The lived experiences of nurses caring for patients at the end of life in clinical settings

Abstract Background: End-of-life care has become the focus of most health care organizations due to the increasing number of patients who are living longer with chronic and terminal diseases. Today, patients are more involved in the discussion towards end-of-life care, and nurses are the ones who provide this care. Most studies that explore the experiences of nurses providing end-of-life care focused mostly on nurses working in oncology and pediatrics. These studies suggested that nurses caring for patients at the end of life lack formal training in end-of-life care. This lack of knowledge and training was perceived to have a negative impact on patients' care. These studies, however, lack generalization, as nurses in varies clinical settings other than oncology and pediatric will likely care for a dying patient at some point in their nursing career. Purpose: The purpose of this study explored the lived experiences of nurses who provide care to patients at the end of life. Exploring the nurses' experiences in various clinical settings, such as an acute care and long-term care facilities will bring more knowledge and a deeper understanding about the essence of the experience of nurses who provide end-of-life care to dying patients. This study has the potential to provide information on nurses’ experiences in order to develop end-of-life care educational programs for nursing students based on nurses’ needs. Methods: This study was guided by Moustakas's (1994) Transcendental Phenomenological approach to phenomenology. The target population was registered nurses and licensed practical nurses who experienced caring for dying patients and have had no prior education or training in palliative or hospice care, post nursing school graduation. Results: From the experiences of 16 nurses who provides end of life care in clinical settings, one primary theme and three subthemes were identified. Conclusion: Experiences of nurses’ generosity as described in kind acts and empathetic behavior and their commitment to patients who are dying, illustrates the essence of dedication. Daily interactions support their commitment to patients and competence increase their confidence and improve the skills needed to create a balance between daily work challenges and patient's care. The results of this study supports the need for nurse educators and employers to provide more opportunities to end life care educational programs for professional nurses and nursing students