Unexpected death : the experiences of nurses working in a cardiology setting

Abstract

Background: Nurses are the professionals present when a patient suddenly deteriorates and dies unexpectedly. This experience results in a negative impact on these nurses. However few studies have explored the nurses’ experiences, when this phenomenon occurs. Objectives: The aim of this dissertation is to explore the experiences of nurses working in a cardiology setting when faced with the unexpected death of their patients. From this aim, study objectives were developed. These explore the emotional responses, the effects on their professional and personal life and the coping strategies adopted when unexpected death occurs. Strategies that could support nurses in these situations were also identified. Design: The research method adopted is a qualitative phenomenological design using Interpretative Phenomenological Analysis. Setting and Participants: Five male and five female nurses working in the three specialist cardiology wards, located at the only acute government general hospital in Malta were recruited for the study. Methodology: The participants were recruited using purposive sampling and approached by intermediaries prior to obtaining consent. Semi-structured interviews, using, were conducted. The data was transcribed verbatim and analysis was conducted using IPA guidelines. Results: From the analysis of the findings, one overarching theme named ‘The human side of professionalism’ and three super ordinate themes emerged titled ‘Uncertainty in the chaotic ordinary’ , ‘Putting a tough face and acting as a professional’ and ‘Confronting one’s fears to build new certainties’. Conclusion: When faced with the sudden death of their patients, the nurses perceive this as a shock and feel both deceived by their abilities to assess the patient’s condition and saddened because of the presence of a relationship with the patient. However the nurses need to put on a tough face and act as professionals to care for the patient and the relatives. These events result in several repercussions on the nurse who copes by building a ‘protective shield’, through peer support and other coping tactics.