TY - JOUR
T1 - Nurses’ perceptions and experiences of caring for patients who die in the emergency department setting
AU - Giles, Tracey M.
AU - Hammad, Karen
AU - Breaden, Katrina
AU - Drummond, Christine
AU - Bradley, Sandra L.
AU - Gerace, Adam
AU - Muir-Cochrane, Eimear
PY - 2019/11
Y1 - 2019/11
N2 - Introduction: The number of people dying in emergency departments (EDs) is increasing. However, EDs are not well designed or resourced for safe and effective End-Of-Life (EOL) care encounters, and there is little evidence regarding clinicians’ perceptions and experiences of providing such care when the death is sudden and unexpected. Aim: This study explored nurses’ perceptions and experiences of caring for patients who die suddenly and unexpectedly in the ED. Methods: Open-end responses were collected as part of a larger descriptive survey design. The qualitative data were analysed thematically. Results: 211 ED nurse completed the online survey. Within the qualitative data, five themes were identified during analysis: 1) key elements of EOL care, 2) systemic and environmental barriers, 3) educational deficits, 4) role ambiguity, and 5) emotional impact. Participants identified communication, a standardised approach, and better educational preparedness as the most important elements of EOL care when the death was sudden and unexpected. Conclusions: ED nurses want to provide high quality care to dying patients and their families. However, their efforts are hampered by systemic and environmental barriers outside their control. There is a need for a culture shift to overcome the barriers that currently obstruct ED nurses from providing meaningful and effective EOL care in the ED.
AB - Introduction: The number of people dying in emergency departments (EDs) is increasing. However, EDs are not well designed or resourced for safe and effective End-Of-Life (EOL) care encounters, and there is little evidence regarding clinicians’ perceptions and experiences of providing such care when the death is sudden and unexpected. Aim: This study explored nurses’ perceptions and experiences of caring for patients who die suddenly and unexpectedly in the ED. Methods: Open-end responses were collected as part of a larger descriptive survey design. The qualitative data were analysed thematically. Results: 211 ED nurse completed the online survey. Within the qualitative data, five themes were identified during analysis: 1) key elements of EOL care, 2) systemic and environmental barriers, 3) educational deficits, 4) role ambiguity, and 5) emotional impact. Participants identified communication, a standardised approach, and better educational preparedness as the most important elements of EOL care when the death was sudden and unexpected. Conclusions: ED nurses want to provide high quality care to dying patients and their families. However, their efforts are hampered by systemic and environmental barriers outside their control. There is a need for a culture shift to overcome the barriers that currently obstruct ED nurses from providing meaningful and effective EOL care in the ED.
KW - Death
KW - Dying
KW - Emergency care
KW - Emergency nursing
KW - End-of-life care
KW - Palliative
KW - Qualitative
UR - http://www.scopus.com/inward/record.url?scp=85071728910&partnerID=8YFLogxK
U2 - 10.1016/j.ienj.2019.100789
DO - 10.1016/j.ienj.2019.100789
M3 - Article
AN - SCOPUS:85071728910
SN - 1755-599X
VL - 47
JO - International Emergency Nursing
JF - International Emergency Nursing
M1 - 100789
ER -