Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-23T13:29:45.799Z Has data issue: false hasContentIssue false
  • English
  • Français

The provision of end-of-life care by medical-surgical nurses working in acute care: A literature review

Published online by Cambridge University Press:  19 November 2013

Judith Gagnon  and
Wendy Duggleby
Judith Gagnon*
Affiliation:
Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
Wendy Duggleby
Affiliation:
Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
*
Address correspondence and reprint requests to: Judith Gagnon, Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, 11405 87th Avenue, Edmonton, Alberta, CanadaT6G 1C9. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Caring for terminally ill patients is complex, stressful, and at times distressing for nurses. Acute care hospitals continue to be the predominant place of death for terminally ill patients in most Western countries. The objective of the present literature review was to explore and gain an in-depth understanding of the experience of providing end-of-life (EOL) care by medical-surgical RNs working in acute care hospitals, to identify knowledge gaps, and to recommend future research.

Method:

A comprehensive literature review was conducted using the following electronic databases: CINAHL, MEDLINE, and PsyInfo (from 1992 to October 2012).

Results:

The findings from the 16 reviewed studies suggest that nurses felt a strong commitment to help terminally ill patients experience a good death. Nurses reported feeling deeply rewarded and privileged to share the EOL experience with patients/families. Organizational and individual factors influenced nurses' experience. Important challenges were associated with managing the divergent needs of a mixed patient load (i.e., curative and palliative care patients) in a biomedical culture of care that is heavily oriented toward cure and recovery. In this culture, nurses' emotional work and ideals of good EOL care are often not recognized and supported.

Significance of results:

Managerial and organizational support that recognize the centrality of emotional work nurses provide to dying patients is needed. More research exploring ways to improve communication among nurses and medical colleagues is essential. Finally, a critical examination of the ideological assumptions guiding nurses' practice of EOL care within the context of acute care is recommended to help reveal their powerful influence in shaping nurses' overall understanding and experience of EOL care.

