Emotional and Psychological Experiences of Nursing students caring for Dying Patients: A phenomenology study at Mulago National Hospital, Uganda

Asha K. Nabirye, I. Munabi, A. Mubuuke, Sarah Kiguli
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Abstract

Abstract Introduction: Caring for dying patients is associated with psychological trauma, strong emotions and enormous stress for nursing staff and nursing students who are relied on by patients and relatives in such difficult situations. Although nurses have an ability of self-control and calm approach towards death, there are still some emotions they need to “work through”. Research studies have documented limited exposure of nursing students to end-of-life care and inadequate understanding of the psychological and emotional experiences they encounter during clinical placements. This study explored the psychological and emotional experiences of Ugandan student nurses on caring for the dying patients at Mulago national referral hospital during clinical placement. Methods A qualitative phenomenological study was conducted among fifteen undergraduate nursing students of Makerere University in clinical placement at Mulago hospital. An In-depth interview guide was used to gather data on nursing students’ emotional and psychological experiences and coping mechanisms. Data was audio recorded, verbatim transcribed and thematically analyzed using Atlas. ti version 6 software. Results The nursing students emotional and psychological experiences when caring for dying patients were emerged into two themes; (1) Psychological and emotional reactions, (2) Coping mechanisms. The sub themes were; anger, anxiety and depression which is triggered by a combination of issues of pressure from relatives, failure to save the dying patient, thoughts of wasted efforts to reverse the dying process, limited resources, limited technical and emotional support. The students cope by seeking help from peers, engagement in problem solving, distancing from patients, spirituality and engaging in personal stress reducing activities. Conclusion Insights from this study provide educators with a snapshot of student encounters, emotions, and coping strategies when facing dying patients and their families. Nursing students experience various negative emotional and psychological stressors triggered by a combination of issues that need to be addressed during care of dying patients. However, they devise different coping mechanisms to continue with provision of necessary end of life care as the clinical placement contributes to their learning, experience and builds confidence among student nurses.
护理临终病人的护理学生的情感和心理体验:乌干达穆拉戈国立医院的现象学研究
摘要 引言:护理临终病人会给护理人员和护理专业学生带来心理创伤、强烈的情绪和巨大的压力,因为在这种困难的情况下,他们是病人和亲属的依靠。虽然护士有能力自我控制并冷静地面对死亡,但仍有一些情绪需要 "克服"。有研究表明,护理专业学生接触临终关怀的机会有限,对他们在临床实习中遇到的心理和情绪体验了解不足。本研究探讨了乌干达护理专业学生在穆拉戈国家转诊医院临床实习期间护理临终病人的心理和情感体验。方法 对在穆拉戈医院临床实习的 15 名马凯雷雷大学护理专业本科生进行了定性现象学研究。研究采用了深度访谈指南,以收集有关护理专业学生的情感和心理体验以及应对机制的数据。对数据进行了录音、逐字记录,并使用 Atlas.结果 护理学生在护理临终病人时的情绪和心理体验分为两个主题:(1)心理和情绪反应;(2)应对机制。次主题包括:愤怒、焦虑和抑郁,这些情绪是由来自亲属的压力、抢救垂死病人的失败、为扭转垂死过程而白费的努力、有限的资源、有限的技术支持和情感支持等问题共同引发的。学生们通过向同伴寻求帮助、参与解决问题、与病人保持距离、灵修和参与个人减压活动来应对。结论 本研究为教育者提供了学生在面对临终病人及其家属时的遭遇、情绪和应对策略。护理学生在护理临终病人时会遇到各种需要解决的问题,从而引发各种负面情绪和心理压力。然而,他们设计了不同的应对机制,继续提供必要的临终护理,因为临床实习有助于他们学习和积累经验,并为护士学生建立信心。
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