absence of subgroup analyses limit the generalisability of results.
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Affiliation(s)
| | - Alireza Bagheri
- Research affiliate Center for Healthcare Ethics, Lakehead University, Thunder Bay, Ontario, Canada
| | - Alexander Simpson
- Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Krol P, Amiri M, Vonarx N. De l’aide médicale à mourir au Québec : une analyse du contexte et de la pratique infirmière en soins palliatifs. Rech Soins Infirm 2022; 147:67-81. [DOI: 10.3917/rsi.147.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Penman J, Malik G, Rogerson K, Murphy J, Zhong Y, Johnson CE. It's all about the individual's right to choose: A qualitative study of Australian culturally and linguistically diverse nurses’ knowledge of and attitudes to voluntary assisted dying. Collegian 2022. [DOI: 10.1016/j.colegn.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Welcoming ease: Building a concept from nursing practice. Appl Nurs Res 2022; 64:151567. [DOI: 10.1016/j.apnr.2022.151567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
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8
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Sinnarajah A, Feldstain A, Wasylenko E. Responding to requests for hastened death in patients living with advanced neurologic disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 190:217-237. [PMID: 36055717 DOI: 10.1016/b978-0-323-85029-2.00002-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A request for hastened death can mean many things, from an emotional plea for help with unmet needs to a request for legal provision of chemically induced hastened death. Regardless of whether the clinician supports legally available hastened death, knowing how to respond to requests for hastened death is important. Responding in an empathic and open manner will strengthen the therapeutic relationship between the patient and clinician. Suggested scripts on how to respond are provided. A framework for assessing the patient's preparation at various stages in the decisional journey is suggested. Additional factors including caring for the family and involving other healthcare providers are discussed. Last, there is some exploration of ethics considerations and a summary of legal chemically induced hastened death availability internationally.
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Affiliation(s)
- Aynharan Sinnarajah
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Medicine, Queen's University, Kingston, ON, Canada.
| | - Andrea Feldstain
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Psychosocial Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Eric Wasylenko
- Department of Oncology, University of Calgary, Calgary, AB, Canada; John Dossetor Health Ethics Centre, University of Alberta, Edmonton, AB, Canada
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Pesut B, Wright DK, Thorne S, Hall MI, Puurveen G, Storch J, Huggins M. What's suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID). BMC Palliat Care 2021; 20:174. [PMID: 34758799 PMCID: PMC8582137 DOI: 10.1186/s12904-021-00869-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intolerable suffering is a common eligibility requirement for persons requesting assisted death, and although suffering has received philosophic attention for millennia, only recently has it been the focus of empirical inquiry. Robust theoretical knowledge about suffering is critically important as modern healthcare provides persons with different options at end-of-life to relieve suffering. The purpose of this paper is to present findings specific to the understanding and application of suffering in the context of MAID from nurses' perspectives. METHODS A longitudinal qualitative descriptive study using semi-structured telephone interviews. Inductive analysis was used to construct a thematic account. The study received ethical approval and all participants provided written consent. RESULTS Fifty nurses and nurse practitioners from across Canada were interviewed. Participants described the suffering of dying and provided insights into the difficulties of treating existential suffering and the iatrogenic suffering patients experienced from long contact with the healthcare system. They shared perceptions of the suffering that leads to a request for MAID that included the unknown of dying, a desire for predictability, and the loss of dignity. Eliciting the suffering story was an essential part of nursing practice. Knowledge of the story allowed participants to find the balance between believing that suffering is whatever the persons says it is, while making sure that the MAID procedure was for the right person, for the right reason, at the right time. Participants perceived that the MAID process itself caused suffering that resulted from the complexity of decision-making, the chances of being deemed ineligible, and the heighted work of the tasks of dying. CONCLUSIONS Healthcare providers involved in MAID must be critically reflective about the suffering histories they bring to the clinical encounter, particularly iatrogenic suffering. Further, eliciting the suffering stories of persons requesting MAID requires a high degree of skill; those involved in the assessment process must have the time and competency to do this important role well. The nature of suffering that patients and family encounter as they enter the contemplation, assessment, and provision of MAID requires further research to understand it better and develop best practices.
