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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
journal contribution
posted on 2013-09-01, 00:00 authored by Melissa BloomerMelissa Bloomer, R Endacott, M O'Connor, W CrossBACKGROUND: 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.
History
Journal
Palliative medicineVolume
27Issue
8Pagination
757 - 764Publisher
SageLocation
London, Eng.Publisher DOI
eISSN
1477-030XLanguage
engPublication classification
C Journal article; C1.1 Refereed article in a scholarly journalCopyright notice
2013, SageUsage metrics
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No categories selectedKeywords
End-of-life careattitude to deathnursingpalliative careterminally illEducation, NursingFocus GroupsHumansLife ExpectancyNurse-Patient RelationsNursesNursing Staff, HospitalQualitative ResearchTerminal CareScience & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesPublic, Environmental & Occupational HealthMedicine, General & InternalGeneral & Internal MedicineLIFE CAREENDDEATHPATHWAYANXIETY
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