Tracey M Giles1, Karen Hammad1, Katrina Breaden2, Christine Drummond3, Sandra L Bradley1, Adam Gerace4, Eimear Muir-Cochrane1. 1. College of Nursing and Midwifery, Flinders University, Bedford Park, Adelaide, South Australia, Australia. 2. College of Nursing and Midwifery, Flinders University, Bedford Park, Adelaide, South Australia, Australia. Electronic address: katrina.breaden@flinders.edu.au. 3. Central Adelaide Palliative Services, Woodville, Adelaide, South Australia, Australia. 4. CQ University, Wayville, Adelaide, South Australia, Australia.
Abstract
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. Crown
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. Crown
Authors: Maria Filomena Passos Teixeira Cardoso; Maria Manuela Ferreira Pereira da Silva Martins; João Miguel Almeida Ventura-Silva; Paulo Emílio Mota; Paula Cristina Rodrigues Costa; Olga Maria Pimenta Lopes Ribeiro Journal: Porto Biomed J Date: 2022-02-08