'Stressors' and difficulties in dealing with the terminal patient

This study investigated by means of questionnaires and semi-structured interviews some of the major sources of stress for palliative care nurses and how they deal with these. The nurses' replies were related to a general measure of health. Irrespective of their shifts, duties, and training, the nurses in two units specializing in palliative care shared very similar views. The most potent influence on the nurses' attitude to death was their own experience with dying patients. The nurses found it particularly stressful to deal with patients who suffer intractable pain, with those patients who have young children, and with those patients who are afraid to die. In addition, dealing with psychiatric symptoms and with relatives are major sources of stress. Generally, it was found that those symptoms and situations which left nurses feeling helpless and useless were the most stressful. The implications of these findings for nurse training and education are discussed.