Nurses experiences of decision regarding life-sustaining treatment within emergency and intensive care units : a litterature review

Background: Every year around 400 000 patients arrives at the emergency wards on the hospitals in Stockholm. Emergency and intensive cares purpose is to take care of acute cases of illness and accidents, and the most prioritized cases ends up within the intensive care units, ICU. Intensive care regards specialized medical staff and modern medicinaltechnology equipment. Nurses task involves promoting the patients’ health, with a unique knowledge about the human with a holistic view, with an attitude well-founded in ethics. Nurses within the intensive care units use life-sustaining treatments and measures from respirators to medicines to save lifes. In spite of this, approximately every fifth patient who is hospitalized in the intensive care unit passes away, and many patients condition can be so critical that communication isn’t an option. Nurses within emergency and intensive care comes across a lot of obstacles in their profession to nurse the patients’ health and might have to perform life-sustaining treatments without approval from the patients. Aim: The aim of this study was to understand the nurses experiences and how nurses handle descisions regarding life-sustaining treatments on patients within emegergency and intensive care. Method: The authors made a litterature review of allready existing data from scientificle articles, to summerize nurses different experiences regarding descisions of life-sustatining treatment, and how the nurses handle these situations. Results: Nurses described different obstacles regarding deciscions of life-sustaining treatment which caused emotional stress. The authors identified these obstacles as communication, cooperation, planing, environment and an emotional weight. Nurses could find a purpose and context in thier role as experts of caring even though there was a decision about ending life-sustaining treatment on terminal patients. Discussion: The authours discussed the choise of method for this study and the different obstacles, experiences and how the nurses handle psychological and emotional stress, from litterature, scientifical articales and Aaron Antonovsky’s contexttheory and Callista Roy’s theory about adaptation