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Affiliation(s)
- Barbara Pesut
- School of Nursing, University of British Columbia Okanagan, ARTS 3rd Floor, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
| | | | - Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Margaret I Hall
- Society of Notaries Public of BC, Chair in Applied Legal Studies, School of Criminology, Simon Fraser University, Surrey, BC, V5A 1S6, Canada
| | - Gloria Puurveen
- School of Nursing, University of British Columbia Okanagan, ARTS 3rd Floor, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Janet Storch
- School of Nursing, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | - Madison Huggins
- School of Nursing, University of British Columbia Okanagan, ARTS 3rd Floor, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada
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Wilson M, Ostroff C, Wilson ME, Wiechula R, Cusack L. Profiles of intended responses to requests for assisted dying: A cross-sectional study. Int J Nurs Stud 2021; 124:104069. [PMID: 34592533 DOI: 10.1016/j.ijnurstu.2021.104069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/07/2021] [Accepted: 08/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Responding to legal medically assisted dying requests may become the most frequent form of nurses' participation in that service. Recent research has explored nurses' discrete responses to requests about or for assisted dying; however, nurses likely hold intentions for multiple responses to these requests. These intentions form patterns shaped by individual factors such as attitude and beliefs. No research has investigated patterns of multiple responses to requests for assisted dying, how these patterns form profiles of nurses and factors that might explain these response profiles. OBJECTIVES Identify patterns of multiple responses that nurses intend for requests for assisted dying. Explore how these patterns form profiles of nurses' who share similar patterns of intended responses. Finally, investigate how attitude, norms and beliefs distinguish response profiles. DESIGN Cross-sectional survey SETTINGS: Online survey of Australian nurses PARTICIPANTS: 365 experienced registered nurses (years in nursing mean = 23, SD = 14.21) working primarily with adults across various practice settings. METHODS Principal components analysis identified five types of intended responses. K-means cluster analysis was then used to develop profiles of nurses' intended responses across these five responses. Multinomial logit regression was utilised to examine psychosocial variables that distinguished different profiles RESULTS: Cluster analysis resulted in five profiles that reflect different patterns of intended responses by nurses - Facilitator, Complier, Expediter, Objector, and Detached. Logit regressions of explanatory variables indicated that nurses' attitude toward assisted dying, ethical beliefs, and social norms predicted nurses' membership in intended response profiles. The overall model was statistically significant, χ2(20) = 106.527, p < .001, and the predictors accounted for 25.3% of the variance in the profiles (Cox and Snell test: Pseudo R2 = 0.253). CONCLUSION Nurses intended responses have been usefully constructed as five patterns or profiles of multiple responses. These profiles represent different types and levels of engagement with requests. Further, attitude and social expectations distinguish profiles with stronger intentions to engage positively. Using a cluster analysis methodology provides a more holistic understanding of nurses' intended responses to assisted dying requests by focusing on various responses and demonstrating that nurses have distinctive patterns of responses.
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Affiliation(s)
- Michael Wilson
- Adelaide Nursing School, University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia.
| | - Cheri Ostroff
- UniSA Business, University of South Australia, City West Campus, Adelaide, South Australia 5000, Australia.
| | - Marie E Wilson
- The Chancellery, University of South Australia, City West Campus, Adelaide, South Australia 5000, Australia.
| | - Richard Wiechula
- Adelaide Nursing School, Medical and Health Sciences Faculty, North Terrace, Adelaide, South Australia 5000, Australia.
| | - Lynette Cusack
- Adelaide Nursing School, Medical and Health Sciences Faculty, North Terrace, Adelaide, South Australia 5000, Australia.
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Ethical, Policy, and Practice Implications of Nurses' Experiences With Assisted Death: A Synthesis. ANS Adv Nurs Sci 2020; 42:216-230. [PMID: 31335329 PMCID: PMC6686960 DOI: 10.1097/ans.0000000000000276] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The conceptualization of assisted death as an act performed by physicians has resulted in a lack of attention to nurses' roles and experiences with the processes that surround an assisted death. In this article, we synthesize evidence from 6 articles focusing on the experiences of 55 nurses from Canada, Belgium, and the Netherlands, with relevant ethical and policy implications derived from the literature. Nurses have a central role in negotiating inquiries about assisted death and in providing wraparound care for patients, families, and other health care providers. This role is impactful for nurses and requires significant personal and professional moral work.
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Abstract
In June 2016, Bill C-14 or Medical Assistance in Dying legislation became law in Canada. With this law came changes to nurses' (ie, nurse practitioner, registered nurse, registered practical nurse) scopes of practice, roles, and responsibilities. While federal law, regulatory, and organizational policies are developed to inform nurses about the practice of medical assistance in dying, there is little evidence examining how nurses' roles and responsibilities are enacted in practice. Therefore, a scoping review was conducted to synthesize the evidence on nurses' roles and responsibilities in relation to medical assistance in dying and to identify gaps in the literature. A secondary aim was to identify organizational supports for nurses to effectively and ethically engage in medical assistance in dying. Using a recognized and rigorous scoping review methodology, the findings from 24 research studies were synthesized in this article. The analysis highlights the importance of effective health care professional engagement with the individual in the decision-making process and of the need to educate, support, and include nurses in providing medical assistance in dying. Overall, the current research on medical assistance in dying is limited in Canada, and more attention is needed on the role of the nurse.
