Nurses´ experiences with dying patients in intensive care units

Teoretična izhodišča: Skrb za hudo bolnega pacienta, ki umira, in pa sama smrt, lahko medicinsko sestro globoko prizadenejo. Medicinske sestre v enotah intenzivne nege in terapije se z umiranjem in s smrtjo soočajo dnevno. Z zaključnim delom smo želeli raziskati izkušnje medicinskih sester ob soočanju z umiranjem in s smrtjo pacientov ter predstaviti najpogostejše težave, s katerimi se ob tem srečujejo. Raziskovalne metode: V zaključnem delu smo uporabili metodo pregleda literature. Iskanje je potekalo v mednarodnih podatkovnih bazah PubMed, ScienceDirect, CINAHL, SAGE in Web of Science. Pri tem smo upoštevali postavljene vključitvene in izključitvene kriterije. Potek iskanja smo prikazali s pomočjo diagramov PRISMA. Rezultate smo sintetizirali z uporabo metode vsebinske analize. Rezultati: Od 1.881 identificiranih zadetkov smo v končno analizo vključili 10 študij. Z analizo podatkov smo oblikovali tri glavne teme: (1) doživljanje ob hudo bolnem in umirajočem pacientu, (2) vpliv na sočutno obravnavo in (3) profesionalni odnos. Medicinske sestre se v intenzivni enoti med obravnavo hudo bolnih pacientov najpogostejše srečujejo s stresom, čustvenim bremenom, z depresijo, žalostjo, izgorelostjo, s stalnimi psihičnimi in fizičnimi obremenitvami, pomanjkanjem čustvene podpore, težavami pri komunikaciji s pacientovimi sorodniki in pomanjkanjem sodelovanja ter podpore v timu. Diskusija in zaključek: Ugotovili smo, da je za prilagoditev na delo v enotah intenzivne nege potreben čas. Vodstvo bi moralo zagotoviti psihološko podporo medicinskim sestram, člani tima bi morali medsebojno sodelovati, medicinske sestre pa bi morale enakopravno sodelovati na sestankih z zdravnikom in družino pacienta.Introduction: The care for a severely ill patient who is dying, and the death itself, can severely affect the nurse. Nurses in intensive care and therapy units are daily confronted with dying and death. The purpose of the thesis was to research the nurses’ experiences when confronting dying and death of patients and to present the most common issues that they encounter. Research methods: In the thesis the literature review method was used. The search was conducted in international databases PubMed, ScienceDirect, CINAHL, SAGE, and Web of Science. The inclusion and exclusion criteria were taken into account. The results of the search were presented with the help of PRISMA diagrams. The results were synthetized using the content analysis method. Results: Out of 1,881 identified hits, 10 studies were included in the final analysis. By analysing the data, three main themes were developed: (1) experiencing a seriously ill and dying patient, (2) the impact on compassionate treatment, and (3) a professional relationship. Nurses in the intensive care unit most often encounter stress, emotional burden, depression, sadness, burnout, constant physical and psychological strains, lack of emotional support, communication problems with patient’s relatives, and lack of cooperation and team support during the treatment of seriously ill patients. Discussion and conclusion: It was found out that time is needed to adapt to work in intensive care units. Management should provide psychological support to nurses, team members should cooperate with each other, and nurses should participate equally in meetings with the doctor and the family of the patient