Acute care nurses' perspectives on end-of-life dreams and visions: An interview study

Aim: This study aimed to explore perspectives on end-of-life dreams and visions (ELDVs) of acute care nurses with experience in caring for dying patients. Design: This study used a qualitative design, with face-to-face semistructured interviews and a reflexive thematic analysis. It was conducted from November 2023 to March 2024. Setting/participants: Participants were medical and surgical nurses from a 200-bed acute care hospital in metropolitan Australia. Findings: Eighteen nurses participated. Five main themes were generated: 1) Assessment and response evolve with repeated exposure, with subthemes: − Is it a delirium?, − To medicate or not medicate?, and − Moving from task-oriented to holistic care; 2) Hesitant conversations; 3) A positive personal experience; 4) Education and training need to better equip nurses to provide holistic end-of-life care, and 5) The acute care setting predisposes to missed opportunities with subthemes – Speed of transition from active care to end-of-life care; and – Competing demands on nurse time. Conclusions: Development and feasibility of consensus-based guidelines to enable those providing end-of-life care, regardless of setting, to distinguish between an ELDV and a delirium, and practice guidelines to support patients and families, should be important inclusions to end-of-life education.