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Pesut B, Thorne S, Schiller CJ, Greig M, Roussel J. The rocks and hard places of MAiD: a qualitative study of nursing practice in the context of legislated assisted death. BMC Nurs 2020; 19:12. [PMID: 32095114 PMCID: PMC7025406 DOI: 10.1186/s12912-020-0404-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 01/31/2020] [Indexed: 11/10/2022] Open
Abstract
Background Medical Assistance in Dying (MAiD) was legalized in Canada in June, 2016. The Canadian government's decision to legislate assisted dying, an approach that requires a high degree of obligation, precision, and delegation, has resulted in unique challenges for health care and for nursing practice. The purpose of this study was to better understand the implications of a legislated approach to assisted death for nurses' experiences and nursing practice. Methods The study used a qualitative approach guided by Interpretive Description. Semi-structured interviews were conducted with 59 registered nurses and nurse practitioners. Interviews were audio-recorded, transcribed, and managed using qualitative analysis software. Analysis followed a procedure of data immersion, open coding, constant comparative analysis, and the construction of a thematic and interpretive account. Results Nurses in this study described great variability in how MAiD had been enacted in their work context and the practice supports available to guide their practice. The development of systems to support MAiD, or lack thereof, was largely driven by persons in influential leadership positions. Workplaces that supported a range of nurses' moral responses to MAiD were most effective in supporting nurses' well-being during this impactful change in practice. Participants cited the importance of teamwork in providing high quality MAiD-related care; although, many worked without the benefit of a team. Nursing work related to MAiD was highly complex, largely because of the need for patient-centered care in systems that were not always organized to support such care. In the absence of adequate practice supports, some nurses were choosing to limit their involvement in MAiD. Conclusions Data obtained in this study suggested that some workplace contexts still lack the necessary supports for nurses to confidently meet the precision required of a legislated approach to MAiD. Without accessible palliative care, sufficient providers, a supportive team, practice supports, and a context that allowed nurses to have a range of responses to MAiD, nurses felt they were legally and morally at risk. Nurses seeking to provide the compassionate care consistent with such a momentous moment in patients' lives, without suitable supports, find themselves caught between the proverbial rock and hard place.
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Affiliation(s)
- Barbara Pesut
- 1Canada Research Chair in Health, Ethics, and Diversity, University of British Columbia Okanagan, 1147 Research Road, Okanagan, Kelowna, BC V1V 1V7 Canada
| | - Sally Thorne
- 2University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5 Canada
| | | | - Madeleine Greig
- 1Canada Research Chair in Health, Ethics, and Diversity, University of British Columbia Okanagan, 1147 Research Road, Okanagan, Kelowna, BC V1V 1V7 Canada
| | - Josette Roussel
- 4Policy, Advocacy and Strategy, Canadian Nurses Association, 50 Driveway, Ottawa, Ontario K2P 1E2 Canada
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Pesut B, Thorne S, Schiller C, Greig M, Roussel J, Tishelman C. Constructing Good Nursing Practice for Medical Assistance in Dying in Canada: An Interpretive Descriptive Study. Glob Qual Nurs Res 2020; 7:2333393620938686. [PMID: 32743024 PMCID: PMC7377599 DOI: 10.1177/2333393620938686] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 11/17/2022] Open
Abstract
Nurses play a central role in Medical Assistance in Dying (MAiD) in Canada. However, we know little about nurses' experiences with this new end-of-life option. The purpose of this study was to explore how nurses construct good nursing practice in the context of MAiD. This was a qualitative interview study using Interpretive Description. Fifty-nine nurses participated in semi-structured telephone interviews. Data were analyzed inductively. The findings illustrated the ways in which nurses constructed artful practice to humanize what was otherwise a medicalized event. Registered nurses and nurse practitioners described creating a person-centered MAiD process that included establishing relationship, planning meticulously, orchestrating the MAiD death, and supporting the family. Nurses in this study illustrated how a nursing gaze focused on relationality crosses the moral divides that characterize MAiD. These findings provide an in-depth look at what constitutes good nursing practice in MAiD that can support the development of best practices.
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Affiliation(s)
- Barbara Pesut
- The University of British Columbia,
Kelowna, British Columbia, Canada
| | - Sally Thorne
- The University of British Columbia,
Vancouver, British Columbia, Canada
| | - Catharine Schiller
- University of Northern British Columbia,
Prince George, British Columbia, Canada
| | - Madeleine Greig
- The University of British Columbia,
Kelowna, British Columbia, Canada
| | | | - Carol Tishelman
- Karolinska Institute, Stockholm,
Sweden
- Stockholm Health Care Services,
Stockholm, Sweden
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15
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Wilson MR, Wiechula R, Cusack L, Wilson M. Nurses' intentions to respond to requests for legal assisted‐dying: A Q‐methodological study. J Adv Nurs 2019; 76:642-653. [DOI: 10.1111/jan.14257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/31/2019] [Accepted: 10/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Michael R. Wilson
- Adelaide Nursing School University of Adelaide Adelaide South Australia Australia
| | - Rick Wiechula
- Adelaide Nursing School University of Adelaide Adelaide South Australia Australia
| | - Lynette Cusack
- Adelaide Nursing School University of Adelaide Adelaide South Australia Australia
| | - Marie Wilson
- Division of Business and Law University of South Australia Adelaide South Australia Australia
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