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Sharing living and dying: A balancing act between vulnerability and a sense of security. Enrolled nurses' experiences of working in the sitting service for dying patients at home

Published online by Cambridge University Press:  15 August 2011

Birgitta Wallerstedt*
Affiliation:
School of Health and Medical Science, Örebro University, Örebro, Sweden
Eva Benzein
Affiliation:
School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden Department of Palliative Care Research, Ersta Sköndal, University College, Stockholm, Sweden
Birgitta Andershed
Affiliation:
Department of Palliative Care Research, Ersta Sköndal, University College, Stockholm, Sweden Department of Nursing, Gjøvik University College, Gjøvik, Norway
*
Address correspondence and reprint requests to: Birgitta Wallerstedt, PRIVO, Vimmerby Hälsocentral, SE-598 84 Vimmerby, Sweden. E-mail: [email protected]

Abstract

Objective:

To describe enrolled nurses' (ENs') experiences of working in a sitting service for dying patients at home (SSH).

Method:

The ENs who participated in this study had permanent jobs in community care/ primary care, but were also employed part time in a special home-sitting service organization in a municipality in the south of Sweden. Data were collected by four focus group interviews with 17 enrolled nurses. Qualitative content analysis was used to analyze the data.

Results:

Care-giving in SSH was a balancing act between a sense of security and a feeling of vulnerability. Feeling secure and valued and that one is developing both professionally and personally, stemmed from working in partnership, whereas a feeling of vulnerability was associated with managing closeness and distance, being a mediator, having responsibility and feeling guilty, feeling hindered from doing good, facing loneliness, and affecting private lives.

Significance of results:

SSH makes it possible for people who are terminally ill to remain at home until they die. If the SSH organization were not an option for dying patients and their families, the pressure on the healthcare would be dramatically increased.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

