Confronting behaviour in palliative care: a qualitative study of the lived experience of nursing staff

Background: Little research examines the extent and impact of aggressive or uncomfortable ‘confronting behaviour’ experienced by palliative care nurses, despite palliative wards being an emotionally labile environment. Methods: Qualitative data on nurses’ experiences of confrontation were collected from 17 palliative care nurses at a major metropolitan hospital via a focus group and individual interviews. Data were analysed using inductive thematic analysis. Findings: Results indicated that family members were the main perpetrators and tolerance of confrontation varied dependent on the characteristics of the aggressor. Confrontation was described as arising in response to grief, and because of misunderstandings of palliative care goals. Nurses reported a perceived lack of appreciation for their work from some patients’ families and feelings of discontent with the nature and amount of structured support available following a confrontation. Informal workplace support helped nurses to deal with these incidents and, despite bad experiences, nurses affirmed their commitment to working in this area. Conclusion: The findings demonstrate the demands placed on nurses working in palliative care, and the importance of compassion in moderating the impact of a challenging environment.