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Nurses' perceptions and experiences of caring for patients who die in the emergency department setting
Tracey M Giles1, Karen Hammad1, Katrina Breaden1
1College of Nursing and Midwifery, Flinders University, Bedford Park, Adelaide, South Australia, Australia.
Introduction:
The number of people dying in emergency departments (EDs) is increasing. However, EDs are not well designed or resourced for safe and effective End-Of-Life (EOL) care encounters, and there is little evidence regarding clinicians' perceptions and experiences of providing such care when the death is sudden and unexpected.
Aim:
This study explored nurses' perceptions and experiences of caring for patients who die suddenly and unexpectedly in the ED.
Methods:
Open-end responses were collected as part of a larger descriptive survey design. The qualitative data were analysed thematically.
Results:
211 ED nurse completed the online survey. Within the qualitative data, five themes were identified during analysis: 1) key elements of EOL care, 2) systemic and environmental barriers, 3) educational deficits, 4) role ambiguity, and 5) emotional impact. Participants identified communication, a standardised approach, and better educational preparedness as the most important elements of EOL care when the death was sudden and unexpected.
Conclusions:
ED nurses want to provide high quality care to dying patients and their families. However, their efforts are hampered by systemic and environmental barriers outside their control. There is a need for a culture shift to overcome the barriers that currently obstruct ED nurses from providing meaningful and effective EOL care in the ED.