Candlelight Guides the Way Through Winter's Chill: A Meta-Ethnography of Critical Care Nurses Supporting Bereaved Families in Intensive Care Units.

Abstract

Aim: To synthesise evidence on critical care nurses supporting bereaved families in intensive care units (ICUs).

Design: Noblit and Hare's meta-ethnography approach.

Methods: We followed Noblit and Hare's 7-phase procedure, using reciprocal translation for data analysis and line-of-argument synthesis. We included studies on registered nurses in adult ICUs with experience supporting bereaved families, using qualitative or mixed-methods studies in English and published in peer-reviewed sources.

Data sources: Five databases were searched without date restrictions, concluding in January 2024.

Results: The final sample included 24 studies published between 1995 and 2023. The metaphor "Candlelight guides the way through winter's chill" symbolised the crucial role of critical care nurses in supporting bereaved families in ICUs. The synthesis encapsulated two themes: (1) challenges in providing bereavement support, with subthemes of emotional intricacies in bereavement support, and ICU setting limitations; and (2) optimising families' bereavement experiences, with subthemes support systems and emotional commitment, professional nursing behaviours and care practices, and curating personalised and meaningful farewell experiences.

Conclusions: Bereavement support in ICUs poses significant challenges, highlighting the need for greater support for critical care nurses. Nonetheless, these nurses draw on support systems and emotional dedication to overcome obstacles, striving to optimise families' bereavement experiences.

Implications for the profession and/or patient care: Our findings highlight the importance of structured training programmes (peer support and emotional management) and systemic improvements (optimised workflows and adequate staffing) to enhance quality bereavement care.

Impact: This study interprets critical care nurses' experiences supporting bereaved families in intensive care, highlighting the emotional demands. The findings offer insights into improving end-of-life and bereavement care practices and policies, benefiting nurses and families.

Reporting method: This review followed the ENTREQ guidelines for reporting meta-ethnography.

Patient or public contribution: There was no patient or public contribution, as the data were drawn from previously published studies.

Trial registration: CRD42024506847 [PROSPERO].