Keywords

End of lifeMedical nursesSurgical nursesAcute careHospital
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 5 , October 2014 , pp. 393 - 408
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Abu-Saad Huijer, H., Abboud, S. & Dimassi, H. (2009). Palliative care in Lebanon: Knowledge, attitudes and practices of nurses. International Journal of Palliative Nursing, 15(7), 170–177.CrossRefGoogle Scholar
Allen, D. (2004). Re-reading nursing and re-writing practice: Towards an empirically based reformulation of the nursing mandate. Nursing Inquiry, 11, 271–283.CrossRefGoogle ScholarPubMed
Badger, J.M. (2005). Factors that enable or complicate end-of-life transitions in critical care. American Journal of Critical Care, 14(6), 513–521.CrossRefGoogle ScholarPubMed
Bjarnason, D. (2010). Nurse religiosity and end-of-life care. Journal of Research in Nursing, 17, 78–91.CrossRefGoogle Scholar
Blomberg, K. & Sahlberg-Blom, E. (2007). Closeness and distance: A way of handling difficult situations in daily care. Journal of Clinical Nursing, 16(2), 244–254.CrossRefGoogle ScholarPubMed
Bloomer, M.J., Moss, C. & Cross, W.M. (2011). End-of-life care in acute hospitals: An integrative literature review. Journal of Nursing and Healthcare of Chronic Illness, 3(3), 165–173.CrossRefGoogle Scholar
Borbasi, S., Wotton, K., Redden, M., et al. (2005). Letting go: A qualitative study of acute care and community nurses' perceptions of a “good” versus “bad” death. Australian Critical Care, 18(3), 104–112.CrossRefGoogle Scholar
Boykin, A. & Schoenhofer, S.O. (2001). Nursing as caring: A model for transforming practice. Boston: Jones & Bartlett Learning.Google Scholar
Canadian Association of Medical and Surgical Nurses (CAMSN) (2008). Canadian Association of Medical and Surgical Nurses practice standards. Retrieved October 2012 from www.medsurgnurse.ca/CAMSNnationalstandards.pdf (Accessed on November 8, 2013).Google Scholar
Ceci, C. & McIntyre, M. (2001). A quiet crisis in health care: Developing our capacity to hear. Nursing Philosophy, 2, 122–130.CrossRefGoogle Scholar
Clarke, A. & Ross, H. (2006). Influences on nurses' communications with older people at the end of life: Perceptions and experiences of nurses working in palliative care and general medicine. International Journal of Older People Nursing, 1(1), 34–43.CrossRefGoogle ScholarPubMed
Cramer, L.D., McCorkle, R., Cherlin, E., et al. (2003). Nurses' attitudes and practice related to hospice care. Journal of Nursing Scholarship, 35(3), 249–255.CrossRefGoogle ScholarPubMed
Davenport, L.A. & Hall, J.M. (2011). To cry or not to cry: Analyzing the dimensions of professional vulnerability. Journal of Holistic Nursing, 29(3), 180–188.CrossRefGoogle ScholarPubMed
Davidson, P., Introna, K., Daly, J., et al. (2003). Cardiorespiratory nurses' perceptions of palliative care in nonmalignant disease: Data for the development of clinical practice. American Journal of Critical Care, 12(1), 47–53.CrossRefGoogle ScholarPubMed
Duggleby, W. & Wright, K. (2005). Transforming hope: How elderly palliative patients live with hope. The Canadian Journal of Nursing Research, 37(2), 70–84.Google ScholarPubMed
Duggleby, W., Holtslander, L., Steeves, M., et al. (2010). Discursive meaning of hope for older persons with advanced cancer and their caregivers. Canadian Journal on Aging, 29(3), 361–367.CrossRefGoogle ScholarPubMed
Eliott, J. & Olver, I. (2002). The discursive properties of “hope”: A qualitative analysis of cancer patients' speech. Qualitative Health Research, 12(2), 173–193.CrossRefGoogle Scholar
Fitzgerald, M.J. (2007). Hope: A construct central to nursing. Nursing Forum, 42(1), 12–19.CrossRefGoogle Scholar
Gélinas, C., Filion, L., Robitaille, M., et al. (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.Google ScholarPubMed
Gysels, M., Richardson, A. & Higginson, I.J. (2004). Communication training for health professionals who care for patients with cancer: A systematic review of effectiveness. Supportive Care in Cancer, 12(10), 692–700.CrossRefGoogle Scholar
Hopkinson, J.B., Hallett, C.E. & Luker, K.A. (2003). Caring for dying people in hospital. Journal of Advanced Nursing, 44(5), 525–533.CrossRefGoogle ScholarPubMed
Hopkinson, J.B., Hallett, C.E. & Luker, K.A. (2005). Everyday death: How do nurses cope with caring for dying people in hospital? International Journal of Nursing Studies, 42(2), 125–133.CrossRefGoogle ScholarPubMed
Jacobs, L.G., Bonuck, K., Burton, W., et al. (2002). Hospital care at the end of life: An institutional assessment. Journal of Pain and Symptom Management, 24(3), 291–298.CrossRefGoogle ScholarPubMed
