Nurses’ experiences of accompanying patients dying during the COVID‐19 pandemic: A qualitative descriptive study

Abstract

Aims The aim was to explore nurses’ experiences of caring for and accompanying patients dying without the presence of family during the COVID‐19 pandemic. Design A qualitative descriptive design was used. Methods A purposive sample of registered nurses, caring for dying patients in Italian health‐care settings during the COVID‐19 pandemic, were selected. To capture a broad range of experiences, a maximum variety of participants about workplace, age, gender and work experience were included. A total of 31 nurses agreed to participate in the study; 28 participants were female; participants were aged 41 on average (range 25–63 years) and worked in hospitals and nursing homes in the Northern and Central Italian regions. Six focus groups were conducted from August to December 2020 through Microsoft Teams, reaching data saturation. The transcripts were analysed through inductive content analysis. The COREQ checklist was followed for study reporting. Results Four main categories emerged describing nurses’ experiences: hugely increased deaths in time of COVID‐19; ensuring physical, emotional, interpersonal and spiritual care for dying patients and supporting their families despite difficulties; ensuring care procedures of patients’ bodies after death and psychological consequences of caring for dying people during the pandemic. Conclusion Registered nurses provided physical, spiritual and emotional care to dying patients during the pandemic, despite limited resources and knowledge, standing in for relatives who were not allowed to visit them; the experiences of caring for dying patients in the absence of the family caused emotional distress in nurses. Impact Health‐care systems should develop guidelines aiming to meet the psychological needs of dying people in case of restrictions on patients’ family visits. Health‐care administrators should offer services to support the grieving process of relatives who cannot accompany dying patients and to reduce emotional distress in nurses caring for dying patients.

Caregivers' experiences and perspectives on caring for the elderly during the COVID‐19 pandemic: A qualitative systematic review

“…Caregivers often stand in for the family in ensuring the best possible death during the last farewell, because of the visitation restrictions. ‘ I saw physicians cry … or that there was nothing more to be done, both for the older … ’ (Castaldo et al, 2022). Synthesized Finding 3: Caregivers show various emotions and mentalities. This synthesized finding was underpinned by 35 extracted findings and subdivided into 4 categories: ‘fear of contagion’, ‘pressure increase’, ‘negative emotions’ and ‘emotional exhaustion’, in that order.…”

“… Synthesized Finding 6: Affirmation of self‐worth. This synthesized finding was underpinned by 15 extracted findings and subdivided into 2 categories: ‘professional pride and sense of responsibilities’ and ‘trust in colleagues, managers and patients’. Seven studies have reported that caregivers express professional pride and a sense of duty (Bilal et al, 2020; Castaldo et al, 2022; Krok‐Schoen et al, 2021; Lingum et al, 2021; Morley et al, 2022; Sarabia‐Cobo et al, 2021; Sun et al, 2020). ‘ The people we serve; and, those we feel a great sense of responsibility for … ’ (Lingum et al, 2021).…”

“…Affirmation of self‐worth (Bilal et al, 2020; Castaldo et al, 2022; Krok‐Schoen et al, 2021; Lingum et al, 2021; Morley et al, 2022; Sarabia‐Cobo et al, 2021; Sun et al, 2020).…”

“…Six synthesized findings were identified from 20 categories with 141 findings (synthesized findings in Empathizing with patient and family (Castaldo et al, 2022) Providing emotional support to patients and their families (Castaldo et al, 2022) Concern for patients (Sun et al, 2020) Caring Daily exercise programmes (Marshall et al, 2021) Healthy eating regimes (Marshall et al, 2021) Daily activities (Marshall et al, 2021) 7…”

Reimagining nursing: A professional awakening

“…Some of these changes are positive some have been challenging. The lack of human connection particularly during the COVID-19 pandemic has negatively impacted those needing care and those providing it (Castaldo et al, 2022;Holaday et al, 2022). Equally, mental health, health inequity and climate change are constant companions in a changing world.…”