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Intensive care nurses' experiences of providing end‐of‐life care after treatment withdrawal: a qualitative study

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  • Nikolaos Efstathiou
  • Wendy Walker

Abstract

Aims and objectives To explore the experiences of intensive care nurses who provided end‐of‐life care to adult patients and their families after a decision had been taken to withdraw treatment. Background End‐of‐life care following treatment withdrawal is a common phenomenon in intensive care. Less is known about nurses' experiences of providing care for the dying patient and their family in this context, when compared to specialist palliative care. Design Descriptive exploratory qualitative study. Methods A purposive sample of 13 intensive care nurses participated in a semistructured face‐to‐face interview. Transcribed data were analysed using the principles of interpretative phenomenological analysis. Results The essence of nurses' experiences of providing end‐of‐life care after the withdrawal of treatment was interpreted as ‘doing the best to facilitate a comfortable and dignified death’. Four master themes included the following: caring for the dying patient and their family; providing and encouraging presence; reconnecting the patient and family; and dealing with emotions and ambiguity. Uncertainties were evident on processes and actions involved in treatment withdrawal, how to reconnect patients and their family effectively and how to reduce the technological environment. Conclusions Providing end‐of‐life care after a decision has been taken to withdraw treatment was a common aspect of intensive care. It was evident that nurses were doing their utmost to support patients and families at the end of life, despite the multiple challenges they faced. Relevance to clinical practice The interpretive findings from this study should assist intensive care unit nurses to better understand and develop their role in providing high‐quality end‐of‐life care after treatment withdrawal. Practice guidelines should be developed to reduce ambiguity and support the delivery of high‐quality care for adults as they approach the final stages of life in intensive care units.

Suggested Citation

  • Nikolaos Efstathiou & Wendy Walker, 2014. "Intensive care nurses' experiences of providing end‐of‐life care after treatment withdrawal: a qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(21-22), pages 3188-3196, November.
    • Handle: RePEc:wly:jocnur:v:23:y:2014:i:21-22:p:3188-3196
    DOI: 10.1111/jocn.12565
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    References listed on IDEAS

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    1. Natalie Pattison & Susan M Carr & Chris Turnock & Shelley Dolan, 2013. "‘Viewing in slow motion’: patients', families', nurses' and doctors' perspectives on end‐of‐life care in critical care," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(9-10), pages 1442-1454, May.
    2. Hoi Un Yu & Sally Chan, 2010. "Nurses’ response to death and dying in an intensive care unit – a qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(7‐8), pages 1167-1169, April.
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    Cited by:

    1. Melissa J Bloomer & Ruth Endacott & Kristen Ranse & Maureen A Coombs, 2017. "Navigating communication with families during withdrawal of life‐sustaining treatment in intensive care: a qualitative descriptive study in Australia and New Zealand," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(5-6), pages 690-697, March.

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