Reflections of Intensive Care Nurses' Experiences of Facing Death on Their Existential Transformation and...

Intensive care nurses are frequently confronted with death as part of their professional life. Continuous contact with death may cause a personal or professional existential transformation in nurses. This transformation may trigger individuals to question the meaning of life and trigger personal transformation processes. However, qualitative studies on how such experiences reflect on nurses' existential perceptions and meaning-making processes are limited.

The aim of this study was to examine the reflections of intensive care nurses' experiences of facing death on their existential transformation and meaning-making processes.

The study was designed using a descriptive phenomenological approach. Nurses working in various intensive care units of a university hospital in Turkey, who had at least three years of experience in intensive care and had encountered patient death at least once during their professional practice, were included in the study. Participants were recruited using the snowball sampling method. Data were collected through 17 in-depth individual interviews with semi-structured quide and analysed using Colaizzi's seven-stage analysis method. COREQ guidelines were used for reporting the research process.

Based on participant narratives, four main emergent themes were identified at the highest level of the analytic hierarchy, supported by eight theme clusters. The four primary emergent themes were as follows: (1) The first confrontation with death; (2) The constant encounter with death; (3) Authentic Living in the Face of Death; and (4) Strategies for coping with death.

Confrontation with death triggers deep existential transformations in intensive care nurses at both personal and professional levels, triggering a process of reinterpreting life and professional roles. Although this experience sometimes has effects that are challenging, it contributes to the transformation of nurses' value judgements, life priorities and understanding of care; thus, it enables them to develop a more holistic awareness.

The findings of this study demonstrate that intensive care nurses' experiences of confronting death have significant existential implications at both personal and professional levels. These results highlight the importance of implementing reflective and meaning-centred interventions, providing death awareness training and fostering a culture of existential safety within intensive care teams. In clinical practice, integrating existentially oriented education, psychosocial support mechanisms and spiritual counselling services into nursing care can strengthen nurses' emotional resilience and enhance the overall quality of patient care.