The experiences of Registered Nurses in delivering end-of-life care for vulnerable older adults: an interpretive phenomenological analysis
Year: 2018
Type: dissertation
Abstract: Background \nThe largest numbers of people dying in the UK are over 85. They are more likely to have multi-morbidity and frailty contributing to vulnerability at end-of life. This study critically explores seven registered nurses (RN's) professional experience of delivering end-of-life care for vulnerable older adults. \nMethod \nData was collected using minimally structured interviews. Interpretive Phenomenological Analysis (IPA) was employed and assisted in 'giving voice' to the concerns of these RN's. The RN's were asked to describe a memorable clinical experience(s) of end-of-life care involving vulnerable older adults with frailty. This approach was designed to provide focus and to elicit their experiences grounded in clinical practice. \nConsistent with the philosophical approach of IPA, the RN's individual experiences were analysed descriptively, conceptually and linguistically. They were subsequently combined to elicit their shared experiences. A review of the literature concerning the experiences of delivering end-of-life care was subsequently interwoven with the findings of this study. Finally to deepen the analysis, their stories were interpreted using the theoretical frameworks of comfort theory, awareness and temporal aspects of dying, and knowledge-in-practice-in-context. A section on reflective practice concludes this discussion. \nFindings \nMuch of the RN's experiences are not novel. The overarching shared experience is that memorable clinical dying and death experiences are imbued with 'emotional work'. This is underpinned by the common themes of 'knowing' and 'doing'. \nFacilitation of the good enough death involved awareness of dying, recognising imminent dying and being able to provide comfort for the patient and their loved ones. Barriers involved futile treatments, staff and family's unpreparedness, and inability to provide sustained comfort. \nThe original contribution of this study includes a little gem "older people's deaths are more run of the mill", the problem of a good enough death for whom, and IPA contributing to the development of reflective nursing knowledge and practice.
Author: Denise Shanahan
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2942096155