Nurses' Experiences of Serious Illness Conversations With Marginalized Patients in COVID-19

Area of Science:

• Nursing
• Palliative Care
• Health Equity

Background:

• Nurses are well-positioned for serious illness conversations (SICs).
• Their experiences conducting SICs with marginalized groups during the COVID-19 pandemic are understudied.
• Understanding these experiences is vital for improving care.

Purpose of the Study:

• To explore nurses' experiences conducting SICs with marginalized patients and families during the COVID-19 pandemic.
• To identify challenges and facilitators in these conversations.

Main Methods:

• A mixed-methods study involving 20 nurses/nurse practitioners.
• Data collection included surveys (demographics, self-efficacy, moral distress) and virtual focus groups.
• Qualitative and quantitative data were integrated to identify themes.

Main Results:

• Nurses reported high self-efficacy but moderate moral distress.
• Key themes included relational skills, pandemic challenges, moral distress/burnout, patients' social needs, and mitigation strategies.
• Nurses faced challenges due to pandemic context and structural barriers for marginalized patients.

Conclusions:

• Addressing patients' health-related social needs is essential.
• Nurses require support to effectively conduct SICs.
• Promoting an environment that supports nurses' well-being is critical.