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Caring for dying patients who have air hunger
1Law and Health Program, University of Maryland, School of Law, Baltimore 21201, USA. atarzian@juno.com
Purpose:
To understand nurses' experiences of caring for dying patients who have "air hunger." When air hunger occurs in people who are close to death, it often triggers increasing panic and breathlessness. Describing this phenomenon is an initial step toward a more informed and consistent response to air-hungry patients.
Design And Methods:
Phenomenological study of 10 hospice, long-term care, oncology, or emergency medicine nurses who cared for air-hungry dying patients. Analysis was based on van Manen's guidelines for interpretive phenomenology. Interviews with two family members who witnessed their dying spouses suffer from air hunger were used to complement the nurses' accounts.
Findings:
Themes of (a) the patient's look-panic beckons, (b) surrendering and sharing control, and (c) fine-tuning dying indicated ways nurses responded to relieve a patient's air hunger, including being prepared before air hunger occurs, calming patients and families, medicating patients, improvising care, attending to family members' needs, and drawing a distinction between palliating and killing.
Conclusions:
The three themes provide a framework for a new vision of "doing everything" for a dying person who suffers from air hunger. Care encompasses knowing what to do as well as how to stay present during suffering.