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The 'dis-ease' of dying: challenges in nursing care of the dying in the acute hospital setting. A qualitative observational study

Bloomer, Melissa J., Endacott, Ruth, O'Connor, Margaret and Cross, Wendy 2013, The 'dis-ease' of dying: challenges in nursing care of the dying in the acute hospital setting. A qualitative observational study, Palliative medicine, vol. 27, no. 8, pp. 757-764, doi: 10.1177/0269216313477176.

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Title The 'dis-ease' of dying: challenges in nursing care of the dying in the acute hospital setting. A qualitative observational study
Author(s) Bloomer, Melissa J.ORCID iD for Bloomer, Melissa J. orcid.org/0000-0003-1170-3951
Endacott, Ruth
O'Connor, Margaret
Cross, Wendy
Journal name Palliative medicine
Volume number 27
Issue number 8
Start page 757
End page 764
Total pages 8
Publisher Sage
Place of publication London, Eng.
Publication date 2013-09
ISSN 0269-2163
1477-030X
Keyword(s) Attitude to Death
Education
Nursing
Life Expectancy
Nurse-Patient Relations
Terminal Care
attitude to death
Summary BACKGROUND: Changes in health care and an ageing population have meant that more people are dying in the acute hospital setting. While palliative care principles have resulted in quality care for the dying, many patients die in an acute care, still receiving aggressive/resuscitative care. AIMS: The aims were to explore nurses' 'recognition of' and 'responsiveness to' dying patients and to understand the nurses' influence on end-of-life care. DESIGN: A qualitative approach was taken utilising non-participant observation to elicit rich data, followed by focus groups and individual semi-structured interviews for clarification. SETTING/PARTICIPANTS: This study was conducted in two acute medical wards in one health service, identified as having the highest rates of death, once palliative care and critical care areas were excluded. Twenty-five nurses consented to participate, and 20 episodes of observation were conducted. RESULTS: Nurses took a passive role in recognising dying, providing active care until a medical officer's declaration of dying. Ward design, nurse allocation and nurses' attitude to death impacts patient care. End-of-life care in a single room can have negative consequences for the dying. Nurses demonstrated varying degrees of discomfort, indicating that they were underprepared for this role. CONCLUSION: When patients are terminally ill, acknowledgement of dying is essential in providing appropriate care. It should not be assumed that all nurses are adequately prepared to provide dying care. Further work is necessary to investigate how the attitudes of nurses towards caring for dying patients in the acute hospital setting may impact care of the dying patient.
Language eng
DOI 10.1177/0269216313477176
Field of Research 1117 Public Health And Health Services
1199 Other Medical And Health Sciences
111099 Nursing not elsewhere classified
Socio Economic Objective 920211 Palliative Care
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, Sage
Persistent URL http://hdl.handle.net/10536/DRO/DU:30081906

Document type: Journal Article
Collection: School of Nursing and Midwifery
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