How new graduate nurses experience patient death : a systematic review and qualitative meta-synthesis

BACKGROUND: Patient death is an emotional and demanding experience for nurses, especially for new graduate nurses who are unprepared to deliver end-of-life care. Understanding new graduate nurses' experience of death and dying will inform the design of training programs and interventions for improvements in the quality of care and support of new graduates. OBJECTIVE: To summarize new graduate nurses' experience with patient death by examining the findings of existing qualitative studies. DESIGN: Systematic review methods incorporating meta-synthesis were used. METHODS: A comprehensive search was conducted in 12 databases from January 1990 to December 2014. All qualitative and mixed-method studies in English and Chinese that explored new graduate nurses' experience of patient death were included. Two independent reviewers selected the studies for inclusion and assessed each study quality. Meta-aggregation was performed to synthesize the findings of the included studies. RESULTS: Five primary qualitative studies and one mix-method study met inclusion and quality criteria. Six key themes were identified from the original findings: emotional experiences, facilitating a good death, support for family, inadequacy on end-of-life care issues, personal and professional growth and coping strategies. New graduate nurses expressed a variety of feelings when faced with patient death, but still they tried to facilitate a good death for dying patients and provide support for their families. The nurses benefited from this challenging encounter though they lacked of coping strategies.