The lived experiences of nurses' encounters with patients' deaths in a palliative inpatient setting

Abstract

Background: Nurses working in an inpatient palliative care unit encounter patient death frequently. Such frequent encounters leave an impact on these nurses and on their nursing practice. However, relatively few studies focus on the impact such frequent encounters have on nurses working in the palliative care unit. Objectives: The aim of this study was to explore the lived experiences of nurses who encounter patient death in a palliative inpatient setting. The objectives were to explore the perceptions and attitudes of nurses about death, how these nurses experience the death of their patients, identify the coping strategies these nurses utilise, and examine nurses’ perception of supportive strategies that could be implemented. Design: A qualitative phenomenological design using the principles of Interpretative Phenomenological Analysis. Setting: The palliative care unit of the general oncology hospital in Malta is the setting of this study. Participants: Five Maltese staff nurses working in the palliative care unit. Methods: The participants were recruited using purposive sampling. Data was collected through two face-to-face semi-structured interviews with each participant, which were audio recorded. The data was transcribed verbatim and analysis was done using Interpretative Phenomenological Analysis. Results: Two super-ordinate themes emerged that described the lived experience of the nurses; Outlook on Death and Dealing with Patient Death. Conclusion: Nurses working in the palliative care unit perceived death as an inevitable part of life. They described some deaths of their patients as being ‘good’ or ‘bad’, and they always aimed to enable a ‘good’ death for their patients. The nurses were affected by both types of these deaths, and also by the relationship they had with their patients prior to their death. Witnessing patient death also shaped the nurses’ perceptions on life and death generally. All participants found their own combination of coping strategies to deal with patient death and find support from their colleagues. Most participants however felt that they could be better supported at work to better deal with patient death, citing training and group activities as methods on how they could be better supported.