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How ICU And ER Nurses Deal with the Death of a Patient

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How ICU And ER Nurses Deal with the Death of a Patient

Introduction

It is a natural path of nursing practice to face issues related to death and dying, but it

does not mean that it is easy to cope with it. For many nurses, facing such a scenario is a

challenging thing in their career. Nurses have to face such difficulties daily, which has led to

the rise in the enquiry for curriculums that can cover the strategies that are applied in coping

with the issue of death and dying. It is unfortunate that many curriculums only focus on a

nurse passing the examinations. This paper focuses on recent studies on how ICU and ER

nurses deal with the death of a patient. The paper provides an in-depth bibliography of

several studies on the topic as well a thematic literature review based on two specific themes;

theoretical content and emotional impact on the nurses.

Literature Review

The first theme that we will focus on is the culture of the work environment of ICU

and ER nurses. Scholtz et al. (2016) focus on the critical care unit environment to understand

the critical care nursing culture. The authors chose an ethnographic study design which is a

qualitative method of research to find more about the ICU nursing environment. The chosen

study design coincides with the post-modern constructivist philosophy of science. The study

finds out that the culture of a nursing environment represents an all-inclusive environment.

The authors further conclude that the patterns of behaviours and interactions in critical care

units have led to the rise of the urge to change the ICU and ER culture.

Another theme we focus on is the emotional impact of how nurses' deal with the death

of dying patient. (Anderson et al. 2015) showed that nurses' day to day life, exposure to

patients at the verge of dying or death of a patient is not evitable. The individual nurse

encountering starts to worry about his or her death arising to being nervous and uneasy. It

may result in affecting the working ability by avoiding attendance to a patient at a critical
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state that may result in death. Showed how anxiety caused by the death of a patient impacts

the nurse. Negative emotions are generated on the sight of a dead patient, fear of attending to

a dying patient and therefore necessitates the need for education to address emotional

impacts.

Annotated Bibliography

Sibiya, M. N., & Naidoo, V. (2014). Experiences of critical care nurses of death and dying in

an intensive care unit: a phenomenological study. Journal of nursing & care (Los

Angeles, Calif.).

Sibiya and Naidoo (2014) explore the experiences of nurses in the critical care of

death and dying patients which is also the aim of the research. The authors use a descriptive

phenomenological qualitative method to come up with the study. The authors researched after

they obtained approval from Durban University of Technology Faculty Committee, the

nursing service manager of the participating healthcare centre, and eThekwini District Health

Research Unit. The authors studied a population that comprised of nurses who work in

Intensive Care Units (ICUs) of the participating medical centres. It is very traumatizing for

several nurses to work in an ICU. They are mostly exposed to repeated experiences of death

and dying because they are always responsible for taking care of patients in critical

conditions and maybe on a terminal sickness or impending death. The authors explain how

the nurses relate with different experiences of the happenings in their field of service. The

authors found out that ER and ICU nurses find it hard coping up with caring for patients in

such critical conditions, especially when the patient has a blood relationship. The researchers

find out that it is essential in nursing education to learn issues like communication, coping

mechanism and multicultural diversity in the care for critically ill patients. They conclude

that ICU nurses should have support networks in place to cope with the nature of their work.
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Zheng, R., Lee, S. F., & Bloomer, M. J. (2018). How nurses cope with patient death: A

systematic review and qualitative meta‐synthesis. Journal of clinical nursing, 27(1-2),

e39-e49. https://doi.org/10.1111/jocn.13975

The authors intend to audit writing on nurses' adapting procedures to patient death by

utilizing an efficient survey configuration Dealing with the departure of a patient was seen as

one of the most requesting and testing experiences in clinical practice. Those nurses who are

not skilled in adapting to patient death might be lacking in supporting passing on patients and

their relatives, and limit the nature of end-of-life care. To get a more extensive

comprehension of how nurses adapt to patient death and to create essential and powerful

mediations, an orderly survey which would help support the multidimensional methodologies

is required. The technique utilized included Exhaustive looking into ten different databases.

The creators utilized the orderly audit total of ten classes from the sixteen subjective

investigations included, and afterwards, two incorporated discoveries were inferred: intrinsic

resources and extrinsic resources. The genetic resources comprised of defining limits,

reflection, crying, death convictions, life and work insight, and everyday schedules and

action. The extraneous resources were contained talking and being heard, profound practices,

instruction and projects, and questioning. The analysts reasoned that nurses need more help

assets, which better help them in adapting to patient death.

