Discrepancies between Perceptions by Physicians and Nursing Staff of Intensive Care Unit End-of-Life Decisions

Ferrand, Édouard; Lemaire, François; Régnier, B.; Kuteifan, Khaldoun; Badet, Michel; Asfar, Pierre; Jaber, Samir; Chagnon, Jean-Luc; Renault, Anne; Robert, R.; Pochard, Frédéric; Hervé, Christian; Brun‐Buisson, Christian; Duvaldestin, Philippe

doi:10.1164/rccm.200207-752oc

Cited by 254 publications

(176 citation statements)

References 30 publications

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“…Decisions regarding the patient's treatment and therapies are the responsibility of the physicians [37]. Nursing staff hardly ever formally participate in the decision-making process regarding the therapeutic methods used, even though patient care and nursing are among the key tasks of nursing staff [50]. The current study confirms that misunderstandings and doubts concerning therapeutic measures taken are still significant stressors for nurses.…”

Section: Discussionsupporting

confidence: 60%

Stress factors vs. job satisfaction among nursing staff in the Pomeranian Province (Poland) and the Vilnius Region (Lithuania)

Kwiecień-Jaguś¹,

Mędrzycka‐Dąbrowska²,

Chamienia³

et al. 2018

Ann Agric Environ Med.

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Introduction. In the opinion of many researchers, nursing staff are exposed to an exceptionally high level of occupational stress. The problem of stress in the working environment of the nursing staff becomes more and more important in the context of increasing staff shortages and insufficient support from colleagues and employers. The aim of this study was to analyse stress factors indicated by the nursing staff in Poland and Lithuania, and to assess their job satisfaction. Materials and method. Two standard research tools were used in the study: the Nursing Stress Scale and the Job Satisfaction Survey. The study involved 230 respondents from Poland and Lithuania. The sample was chosen randomly and incidentally. Results. Based on the analysis of collected materials, the greatest stress factors in the work of the nursing staff were identified, which included interpersonal conflicts between nurses and doctors and between nurses, and death and dying. The study indicated that there is a relationship between stress and job satisfaction among Polish nurses (r=-0.33;p=0.001) and Lithuanian nurses (r=0.34; p=0.001). The greater the stress, the lower the job satisfaction. Low job satisfaction was connected with low remuneration, which is still inadequate to professional duties, and the lack of promotion opportunities. The study confirmed that there were significant differences in job satisfaction among Polish and Lithuanian nurses (Z= -6.27; p<0.001). Conclusions. The study confirmed a high level of stress and dissatisfaction among nursing staff in Poland and Lithuania.

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Section: Discussionsupporting

confidence: 60%

Stress factors vs. job satisfaction among nursing staff in the Pomeranian Province (Poland) and the Vilnius Region (Lithuania)

Kwiecień-Jaguś¹,

Mędrzycka‐Dąbrowska²,

Chamienia³

et al. 2018

Ann Agric Environ Med.

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“…And the differences were quite large. Thomas et al 33 reported that 73% of physicians but only 33% of nurses in their study thought that their relationships were collaborative; Ferrand et al 19 found that 50% of the physicians but only 27% of the nurses identified relationships with physicians as collaborative. Studies also reported that nurses' perceptions of the degree and quality of collaboration were a more accurate predictor of patient outcomes-deaths and transfer back to the ICU-than were physicians' perceptions.…”

Section: Types and Measurement Of Nurse-physician Relationshipsmentioning

confidence: 97%

“…[18][19][20][21] In all of these writings, what constitutes good or high-quality relationships between physicians and nurses is seldom defined, and when an attempt is made to assess goodness, nurse-physician relationships are measured as though all interactions between nurses and physicians on …”

mentioning

confidence: 99%

Nurse-Physician Relationships in Hospitals: 20 000 Nurses Tell Their Story

Schmalenberg¹,

Kramer²

2009

Critical Care Nurse

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Throughout the 1990s, a great deal was written about the importance of "good" nurse-physician relationships, about how high-quality nurse-physician relationships were 1 of the 3 cornerstones of excellent (magnetic) work environments, about how the quality of nursephysician relationships is more of a concern to nurses than to physicians, and about how physicians consistently rate the quality of these relationships higher than do nurses. [18][19][20][21] In all of these writings, what constitutes good or high-quality relationships between physicians and nurses is seldom defined, and when an attempt is made to assess goodness, nurse-physician relationships are measured as though all interactions between nurses and physicians on

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“…Nonetheless, there is ample evidence that there remains significant room for improvement in the care of these patients. (6,7,8,9) Due to inherent challenges in assessing patients' dying experience, it is difficult to measure the quality of care of these patients. Surrogate markers such as ICU length of stay are markers of intensity of care, but may not directly reflect the quality of endof-life care.…”

Section: Introductionmentioning

confidence: 99%

Using the medical record to evaluate the quality of end-of-life care in the intensive care unit*

Glavan

Engelberg

Downey

et al. 2008

Critical Care Medicine

113

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Rationale-We investigated whether proposed "quality markers" within the medical record are associated with family assessment of the quality of dying and death in the ICU.Objective-To identify chart-based markers that could be used as measures for improving the quality of end-of-life care.Design-A multi-center study conducting standardized chart abstraction and surveying families of patients who died in the ICU or within 24 hours of being transferred from an ICU. Setting-ICUs at ten hospitals in the Northwest US.Patients-356 patients who died in the ICU or within 24 hours of transfer from an ICU.Measurements-1) the 22-item family-assessed Quality of Dying and Death (QODD-22); 2) a single item rating of the overall quality of dying and death (QODD-1).Analysis-The associations of chart-based quality markers with QODD scores were tested using Mann-Whitney tests, Kruskal Wallis tests, or Spearman correlation coefficients as appropriate.Results-Higher QODD-22 scores were associated with documentation of a living will (p = 0.03), absence of CPR performed in the last hour of life (p = 0.01), withdrawal of tube feeding (p = 0.04), family presence at time of death (p=0.02), and discussion of the patient's wish to withdraw life support during a family conference (p<0.001). Additional correlates with a higher QODD-1 score included use of standardized comfort care orders and occurrence of a family conference (p≤0.05).Conclusions-We identified chart-based variables associated with higher QODD scores. These could serve as targets for measuring and improving the quality of end-of-life care in the ICU. MeSH Headings

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Discrepancies between Perceptions by Physicians and Nursing Staff of Intensive Care Unit End-of-Life Decisions

Cited by 254 publications

References 30 publications

Stress factors vs. job satisfaction among nursing staff in the Pomeranian Province (Poland) and the Vilnius Region (Lithuania)

Stress factors vs. job satisfaction among nursing staff in the Pomeranian Province (Poland) and the Vilnius Region (Lithuania)

Nurse-Physician Relationships in Hospitals: 20 000 Nurses Tell Their Story

Using the medical record to evaluate the quality of end-of-life care in the intensive care unit*

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