The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study

2017 ◽  
Vol 27 (1-2) ◽  
pp. 257-268 ◽  
Author(s):  
Keh Kiong Ong ◽  
Kit Cheng Ting ◽  
Yeow Leng Chow
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Descriptive Study ◽  
Critical Care Nurses ◽  
Life Care ◽  
Qualitative Descriptive

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

‘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.

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.

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