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
Nurses Stress was a common factor in the literature in relation to
E.O.L.C.
After reading through the literature the reality is that patients and
their families who experience a good death in ICU are infrequent.
The literature presented several issues of concern for patients, their
families and health care workers for E.O.L.C. The mains ones
highlighted were family dynamics, cultural differences, ethical
problems and poor pain management. Family dynamics change in
the ICU Families that normally would be united and calm can be
torn apart by the care of their dying loved ones. The literature
suggests that poor communication between patient, families and
medical staff can be the cause of unnecessary conflict. However
other literature states that nurses can be the positive light in
communicating between patient, family and doctors (Jamerson,
Scheibmeir and Bott, 1996).
The literature acknowledges the need for cultural awareness in
order to help with the care of dying patients (Le Var, 1998; Giger
and Davidhizar, 1999 and ERHA, 2003). Education and training is
important in this area although Joye (2003) stated that in Ireland
this has been introduced recently in the nursing curriculum. There is
a large percentage of the literature regarding E.O.L.C. which
pertains to ethical issues. Chelluri and Grenvik (1995) identified
nurses find ethical decisions difficult to make, as they were
educated to use the necessary treatment to prolong life. Although
Scanlon (1997) had stipulated that nurses have helped to solve
these issues and give holistic E.O.L.C. According to the literature,
pain management was highlighted as one important factor in
providing good E.O.L.C. (Rocker and Dunbar, 2000), although it still
remains poorly managed. The literature also shows how dealing
with E.O.L.C. in ICU can cause stress and burnout for nurses.
Despite the prevalence of E.O.L.C. literature, there is a lack of
research specifically related to experiences and perceptions of
intensive care nurses in this area. The researcher believes a better
understanding of ICU nurses experiences and perceptions of their
knowledge, beliefs and ethical concerns relating to practices in
caring for dying ICU patients is essential in order to improve nursing
practice in ICUs. Due to this challenge and the need to improve
treatment of dying ICU patients this study was undertaken to
assess the knowledge, expertise and thoughts that ICU nurses,
working in the researchers ICU, have in regard to changes that
would facilitate appropriate end of life care.
- 427 -