Providing end of life care in the emergency department: A hermeneutic phenomenological study

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care Pub Date : 2024-02-02 DOI:10.1016/j.auec.2024.01.002

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引用次数: 0

Abstract

Background

Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the emergency department.

Methods

A hermeneutic phenomenological study was conducted in 2021, using semi-structured interviews with seven registered nurses across two hospital emergency departments in Queensland, Australia. Thematic analysis of participants’ narratives was undertaken.

Findings

Seven registered nurses were interviewed; six of whom were women. Participant’s experience working in the emergency department setting ranged from 2.5–20 years. Two themes were developed through analysis: (i) Presenting the patient as a dying person; and (ii) Mentalising death in the context of the emergency department.

Conclusions

Nurses providing end of life care in the emergency department draw upon their personal and aesthetic knowing to present the dying patient as a person. The way death is mentalised suggests the need to develop empirical knowing about ageing and supportive medical care and ethical knowing to assist with the transition from resuscitation to end of life care. Shared clinical reflection on death in the emergency department, facilitated by experts in ageing and end of life care is recommended.

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在急诊科提供临终关怀：诠释学现象学研究

背景注册护士表示，在急诊科提供临终关怀具有挑战性。研究目的是了解注册护士在急诊科为老年人提供临终关怀服务的感受。方法在 2021 年进行了一项诠释学现象学研究，在澳大利亚昆士兰州的两家医院急诊科对七名注册护士进行了半结构化访谈，并对参与者的叙述进行了主题分析。研究结果七名注册护士接受了访谈，其中六名为女性。参与者在急诊科的工作经验为 2.5-20 年不等。通过分析提出了两个主题：(i) 将病人作为临终者；(ii) 在急诊科环境中将死亡心理化。死亡心理化的方式表明，有必要发展有关老龄化和支持性医疗护理的经验知识和伦理知识，以协助从复苏到生命末期护理的过渡。建议在老龄化和临终关怀专家的协助下，在急诊科共同对死亡进行临床反思。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australasian Emergency Care Nursing-Emergency Nursing

CiteScore

3.30

自引率

5.60%

发文量

审稿时长

37 days

期刊介绍： Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.