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RES238
End-of-Life Transition Experiences of ICU Nurses: Mindful Realization
By: Sarah Moscatel,; Eastern Colorado Healthcare System: Denver Veterans Affairs Medical Center, Denver, CO
For further information, please contact: sarah.moscatel@med.va.gov
Purpose: The purpose of this study was to understand the perceptions and meanings constructed by nurses who have experienced the realization in an ICU that restorative care (life-sustaining therapies) is failing and the patient is actively dying.
Background/Significance: Despite significant advances and efforts over the last two decades in the management of end-of-life care and prognostication of death, experiences of dying in the Intensive Care Unit (ICU) have not improved. Current ICU end-of-life care often lags behind human compassion that enhances well-being, provides comfort, and relieves suffering during the dying process.
Methods: Qualitative descriptive methodology informed by van Manen’s hermeneutic phenomenology and directed by Colaizzi’s analytic approach guided the research process. A purposeful sampling strategy was used to select ten nurses who currently worked in ICU and had cared for adult dying patients. In-depth non-structured phenomenological interviews were used to generate data. Interviews were audiotaped, transcribed, and all identifiers removed.
Results: Phenomenological analysis revealed common themes: Recognition of Dying, Timing, Emotional Manifestations, and Humanistic Transition. Significant statements, formulated meanings, and themes were integrated into an exhaustive description to formulate the fundamental structure “Mindful Realization with a Desire to Share”. Mindful realization was the essential nursing skill that facilitated awareness to dying patterns and the ability to assess whether a patient was actively dying, while being sensitive to the patient’s experience. Once dying was realized the nurses had “a Desire to Share” that with the others in hopes of improving the quality of the dying process for the patient and family.
Conclusions: This study provided insight into understanding the experience of ICU nurses who cared for patients transitioning into active dying. The results have immediate application into clinical practice and can serve as the foundation for improving end-of-life experiences in the ICU environment.
Funding: AACN End-of-Life/Palliative Case Small Projects Grant
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