Palliative care nurses’ perceptions of good and bad deaths and care expectations: a qualitative analysis

Abstract

Individuals who are involved with the death of a person with a terminal illness will often classify the death as either 'good' or 'bad'. Families and healthcare practitioners assess many factors when determining their 'success' or 'failure' in assisting someone in the terminal phase. Palliative care nurses are particularly vulnerable to self-assessments about care of the dying, because death is a daily occurrence. Feelings of failure, unmet expectations and feeling of regret about not being able to prevent a traumatic death may be a source of stress for palliative care nurse and may affect their abilities to function effectively. This article reports the findings of a study involving interviews with 20 palliative care nurses to determine their perceptions of a good and bad death. The study also examined the expectations they hold of themselves and that they believe others hold of them in helping patients to attain a good death. Clinical implications are discussed based on these findings.

Provider Insights About Palliative Care Barriers and Facilitators: Results of a Rapid Ethnographic Assessment

“…2,3 Several explanations for this phenomenon have been put forth, including negative feelings on the part of providers, concerns regarding safety, efficacy and ease of utilization, inadequate knowledge on the part of healthcare professionals, and lack of administrative organization. [4][5][6][7][8][9][10][11][12][13] Under-adoption of interventions with a solid evidence base for benefit, including programs of PC, is an example of failure of translation of innovation into practice. Qualitative methods have proven Palliative care remains underutilized in the United States.…”

Moving Toward Peace: An Analysis of the Concept of a Good Death

“…The elements comprising the attribute of being in control were (1) choices/ wishes being honored including communication of wishes, [2][3][4][5]7,30,33,34,36,39,40,42,46,47,[56][57][58] (2) clear decision making, 3,5,6,34,35,40 (3) option for suicide/euthanasia, 3,7,34,40 and (4) control over the death event including control of location, timing, and presence or absence of others. [2][3][4][5][31][32][33][34]36,37,39,40,42,45,46,[55][56][57] Being in control was clearly the most important and most common attribute. There were more than 100 references to issues of control in the 39 articles in the final analysis.…”

“…Bosek et al 5 Cohen et al 30 Hopkinson and Hallett 3 Kristjanson et al 31 Leichtentritt and Rettig 32 Low and Payne 33 Pierson et al 34 Schwartz et al 4 Steinhauser et al 35 Tong et al 37 Curtis 43 El-Nimr et al 44 Grogono 45 Jones and Willis 47 Kittel 46 Smith 42 Essay or editorial Ayers et al 48 Erlen 56 Feinmann 57 Gazelle 59 Hart et al 54 McNeil 58 Neuberger 61 Winslow and Jacobson 55…”

“…Affirmation or recognizing the value of the dying person was multifaceted and encompassed (1) dignity 2,3,31,33,35,38,40,42,45,48,54,56,59 ; (2) wholeness or being a whole person, 5,31,34,35,40 including having physical, emotional, social, and spiritual aspects; (3) quality of life, which includes living fully 33,40,48,59 ; and (4) individuality. 3,34,35,37 This attribute is attended to by holistic care on the part of care providers.…”

Long-Term Palliative Care Workers: More Than a Story of Endurance

“…7 Many health professionals may also hold unrealistic expectations about their role and how they can be expected to help. 8,9 Health professionals who choose to work in palliative care have possibly self-selected to work in an area that others might find more difficult. The challenges of this work, however, remain.…”