Wu, T. W., Oliffe, J. L., Bungay, V., & Johnson, J. L. (2015). Male ICU nurses' experiences

of taking care of dying patients and their families: A gender analysis. American

journal of men's health, 9(1), 44-52.

The authors choose to specifically talk about male emergency unit nurses who carry

energy and aptitude alongside a variety of convictions and practices to their work

environment. This article researches the encounters of male ICU nurses with regards to

thinking about passing on patients and their families. Applying a sex examination, refined are
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bits of knowledge to how masculinities illuminate and impact the members' practices and

adapting systems. The discoveries uncover members draw on manly standards of being a

defender and balanced in their definitive activities toward meeting the solace needs of biting

the dust patients and their families. Somewhat oddly, most members likewise violated manly

standards by apparently communicating their sentiments and discussing feelings identified

with these encounters. Members additionally revealed restored enthusiasm for their life and

their families and numerous men chronicled recreational exercises and social connectedness

as systems for adapting to working environment-initiated stresses. The discoveries drawn

from this examination can direct both formal and casual help administrations for men who are

ICU nurses, which like this may help the maintenance of this subgroup of labourers.

Rafii, F., Nikbakht Nasrabadi, A., & Karim, M. A. (2016). End‐of‐life care provision:

experiences of intensive care nurses in Iraq. Nursing in critical care, 21(2), 105-112.

This investigation looked to investigate the significance of thinking about at death's

door patients from the point of view of Kurdish ICU nurses by the utilization of Van Manen's

(1990) hermeneutic phenomenological plan. Nurses assume a vital function in considering

the fundamentally sick in the emergency unit). The physical, mental, enthusiastic and

profound private consideration given by Kurdish nurses permits them to build up a remedial

relationship with at death's door patients in the ICU. The information was gathered through

inside and out semi-organized meetings with a purposive example of 10 nurses working in

ICUs. Meetings were interpreted lastly investigated by Van Manen's strategy. Results

indicated that four significant subjects including enthusiastic work, death as a positive

measurement, hopeful instead of pointless consideration and working inside imperatives

arose. The creators inferred that Kurdish nurses in their conscious experiences within critical

condition patients encountered a scope of sentiments from emotional strain to being idealistic

while working inside restricted assets in the ICU.

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Further exploration is expected to investigate the encounters of nurses with different

societies of thinking about at death's door patients in ICUs. Importance of the examination to

rehearse is that finish of-life care in ICU is sincerely testing. Accordingly, nurses in this

setting require mental and otherworldly.

Anderson, Natalie & Kent, Bridie & Owens, Glynn. (2015). Experiencing patient death in

clinical practice: Nurses' recollections of their earliest memorable patient death.

International journal of nursing studies. 52. 695-704.

https://doi.org/10.1016/j.ijnurstu.2014.12.005

A nurse's first encounter with a dying patient or any cause of death affects the nurse's

intellectual, emotions and medical-related challenges. However, such experiences will be part

and parcel of a nurse's life. This author's work gives the outcomes of a furthered research

work that had been conducted earlier, hence gives a deeper understanding of the death and

dying nurses' encounters. This phase researched New Zealand nurses' first and unforgettable

experiences with dying patients. The research employed the use of samples of self-

volunteering new- Zealand registered nurses with a driven purpose, one on one partially

structured interviews were used. Interpretative Phenomenological Analysis (IPA) was used to

look to comprehend the responses of interviewed persons' encounters. An investigation based

on topics was attempted to distinguish arising subjects, with interviewed person's' own words

utilized as topic headings, where their expressions gave brief or incredible descriptors. The

results of assorted participant groupings of twenty, presently rehearsing, New Zealand

enlisted medical caretakers gave rich and definite portrayals of their unforgettable vital

involvement in patient passing. Seven eminent topics and highlights of better, or negative

encounters were recognized: Event Significance; Emotional Challenges; Sharing the

Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits. The
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conclusion reached upon showed participants in this investigation, had ample proof that their

patient demise was a monumental occasion and unforgettable.

Ahwal, Sarita & Arora, Smriti. (, 2015). Workplace Stress for Nurses in the Emergency

Department. International Journal of Emergency and Trauma Nursing. 1. 17-21.