Johansson, K. & Lindahl, B. (2012). Moving between rooms — moving between life and death: Nurses' experiences of caring for terminally ill patients in hospitals. Journal of Clinical Nursing, 21(13–14), 2034–2043.CrossRefGoogle ScholarPubMed
MacLeod, R.D. & Carter, H. (1999). Health professionals' perceptions of hope: Understanding its significance in the care of people who are dying. Mortality, 4(3), 309–317.CrossRefGoogle Scholar
Maunder, E.Z. (2006). Emotion work in the palliative nursing care of children and young people. International Journal of Palliative Nursing, 12(1), 27–33.CrossRefGoogle ScholarPubMed
Oberle, K. & Hughes, D. (2001). Doctors' and nurses' perceptions of ethical problems in end-of-life decisions. Journal of Advanced Nursing, 33(6), 707–715.CrossRefGoogle ScholarPubMed
O'Gorman, S.M. (1998). Death and dying in contemporary society: An evaluation of current attitudes and the rituals associated with death and dying and their relevance to recent understandings of health and healing. Journal of Advanced Nursing, 27(6), 1127–1135.CrossRefGoogle ScholarPubMed
Pope, C., Mays, N. & Popay, J. (2007). Synthesizing qualitative and quantitative health research: A guide to methods. Maidenhead, UK: McGraw-Hill House.Google Scholar
Rice, E.M., Rady, M.Y., Hamrick, A., et al. (2008). Determinants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital. Journal of Nursing Management, 16(3), 360–373.CrossRefGoogle ScholarPubMed
Roche-Fahy, V. & Dowling, M. (2009). Providing comfort to patients in their palliative care trajectory: Experiences of female nurses working in acute settings. International Journal of Palliative Nursing, 15(3), 134–141.CrossRefGoogle Scholar
Sasahara, T., Miyashita, M., Kawa, M., et al. (2003). Difficulties encountered by nurses in the care of terminally ill cancer patients in general hospitals in Japan. Palliative Medicine, 17(6), 520–526.CrossRefGoogle ScholarPubMed
Smyth, T. & Allen, S. (2011). Nurses' experiences assessing the spirituality of terminally ill patients in acute clinical practice. International Journal of Palliative Nursing, 17(7), 337–343.CrossRefGoogle ScholarPubMed
Sorensen, R. & Iedema, R. (2009). Emotional labour: Clinicians' attitudes to death and dying. Journal of Health Organization and Management, 23(1), 5–22.CrossRefGoogle ScholarPubMed
Sorensen, R. & Iedma, R. (2011). End of life in acute care hospital: Linking policy and practice. Death Studies, 35, 481–503.CrossRefGoogle ScholarPubMed
Stayt, L.C. (2009). Death, empathy and self-preservation: The emotional labour of caring for families of the critically ill in adult intensive care. Journal of Clinical Nursing, 18(9), 1267–1275.CrossRefGoogle ScholarPubMed
Summer, J. & Townsend-Rocchiccioli, J. (2003). Why are nurses leaving nursing? Nursing Administration Quarterly, 27(2), 164–171.CrossRefGoogle Scholar
Thacker, K.S. (2008). Nurses' advocacy behaviors in end-of-life nursing care. Nursing Ethics, 15(2), 174–185.CrossRefGoogle ScholarPubMed
Thompson, G., McClement, S. & Daeninck, P. (2006 a). “Changing lanes”: Facilitating the transition from curative to palliative care. Journal of Palliative Care, 22(2), 91–98.CrossRefGoogle ScholarPubMed
Thompson, G., McClement, S. & Daeninck, P. (2006 b). Nurses' perceptions of quality end-of-life care on an acute medical ward. Journal of Advanced Nursing, 53(2), 169–177.CrossRefGoogle Scholar
Utriainen, K. & Kyngas, H. (2009). Hospital nurses' job satisfaction: A literature review. Journal of Nursing Management, 17(8), 1002–1010.CrossRefGoogle ScholarPubMed
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(1), 32–40.CrossRefGoogle ScholarPubMed
White, K.R. & Coyne, P.J. (2011). Nurses' perceptions of educational gaps in delivering end-of-life care. Oncology Nursing Forum, 38(6), 711–717.CrossRefGoogle ScholarPubMed
Whittemore, R. (2005). Combining evidence in nursing research: Methods and implications. Nursing Research, 54(1), 56–62.CrossRefGoogle ScholarPubMed
Willard, C. & Luker, K. (2006). Challenges to end-of-life care in the acute hospital setting. Palliative Medicine, 20(6), 611–615.CrossRefGoogle ScholarPubMed
Wilson, J. & Kirshbaum, M. (2011). Effects of patient death on nursing staff: A literature review. British Journal of Nursing, 20(9), 559–563.CrossRefGoogle ScholarPubMed
Yin, O.S., Xia, Z., Yi, X., et al. (2007). Nurses' perceptions towards caring for dying patients in oncology ward and general surgical ward. Singapore Nursing Journal, 34(3), 16–21.Google Scholar