Critical care nurses' perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients

2000 ◽  
Vol 9 (2) ◽  
pp. 96-105 ◽  
Author(s):  
KT Kirchhoff ◽  
RL Beckstrand
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Support ◽  
Critical Care Nurses ◽  
Life Care ◽  
Dying Patients ◽  
Life Issues ◽  
End Of Life Issues ◽  
Nurses Perceptions

BACKGROUND: Little is known about nurses' perceptions of obstacles or helpful behaviors ("helps") in providing end-of-life care in the intensive care setting. OBJECTIVE: To determine the importance of various obstacles and helps in providing end-of-life care as perceived by critical care nurses. METHODS: A questionnaire was mailed to 300 members of the American Association of Critical-Care Nurses. Nurses were asked to rate obstacles and helps in giving end-of-life care, and additional obstacles and/or helps, and answer demographic questions. RESULTS: Six of the top 10 obstacles were related to issues with patients' families that make care at the end of life more difficult, such as the family's not fully understanding the meaning of life support, not accepting the patient's poor prognosis, requesting more technical treatment than the patient wished, and being angry. Added obstacles related mostly to problems with physicians' behavior. Most helps were ways to make dying easier for patients and patients' families, such as agreement among physicians about care, dying with dignity, and families' acceptance of the prognosis. Added helps included allowing music, pets, and so forth into the patient's room. CONCLUSIONS: Nurses have difficulties with patients' families and physicians concerning end-of-life issues, especially when the behaviors remove the nurses from caring for a patient or cause the patient pain or prolong suffering. Nurses do not acknowledge having difficulty providing care to dying patients aside from conflicts that arise because of patients' families and physicians.

‘Death rounds to support critical care nurses: a qualitative study’

2020 ◽  
pp. bmjspcare-2020-002533
Author(s):  
Keh Kiong Ong ◽  
Chew Lai Sum ◽  
Xuelian Jamie Zhou ◽  
Yeow Leng Chow
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychological Impact ◽  
Structured Interview ◽  
Tertiary Hospital ◽  
Critical Care Nurses ◽  
Life Care ◽  
One To One ◽  
Nurses Perceptions

ObjectiveProviding end-of-life care has a significant psychological impact on critical care nurses. Little is known about whether critical care nurses find death rounds useful as a support system. This study aimed to describe critical care nurses’ perceptions of attending death rounds.MethodsThis study was conducted using a qualitative descriptive design, using one-to-one audio-recorded interviews. The study was conducted at a 20-bed medical intensive care unit in a 1200-bed public tertiary hospital in Singapore. One-to-one interviews were conducted with 14 nurses using a semi-structured interview guide. Data was analysed using thematic analysis.ResultsCritical care nurses valued attending death rounds. They found death rounds to be an outlet to express themselves and remember patients, to draw and give peer support, to build nursing and interprofessional cohesiveness and to learn to improve palliative care. The death rounds were optimal when they felt safe to share, when there was a good facilitator, when the hierarchy was flat and when the audience was interdisciplinary. The barriers to a successful death round were the rounds being too formal, timing and not knowing the patients.ConclusionDeath rounds are a viable way to support critical care nurses in providing end-of-life care.

scholarly journals Talking About End-of-Life Care: How Should Physicians Act

2021 ◽  
Vol 9 (1) ◽  
pp. 38-42
Author(s):  
Abu Sadat Mohammad Nurunnabi ◽  
Nezamuddin Ahmad ◽  
Shuchana Chakma ◽  
- Md Asaduzzaman ◽  
Arif Mohammad
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Review Paper ◽  
Good Death ◽  
Life Care ◽  
Dying Patients ◽  
Life Issues ◽  
End Of Life Issues ◽  
Common Understanding ◽  
Dying Patient

Physicians should be adept in communication and familiar with the various end-of-life issues and their implications. However, physicians in Bangladesh usually receive very little training or guidance on how to communicate with the dying patients and their families. Since death is a common phenomenon, for physicians in their day-to-day practice, it sometimes becomes difficult to engage in end-of-life discussions in a death-averse society. This review paper aims to discuss a pragmatic step-by-step approach to discussing end-of-life care in a Bangladeshi context maintaining local social and cultural views. Specifically outlined in each of these four steps, a physician should seek a common understanding with the patient and family. Moreover, if any disagreement arises, overt conflict can often be avoided by reviewing what was discussed earlier with the patient or family. We all know that providing a supportive care for a dying patient is challenging. However, when it is done well, it becomes a meaningful and gratifying experience for the physician. As we know, helping someone die in comfort and with dignity signifies a good death and one of the best gifts of life that theoretically leads him/her to rest in peace. CBMJ 2020 January: Vol. 09 No. 01 P: 38-42

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

Critical Care Nurses’ Suggestions to Improve End-of-Life Care Obstacles

2017 ◽  
Vol 36 (4) ◽  
pp. 264-270 ◽  
Author(s):  
Renea L. Beckstrand ◽  
Kacie Hart Hadley ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care

530: Education on End-of-Life Care for Pediatric Critical Care Nurses: A Needs Assessment

2020 ◽  
Vol 49 (1) ◽  
pp. 257-257
Author(s):  
Kelley Groves ◽  
Larissa Anglim ◽  
Tensing Maa ◽  
Megan Daniel ◽  
Markita Suttle
Keyword(s):  
Critical Care ◽  
Needs Assessment ◽  
End Of Life ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Pediatric Critical Care

Dignified end-of-life care in the patients’ own homes

2011 ◽  
Vol 18 (3) ◽  
pp. 374-385 ◽  
Author(s):  
Christina Karlsson ◽  
Ingela Berggren
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Human Beings ◽  
Life World ◽  
Life Phase ◽  
Dying Patients ◽  
Nurses Perceptions ◽  
Significant Factors

Nowadays it is increasingly common that the patients in the end of life phase choose to be cared for in their own home. Therefore it is vital to identify significant factors in order to prevent unnecessary suffering for dying patients and their families in end-of-life homecare. This study aimed to describe 10 nurses’ perceptions of significant factors that contribute to good end-of-life care in the patients own home. The transcribed texts from the interviews’ were analyzed using phenomenological hermeneutical method, which focuses on the life-world of human beings. The results demonstrate that good end-of-life care presupposes that the aim of the caring staff is to provide safety, autonomy and integrity for the patient and family in order to create the respect required for as good and dignified a death as possible.

Sign in / Sign up

Export Citation Format

Share Document