This paper portrayed Emergency Departments (ED) as high-stress conditions grasping an

assortment of intense upsetting occasions. Rehashed introduction of ED staff to unpleasant

occasions, for example, abrupt demise, injury, patients in torment, revival, hostility and

savagery may prompt a negative impact on their physical, mental and passionate wellbeing.

Work pressure may add to non-appearance and high turnover, which thus influence persistent

results. The lion's share of the staff gets lacking help from medical clinic overseers following

the horrible episode. Directors are essential in the decrease and the board of pressure at work.

Chiefs should start measures to perceive stressors for the ED staff and redesign the work to

limit pressure among labourers.

The creators inferred that crisis division attendants are presented to an assortment of expert

pressure that unquestionably influences their work and wellbeing. Procedures should be

figured to rearrange the work in a manner to ease the physical and mental stressors of the ED

staff. This would help in channelizing their endeavours towards giving quality consideration

to the patients and improve the maintenance of medical caretakers in their clinical regions.

The overseers ought to direct periodic wellbeing evaluations for both physical and mental

elements of wellbeing. Intercessions to help chiefs create viable practices are needed to help

decrease and oversee pressure at work.

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Croxon, L., Deravin, L., & Anderson, J. (2018). Dealing with the end of life—New graduated

nurse experiences. Journal of clinical nursing, 27(1-2), 337-344.

https://doi.org/10.1111/jocn.13907

This paper writes about a subjective interpretative investigation with information

gathered in seven semi‐structured interviews. A primary thought for nurses being taken care

of by individuals with life‐limiting sickness is the degree of their groundwork for this region

of training. Nurses should know about a large number of exacerbating components that will

impact how and where the individual is thought about. Regardless of massive writing about

how to give the end of life schooling to undergraduate nurses, there is minimal in the writing

that investigates the encounters of new graduate nurses. Members were welcome to be met

with an online mail‐out to Alumni who had graduated between 1–2 years sooner. A topical

examination of the meetings was then directed. Four subjects rose out of the topical

examination of the meetings. These were; the part of the new graduate in palliative

consideration, the groundwork for palliative consideration in undergraduate nursing

educational plans, availability for managing death and dying, and holes in instructive

preparation. While palliative consideration is seen as a significant part of undergraduate

nursing training, it is perceived as a zone of training that undergraduate nurses feel they are

not sufficiently ready for. This investigation distinguishes the need to fuse aptitudes, for

example, having discussions and discussing viably with patients and families encountering

the end of life issues. Graduate nurses feel they are not sufficiently ready for the end of life

care, which shows the requirement for the quality finish of life care training in undergraduate

nursing education programs.

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Zheng, R., Lee, S. F., & Bloomer, M. J. (2016). How new graduate nurses experience patient

death: A systematic review and qualitative meta-synthesis. International journal of

nursing studies, 53, 320-330. https://doi.org/10.1016/j.ijnurstu.2015.09.013

The authors' point is, to sum up, new graduate nurses' involvement in patient death by

inspecting the discoveries of existing subjective investigations utilizing efficient audit

techniques fusing meta-amalgamation were utilized. Patient death is an emotional and

requesting experience for nurses, particularly for new graduate nurses who are ill-equipped to

convey end-of-life care. Seeing new graduate nurses' insight of death and dying will educate

the plan regarding preparing projects and mediations for enhancements like care and backing

of new graduates. The system applied an extensive inquiry led in 12 information bases from

January 1990 to December 2014. All subjective and blended technique concentrates in

English and Chinese that investigated new graduate nurses' insight into patient death was

incorporated. Two free commentators chose the investigations for incorporation and surveyed

each examination quality, and a meta-conglomeration was performed to blend the discoveries

of the included investigations. The outcomes demonstrated five essential subjective

investigations and one blend technique study met consideration and quality models. Six key

subjects were recognized from the first discoveries: enthusiastic encounters, encouraging a

decent death, uphold for family, insufficiency on finish of-life care issues, individual and

expert development and adapting techniques.

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References

Anderson, Natalie & Kent, Bridie & Owens, Glynn. (2015). Experiencing patient death in

clinical practice: Nurses' recollections of their earliest memorable patient death.

International journal of nursing studies. 52. 695-704.

https://doi.org/10.1016/j.ijnurstu.2014.12.005

Scholtz, S., Nel, E. W., Poggenpoel, M., & Myburgh, C. P. (2016). The culture of nurses in a

critical care unit. Global Qualitative Nursing Research, 3, 2333393615625996.

https://doi.org/10.1177/2333393615625996