Experiencing the dying process from a nurse's perspective
A literature review
DOI:
https://doi.org/10.14528/snr.2021.55.4.3090Keywords:
nursing, intensive care, palliative care, experiencesAbstract
Introduction: In intensive care units, nurses cope with dying on a daily basis. This is stressful for nurses and may lead to psychological distress. The aim of the literature review is to establish the experiences of nurses with the dying process in intensive care units and how to understand they cope with the dying process.
Methods: The literature review was used. The search was conducted in the following databases: COBISS, PubMed, ScienceDirect, SAGE, Web of Science and CINAHL based on eligibility criteria. The PRISMA diagram is used to present the literature selection process. The method of thematic analysis was used for analysis and synthesis of data.
Results: From 1,886 search results, we included ten articles in the final analysis. Based on content analysis, we formed two main themes: (1) Experiences of nurses with very ill and dying patients; (2) Professional attitude of nurses.
Discussion and conclusion: Conducting nursing care in intensive care units is very stressful for nurses. In nursing critically ill patients, nurses most often experience persistent physical and emotional stress, lack of emotional support, sadness, burnout, depression, difficulties in communication with relatives, and poor teamwork and team support. Many of the factors that nurses are exposed to contribute to their own feelings of distress. Policies are necessary to protect, more effectively assist and support nurses who face the dying process and ensure support to a dying person's relatives on a daily basis.
Downloads
Metrics
References
Andersson, E., Salickiene, Z., & Rosengren, K. (2016). To be involved: A qualitative study of nurses' experiences of caring for dying patients. Nurse Education Today, 38(3), 144–149. https://doi.org/10.1016/j.nedt.2015.11.026 PMid:26689734
Attia, A. K., Abd-Elaziz, W. W., & Kandeel, N. A. (2013). Critical care nurses' perception of barriers and supportive behaviors in end-of-life care. American Journal of Hospice and Palliative Medicine, 30(3), 297–304. https://doi.org/10.1177/1049909112450067 PMid:22743231
Bassah, N., Seymour, J., & Cox, K. (2014). A modified systematic review of research evidence about education for pre-registration nurses in palliative care. BMC Palliative Care, 13(1), Article 56. https://doi.org/10.1186/1472-684X-13-56 PMid:25859159; PMCid:PMC4391725
Benedik, J. (2011). Oskrba bolnika ob koncu življenja. Onkologija, 7, 52–58.
Bumb, M., Keefe, J., Miller, L., & Overcash, J. (2017). Breaking bad news: An evidence-based review of communication models for oncology nurses. Clinical Journal of Oncology Nursing, 21(5), 573–580. https://doi.org/10.1188/17.CJON.573-580
Bush, T., & Shahwan-Akl, L. (2013). Palliative care education: Does it influence future practice. Contemporary Nurse, 43(2), 172–177. https://doi.org/10.5172/conu.2013.43.2.172 PMid:23485219
Ećimović, P., Lahajnar-Čavlović, S., & Kompan, L. (2009). Paliativna oskrba v intenzivni medicini: prikaz primera in pregled literature. Zdravniski Vestnik, 78(5), 255–259.
Efstathiou, N., & Clifford, C. (2011). The critical care nurse's role in end-of-life care: Issues and challenges. Nursing in Critical Care, 16(3), 116–123. https://doi.org/10.1111/j.1478-5153.2010.00438.x PMid:21481113
Espinosa, L., Young, A., Symes, L., Haile, B., & Walsh, T. (2010). ICU nurses' experiences in providing terminal care. Critical Care Nursing Quarterly, 33(3), 273–281. https://doi.org/10.4172/2155-9627.s1.01
Gélinas, C., Fillion, L., Robitaille, M. A., & Truchon, M. (2012). Stressors experienced by nurses providing end-of-life palliative care in the intensive care unit. Canadian Journal of Nursing Research, 44(1), 18–39.
Globočnik Papuga, P. (2007). Pomen izobraževanja o komunikaciji v paliativni oskrbi. Obzornik Zdravstvene Nege, 41(1), 33–36. Retrieved April 15, 2020 from https://obzornik.zbornica-zveza.si/index.php/ObzorZdravNeg/article/view/2617
Kalender Smajlović, S. (2019). Etične dileme pri izvajanju zdravstvene nege v enoti intenzivne terapije: pregled literature. Obzornik zdravstvene nege, 53(2), 157–168. https://doi.org/10.14528/snr.2019.53.2.222
Kisorio, L. C., & Langley, G. C. (2016). Intensive care nurses' experiences of end-of-life care. Intensive and Critical Care Nursing, 33, 30–38. https://doi.org/10.1016/j.iccn.2015.11.002 PMid:26791353
Kmetec, S., Štiglic, G., Lorber, M., Mikkonen, I., McCormack, B., Pajnkihar, M., & Fekonja, Z. (2020). Nurses' perceptions of early person-centred palliative care: A cross-sectional descriptive study. Scandinavian Journal of Caring Sciences, 34(1), 157–166. https://doi.org/10.1111/scs.12717 PMid:31111510
McAndrew, N. S., & Leske, J. S. (2015). A balancing act: Experiences of nurses and physicians when making end-oflife decisions in intensive care units. Clinical Nursing Research, 24(4), 357–374. https://doi.org/10.1177/1054773814533791 PMid:24864319
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice (2nd ed.). Lippincott Williams & Wilkins.
