Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Back to contents page
AN EXPLORATION OF ICU NURSES PERCEPTIONS AND
EXPERIENCES OF PROVIDING END OF LIFE CARE
Author: Paula Ince RGN, Dip.M, PG Dip.N (ICU/CCU), MSc in N.
CNMII ICU, Hermitage Medical Clinic, Old Lucan Road, Dublin 20.
Address: 290 Duncreevan, Courtown Park, Kilcock, Co. Kildare.
Tel: 01-6103913, Email: maula74@hotmail.com.
Literature Review: According to the International Council of
Nurses (2000) the primary responsibility of nurses is to provide
good end of life care for their patients. E.O.L.C. is a topic that
appears frequently in nursing literature but is never defined.
Intensive care nurses are concerned with the quality of dying,
human relationships and being a good advocate for their patient
(Beland and Froman, 1995). A good death was defined by the
Institute of American Medicine (1997:4) as:
“one that is free from avoidable distress and suffering for
patients, families and caregivers; in general accord with
patients’ and families’ wishes; and reasonably consistent
with clinical, cultural and ethical standards.”
Several authors have defined what a ‘good’, ‘quality’ or ‘peaceful’
death is (Asch et al, 1997; Rittman, Rivera, and Godown, 1997;
Steinhauser et al, 2000 and Yang and Mcilfatrick, 2001) even
though it appears, neither has suggested how to provide good
E.O.L.C. in ICUs.
Recent research shows that care of the dying patient receives poor
attention in nursing degree programmes and in ICU course
curriculum and only recently has published articles in critical care
literature (Nelson-Marten, Braaten and English, 2001). According to
Moss et al (2005) it can be difficult for professionals who have been
educated in the intensive care behaviour of saving lives, to aid
patients to die comfortably. Chapple (1999) suggested the reasons
that E.O.L.C. in the ICU is so difficult are because the healthcare
team do not have proper guidelines and protocols. The ICU has a
standard of care for almost any clinical diagnosis, procedure or
emergency response however for E.O.L.C. standardised protocols
and policies have not been adopted.
As mentioned in the previous chapter there are many discrepancies
in the literature with E.O.L.C. These include family dynamics,
cultural differences, ethical problems and poor pain management.
- 426 -