REFERENCES

Ashworth, M. & Baker, A. (2000). Time and space: Carers' views about respite care. Health and Social Care in the Community, 8, 5056.CrossRefGoogle ScholarPubMed
Andershed, B. & Ternestedt, B.M. (2001). Development of a theoretical framework of understanding about relatives' involvement in palliative care. Journal of Advanced Nursing, 34, 554562.CrossRefGoogle Scholar
Barnard, A., Hollingum, C. & Hartfield, B. (2006). Going on a journey: understanding palliative care nursing. International Journal of Palliative Nursing, 12, 612.Google Scholar
Benzein, E.G., Hagberg, M. & Saveman, B.I. (2008). ‘Being appropriate unusual’: A challenge for nurses in health-promoting conversations with families. Nursing Inquiry, 15, 106115.CrossRefGoogle ScholarPubMed
Bergdahl, E., Wikström, B.M. & Andershed, B. (2007). Esthetic abilities: A way to describe abilities of expert nurses in palliative home care. Journal of Clinical Nursing, 16, 752760.CrossRefGoogle ScholarPubMed
Blomberg, K. & Sahlberg-Blom, E. (2007). Closeness and distance: A way of handling difficult situations in daily care. Journal of Clinical Nursing, 16, 244254.CrossRefGoogle ScholarPubMed
Boston, P., Towers, A. & Barnard, D. (2001). Embracing vulnerability: Risk and empathy in palliative care. Journal of Palliative Care, 17, 248253.Google Scholar
Bradley, N., Davies, L. & Chow, E. (2005). Symptom distress in patients attending an outpatient palliative radiotherapy clinic. Journal of Pain and Symptom Management, 30, 123131.CrossRefGoogle ScholarPubMed
Brobäck, G. & Berterö, C. (2003). How next of kin experience palliative care of relatives at home. European Journal of Cancer Care, 12, 339346.CrossRefGoogle ScholarPubMed
Brännström, M., Brulin, C., Norberg, A., et al. (2005). Being a palliative nurse for persons with severe congestive heart failure in advanced homecare. European Journal of Cardiovascular Nursing, 4, 314323.CrossRefGoogle ScholarPubMed
Dunne, K., Sullivan, K. & Kernohan, G. (2005). Palliative care for patients with cancer: District nurses' experiences. Journal of Advanced Nursing, 50, 374380.CrossRefGoogle ScholarPubMed
Dunniece, U. & Slevin, E. (2000). Nurses' experiences of being present with a patient receiving a diagnosis of cancer. Journal of Advanced Nursing, 32, 611618.CrossRefGoogle ScholarPubMed
Ferrell, B.R. & Coyle, N. (2008). The nature of suffering and the goals of nursing. Oncology Nursing Forum, 35, 241247.Google Scholar
Graneheim, U.H. & Lundman, B. (2004). Qualitative content analysis in nursing research: Concept, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105112.CrossRefGoogle ScholarPubMed
Green, A. & Wakefield, A. (2006). A unique approach to supportive palliative care. Journal of Hospice and Palliative, 8, 164170.Google Scholar
Hsieh, H.F. & Shannon, S.E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15, 12771288.CrossRefGoogle ScholarPubMed
Ingleton, C., Payne, S., Nolan, M., et al. (2003). Respite in palliative care: A review and discussion of literature. Palliative Medicine, 17, 567575.CrossRefGoogle Scholar
Juthberg, C., Eriksson, S., Norberg, A., et al. (2007). Perceptions of conscience in relation to stress of conscience. Nursing Ethics, 1, 329343.CrossRefGoogle Scholar
Kitzinger, J. (1995). Qualitative Research: Introducing focus groups. British Medical Journal, 311, 299302.Google Scholar
Krueger, R.A. & Casey, M.A. (2000). Focus groups – A Practical Guide for Applied Research, 3rd ed.Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Lidskog, M. (2008). Learning with, from and about Each Other. Interprofessional Education on a Training Ward in Municipal Care for Older Persons. Doctoral Dissertation, Örebro University, Örebro, Sweden.Google Scholar
Lincoln, Y.S. & Guba, EG. (1985). Naturalistic Inquiry. Beverly Hills, CA: Sage.CrossRefGoogle Scholar
Lützén, K., Dahlqvist, V., Eriksson, S., et al. (2006). Developing the concept of moral sensitivity in health care practice. Nursing Ethics, 13, 187196.CrossRefGoogle ScholarPubMed
Mohan, S., Wilkes, L.M., Ogunsiji, O., et al. (2005). Caring for patients with cancer in non-specialist wards: nurse experience. European Journal of Cancer Care, 14, 256263.Google Scholar
Määtä, S.M. (2006). Closeness and distance in the nurse—Patient relation. The relevance of Edith Stein's concept of empathy. Nursing Philosophy, 7, 310.Google Scholar
Namasivayam, P., Orb, A. & O'Connor, M. (2005). The challenges of caring for families of the terminally ill: Nurses' lived experience. Contemporary Nursing, 19, 169180.Google Scholar
Olthuis, G., Leget, C. & Dekkers, W. (2007). Why hospice nurses need high self-esteem. Nursing Ethics, 14, 6271.CrossRefGoogle ScholarPubMed
Pask, E.J. (2003). Moral agency in nursing: Seeing value in the work and believing that I make a difference. Nursing Ethics, 10, 165174.Google Scholar
Payne, S., Ingleton, C., Scott, G., et al. (2004). A survey of perspectives of specialist palliative care providers in UK of inpatient respite care. Palliative Medicine, 18, 692697.CrossRefGoogle Scholar
Philips, J.L., Davidson, P.M., Jackson, D., et al. (2008). Multi-faceted palliative care intervention: Aged care nurses' and care assistants' perceptions and experience. Journal of Advanced Nursing, 62, 216227.Google Scholar
Reid, J. (2009). Conducting qualitative research with advanced cancer patients and their families: Ethical considerations. International Journal of Palliative Nursing, 15, 3033.CrossRefGoogle ScholarPubMed
Spiers, J. (2000). New perspective on vulnerability using emic and ethic approaches. Journal of Advanced Nursing, 31, 715721.Google Scholar
Stajduhar, K.I. & Davies, B. (1998). Palliative care at home: Reflections on HIV/AIDS family caregiving experiences. Journal of Palliative Care, 14, 1422.Google Scholar
Stajduhar, K.I., Nickel, D.D., Martin, W.L., et al. (2008). Situated/being situated: Client and co-workers roles of family care-givers in hospice palliative care. Social Science & Medicine, 67, 17891797.CrossRefGoogle ScholarPubMed
Sörlie, V., Larsson, A., Kihlgren, A.L., et al. (2004). Meeting ethical challenges in acute care word as narrated by enrolled nurses. Nursing Ethics, 11, 179188.CrossRefGoogle Scholar
Tapp, D. (2000). The ethics of rational stance in family nursing: resisting the view of ‘nurse as expert’. Journal of Family Nursing, 6, 6991.Google Scholar
Tarzian, A.J. (2000). Caring for dying patients who have air hunger. Journal of Nursing Scholarship, 32, 137143.Google Scholar
Wakefield, A. (2000). Nurses' responses to death and dying: A need for relentless self-care. International Journal of Palliative Nursing, 6, 245251.Google Scholar
Wallerstedt, B. & Andershed, B. (2007). Caring for dying patients outside special palliative care settings: Experiences from a nursing perspective. Scandinavian Journal of Caring Sciences, 21, 3240.Google Scholar
White, K., Wilkes, L., Cooper, K. & Barbato, M. (2004). The impact of unrelieved patient suffering on palliative care nurses. International Journal of Palliative Nursing, 10 438444.Google Scholar
Winchester, T. (2003). Teaching communication skills to nursing home certified nursing assistants. Geriatric Nursing, 24, 178181.Google Scholar