Nursing's professional dignity in palliative care: Exploration of an Italian context

Aims and objectives: To determine the relevance of nursing's professional dignity in palliative care. Background: Dignity is a valued concept in the ethical discourse of health disciplines. Nursing's professional dignity, a concept related to professional identity, is not clearly defined nor have its characteristics been delineated for its clinical relevance in palliative care. Design: A qualitative methodological approach. Methods: Focus groups elicited dialogues of nursing's professional dignity among 69 nurses working in hospices and home-care in Italy. Data were content-analysed via an inductive process. The COREQ checklist for qualitative studies was used for reporting this research. Results: A central theme related to (a) "Intrinsic dignity of persons" was embedded in the essence of palliative care. Several corollary themes underscored this central theme: (b) Professional (intra- and inter) relationships and teamwork; (c) Nursing professionalism; (d) Ethical dilemmas; and (e) Relationships with patients and their significant persons. Conclusions: Nurses valued the essence of respect as persons and the essence of respect for their work as coherent with intrinsic dignity and work dignity in palliative care. Nurses perceived their psycho-social relationships with patients and their families as rewarding incentives amidst disputatious interactions with peers and/or other healthcare professionals. They experienced ethical dilemmas, which they perceived as inherent in palliative care. Relevance to clinical practice: Study findings corroborate the literature regarding the concept of nursing's professional dignity which is intrinsic in respect of the human person. The intrinsic dignity in palliative care manifests as nurses are working in juxtaposition of a demanding yet rewarding care ambience