Mlinšek, A. (2012). Soočanje izvajalcev zdravstvene nege s smrtjo pacienta. Revija za univerzalno odličnost, 1(3), 106–117.
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ, 349, Article g7647. https://doi.org/10.1136/bmj.g7647 PMid:25555855
Pais, M., Martinez, L., Ribeiro, O., Loureiro, J., Fernandez, R., Valiengo, L., Canineu, P. … Forlenza, O. V. (2020). Early diagnosis and treatment of Alzheimer's disease: New definitions and challenges. Brazilian Journal of Psychiatry, 42(4), 1–11. https://doi.org/10.1590/1516-4446-2019-0735 PMid:31994640; PMCid:PMC7430379
Palmryd, L., Rejnö, Å., & Godskesen, T. E. (2021). Integrity at end of life in the intensive care unit: A qualitative study of nurses' views. Annals of Intensive care 11, Article 23. https://doi.org/10.1186/s13613-021-00802-y
Pautex, S., Curiale, V., Van Nes, M. C., Frühwald, T., Rexach, L., & Van Den Noortgate, N. (2013). Palliative care in acute geriatric care units across Europe: Some reflections about the experience of geriatricians. European Geriatric Medicine, 4(4), 288–292. https://doi.org/10.1016/j.eurger.2013.05.002
Peters, L., Cant, R., Payne, S., O'Connor, M., McDermott, F., Hood, K., Morphet, J., & Shimoinaba, K. (2013). How death anxiety impacts nurses' caring for patients at the end of life: A Review of literature. The Open Nursing Journal, 7, 14–21. https://doi.org/10.2174/1874434601307010014 PMid:23400515; PMCid:PMC3565229
Rafii, F., Nikbakht Nasrabadi, A., & Karim, M. A. (2016). Endof-life care provision: Experiences of intensive care nurses in Iraq. Nursing in Critical Care, 21(2), 105–112. https://doi.org/10.1111/nicc.12219 PMid:26487503
Santiago, C., & Abdool, S. (2011). Conversations about challenging end-of-life cases: Ethics debriefing in the medical surgical intensive care unit. Dynamics, 22(4), 26–30.
Shorter, M., & Stayt, L. C. (2010). Critical care nurses' experiences of grief in an adult intensive care unit. Journal of Advanced Nursing, 66(1), 159–167. https://doi.org/10.1111/j.1365-2648.2009.05191.x PMid:20423442
Šajn Lekše, S., Drnovšek, R., Žibert, A., & Milavec Kapun, M. (2021). Slaba vest in izgorelost medicinskih sester v enotah intenzivne nege in terapije. Obzornik zdravstvene nege, 55(3), 169–179. https://doi.org/10.14528/snr.2021.55.3.3007
Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, Article 45. https://doi.org/10.1186/1471-2288-8-45
Tornøe, K. A., Danbolt, L. J., Kvigne, K., & Sørlie, V. (2015). The challenge of consolation: Nurses' experiences with spiritual and existential care for the dying-a phenomenological hermeneutical study. BMC Nursing, 14, Article 62. https://doi.org/10.1186/s12912-015-0114-6 PMid:18616818; PMCid:PMC2478656
Valiee, S., Negarandeh, R., & Dehghan Nayeri, N. (2012). Exploration of Iranian intensive care nurses' experience of end-of-life care: A qualitative study. Nursing in Critical Care, 17(6), 309–315. https://doi.org/10.1111/j.1478-5153.2012.00523.x PMid:23061621
van der Plas, A. G. M., Deliens, L., van de Watering, M., Jansen, W. J. J., Vissers, K. C., & Onwuteaka-Philipsen, B. D. (2013). Palliative care case management in primary care settings: A nationwide survey. International Journal of Nursing Studies, 50(11), 1504–1512. https://doi.org/10.1016/j.ijnurstu.2013.03.002 PMid:23545141
Wessel, E. M., & Rutledge, D. N. (2005). Home care and hospice nurses' attitudes toward death and caring for the dying: Effects of palliative care education. Journal of Hospice & Palliative Nursing, 7(4), 212–218. https://doi.org/10.1097/00129191-200507000-00012
Kmetec, S., Fekonja, Z., Škrbić, S., & Mlinar Reljić, N. (2021). Doživljanje umiranja z vidika medicinskih sester: pregled literature. Obzornik zdravstvene nege, 55(4), 264–273. https://doi.org/10.14528/snr.2021.55.4.3090
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Slovenian Nursing Review
This work is licensed under a Creative Commons Attribution 4.0 International License.
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.