Intensive care nurses’ perceptions of ‘good’ end-of-life care for the adult patient who has had treatment withdrawn or withheld: A North Island non-metropolitan ICU nursing study.
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Other Title
Authors
Hine, Catherine
Author ORCID Profiles (clickable)
Degree
Master of Nursing
Grantor
Eastern Institute of Technology
Date
2006
Supervisors
Marshall, Bob
Vernon, Rachael
Vernon, Rachael
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
North Island (N.Z.)
New Zealand
intensive care nurses
intensive care units (ICU)
death and dying
end of life care
perceptions
barriers
surveys
New Zealand
intensive care nurses
intensive care units (ICU)
death and dying
end of life care
perceptions
barriers
surveys
ANZSRC Field of Research Code (2020)
Citation
Hine, C. (2006). Intensive care nurses’ perceptions of ‘good’ end-of-life care for the adult patient who has had treatment withdrawn or withheld: A North Island non-metropolitan ICU nursing study. (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Nursing). Eastern Institute of Technology (EIT), New Zealand.
Abstract
Intensive care is a place for the critically ill. It is a place of advanced technology where alarms, lights and noise are plentiful and where privacy and dignity are not always able to be given the highest priority. ICUs are places catering for the most acutely unwell patients, a number of these patients do not recover. A percentage of those patients who die, do so after extensive discussions, when treatment is withdrawn or withheld. The focus turns from cure to comfort for the patient and their family. Providing a ‘good’ death for the adult patient who has had treatment withdrawn or withheld is a challenge in an environment where the emphasis is on cure.
I designed a questionnaire to investigate nurse’s perceptions of ‘good’ end-of-life care. Nurses in eight ICUs who worked at the bedside were requested to numerically rank 10 important end-of-life issues as they perceived to be most important for the patient, family and themselves. The nurses were then asked to rank those same issues for how well the unit they work in performs. Some open-ended questions were also asked to combine the qualitative approach with the quantitative, to add richness to data.
Results showed the top four issues nurses perceived to be most important when providing ‘good’ end-of-life care was the administration of medication for analgesia and symptom relief, preservation of the patient’s dignity, maintaining open communication channels for the patient, family and health care team and unlimited family visiting. Featuring consistently last was the documentation of an alternative care plan based on maximising patient comfort and attention to environmental issues.
It appears generally end-of-life care in non-metropolitan ICUs is done reasonably well. Barriers to providing ‘good’ end-of-life care documented by nurses in this study are similar to results from nurses who have studied similar themes overseas.
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