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Published on: July 4, 2018
How nurses' and physicians' emotions, psychosocial factors, and professional roles influence the end-of-life decision
Melissa De Boer1, Sheryl Reimer-Kirkham2, Richard Sawatzky2
12733 Elm Drive, Coaldale, Alberta T1M 0C9, Canada.
Background:
Critical care physicians and nurses have significant roles in the complex process of end-of-life decision making.
Objective:
To understand how nurses' and physicians' emotions, psychosocial factors and professional roles influence end-of-life decision making in critical care.
Research Design/Methodology:
An interpretive descriptive qualitative approach was applied to collect and analyse data from semi-structured interviews with five critical care nurses and four critical care physicians from April to June 2018.
Setting:
Four Canadian critical care units; three tertiary and one rural setting.
Findings:
Three major themes arose: (1) the goal of avoiding futility as a shared mission, (2) ambiguity of the decision making process; and (3) influencing factors of subjective variability. The significant influencers shaping the dynamic and value-laden process were individual philosophy, moral weightiness, and family receptiveness.
Conclusion:
There is a need for a shared understanding of professional roles and clear communication of shared mission within health professional teams. Improved understanding of the end-of-life decision making process in critical care is essential to support nurses and physicians.
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