Caring Amid Complexity: Intensive Care Nurses' Perceptions and Experiences of End-Of-Life Care-A Qualitative Study

Area of Science:

• Nursing
• Critical Care Medicine
• Palliative Care

Background:

• End-of-life care in intensive care units (ICUs) presents complex challenges for nurses.
• Nurses balance clinical duties with emotional and ethical aspects of caring for dying patients and families.

Purpose of the Study:

• To explore intensive care nurses' perceptions and experiences with end-of-life care.
• To identify challenges faced by nurses in the adult intensive care unit setting.

Main Methods:

• Qualitative exploratory descriptive study.
• 16 experienced ICU nurses (≥5 years experience) participated.
• Data collected via semi-structured interviews and analyzed using inductive thematic analysis.

Main Results:

• Identified four themes: emotional toll, communication challenges with families, ICU environmental issues, and feelings of powerlessness/exclusion.
• Nurses experienced burnout due to personal attachments and emotional strain.
• Communication was hindered by grief, denial, and strained relationships; environmental factors like overcrowding and lack of privacy increased stress.

Conclusions:

• Enhancing ICU end-of-life care requires addressing systemic barriers, promoting interprofessional collaboration, and improving nurse education and support.
• Empowering nurses in decision-making and supporting their roles is vital.
• Improving care involves communication/palliative care training, family-inclusive environments, and staff well-being initiatives.