Palliative Medicine: Nursing

NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.

NB: All your data is kept safe from the public.

Problem statement

A growing number of patients die in acute care units; nurses are not always prepared to provide the necessary end-of-life (EOL) care. Moreover, dying patients often have to compete for nursing attention with the acutely diseased. There also exists trouble in prognostication of unavoidable death, which means that patients often receive inappropriately aggressive, resuscitative care.

Purpose

To explore the ways in which nurses identify the dying patients and how they respond to their state while working with them, in order to comprehend these ways’ impact on EOL care.

Research question or hypothesis

Do nurses effectively recognize the dying state of patients? Do they provide adequate EOL care? What challenges do they face? Which factors influence the quality of EOL nursing care?

Review of the literature

The section of the article labeled “Background” provides an analysis of the current situation that dying patients and acute care nurses find themselves in; the review is based on 26 sources. The article contains references to 41 sources on the whole.

Theory or theoretical framework used in the study

The researchers utilized an adaptation of the theoretical model offered by Moretti et al. (420-428).

Population

The nursing staff of two acute wards in a hospital in Melbourne, Australia. Palliative and critical care wards were excluded from the study.

Sample population

25 nurses (11 of them were non-permanent personnel) were observed and took part in the study.

Participants

Apart from the 25 named nurses, two nursing managers of the two wards were interviewed.

Have the subjects’ rights been ensured? Confidentiality?

All the participants were given the option to quit the research at any phase, either from the phase only or from the whole research. No nurses decided to withdraw from the study. No names or personal data are given in the article, preserving the participants’ confidentiality.

Measurement tools

The reliability and validity of the utilized analysis tools are not discussed; however, a reference to Moretti et al. (420-428), whose theoretical model was used, is present.

Data collection method

Overt and non-participant observation was conducted to record what happened in acute wards. The researchers started observation when they received a phone call informing them that a patient was dying, or if there were dying patients during impromptu visits. The researchers observed the interactions that occurred between dying patients, their relatives and colleagues, and nursing staff. The observations were ceased when the state of data saturation was reached; this state was identified by researchers via personal reflection, and via consultations with colleague researchers.

Besides, interviews with nurse managers, as well as with focus groups consisting of six nurses each, were conducted to better comprehend the observations.

Data analysis

Qualitative content analysis was employed. A color coding system was utilized to sort the data into topics and sub-topics. Focus group interviews with nurses and individual interviews with nursing managers were coded in a similar way.

Statistical procedures

There are no statistical procedures explicitly mentioned in this qualitative research.

Findings – significant to nursing?

It was found that

nurses had difficulty recognizing dying patients, and when they did recognize the state, they sometimes had trouble getting the proper authorization from physicians;
nurses gave preference to single rooms for dying patients;
nurses often hesitated and showed signs of moral unpreparedness when it came to caring for dying patients.

The findings are significant in that they show the need for special preparation for EOL care during nursing education. Besides, the unequal power distribution in the nurse-physician relationship was also shown to have adverse implications in cases with dying patients.

Are there implications suggested for nursing practice, nursing education and nursing research?

No such implications are explicitly suggested.

Are there recommendations made for further research?

It is stated that further research ought to explore the influence that nurses’ attitudes towards EOL care might have on this type of care.

Limitations of the study

Some methodological limitations were uncovered retrospectively: 1) nurses rarely made phone calls to inform the researchers about the beginning of EOL care process; 2) the difference in training and education concerning EOL care between permanent and non-permanent nursing personnel was not explained; 3) a greater number of focus groups might have provided additional data.

References

Bloomer, Melissa J., Ruth Endacot, Margaret O’Connor and Wendy Cross. “The ‘Dis-Ease’ of Dying: Challenges in Nursing Care of the Dying in the Acute Hospital Setting. A Qualitative Observational Study.” Palliative Medicine 27.8 (2013): 757-764. ProQuest. Web.

Moretti, Francesca, Liesbeth van Vliet, Jozien Bensing, Giuseppe Deledda, Mariangela Mazzi, Michela Rimondini, Christa Zimmermann and Ian Fletcher. “A standardized approach to qualitative content analysis of focus group discussions from different countries.” Patient Education and Counseling 82.3 (2011): 420-428.

Click Here To Order Now!