End-of-Life Care: Registered Nurses' Experiences in ICU - NURS 3046

This report explores the experiences, beliefs, and coping strategies of registered nurses providing end-of-life care to patients and their families in intensive care settings. It highlights the demanding yet potentially rewarding nature of this work, emphasizing the importance of emotional intelligence and support for nurses dealing with patient loss and grief. The report discusses the nurses' roles in building therapeutic relationships, managing emotional labor, and providing comfort and support to both patients and their families. It also reflects on how this knowledge can influence clinical practice for newly qualified registered nurses, promoting evidence-based care and integrating national and international standards. The research underscores the need for ongoing education, training, and support to equip nurses with the skills and resilience required to navigate the complexities of end-of-life care effectively.

Recommendations to address gaps in
clinical practice, education, research
The Literature has studied about the various causes of the increasing
growth of deaths in Australia. However, there remains a gap in the
literature that there are no evidences and proof where it can be identified
that where are the remedies to the growing rates of death that is taking
place due to fatal diseases in Australia. Therefore, there are no such
evidences that support the implementation interventions to reduce the
rate of fatal diseases from the populations.
Background
For providing the end of life care to the patients, who are dying are in the huge demand of nurses. However the hospice and
the palliative care of the nurses have received the support of the organizational and the emotional for coping with the death
and grief of the family of the patients. However there are huge lack in the support of the nurses in the intensive care units. If
there is a proof about the cause of the stress, burnouts that affect the work performance and the optimal care of the patients
(Coetzee & Klopper 2010; Yoder 2010). ). Clinicians who experience burnout are more likely to depersonalize their patients,
such as referring to them as their disease (Bauer-Wu & Fontaine 2015)
Relevance and significance of the problem
Death is the critical form of situation that occurs at any of the situation that takes place majorly in the neonatal units, the
intensive care units, the emergency departments, the emergency departments and in the community (Kain 2013; Hinderer
2012). The registered nurses are always available for providing the best possible care for the patients who are deteriorating
with every passing day. The patients can be of any age and the nurses engage in building some sort of therapeutic
relationships with the families of the patients (NMBA 2016; van der Riet, Pitt & Blyton 2014).
Various extensive researches have been taken place based on the experiences of the patients who are approaching their death
and the mental conditions of the ailing patients (Hinderer 2012). However, it is a less known fact that how these nurses takes
care of these patients and make them realize about their actual conditions and gives them resilience to sustain their condition.
Moreover, they tend to support the family of the patients and gives them mental strength to adjust to the situation (van der
Riet, Pitt & Blyton 2014).
Research question
What are nurses’ experiences, beliefs and coping strategies when providing end-of-life care for patients and their families in
the intensive care setting?
Five Key Messages
• These nurses have to find the reward for providing care for the dying persons that at last can be created by the
positive environment for the patients and the relatives of them (Bailey, Murphy, & Porock,, 2011).
• Nurses in the emergency care has been established for the expertise by providing care in the three stages that included the
self-investment in the relationships of the nurse and the patient, the emotion impact and the management and the
emotional expertise development (Katherine, 2012)
• Nurses who are in charge of the care home are very much interested in the maintaining their good patient and the nurse
relationship so that it can provide a positive environment around the dying and death patient. Nurses are taking ton his
intensive care as an opportunity and providing good care to dying and death patients (King,& Thomas, 2013).
• The nurses have been giving care to the patients who are in critical conditions and in intensive care units (Ranse, Yates, &
Coyer, 2012)
• Nurses can become visionaries who will be practising and making efforts for rendering peaceful deaths in the ICU
environments
Implement and disseminate your results for relevant target
audiences
For the Patients
The nurses who given the primary care to the patients have developed their expertise in the areas of end to end life.
It commonly follows through the three major stages that include the investments in the relationships between the
nurse, patients and the management. The outcome of the study also mentions that there exist emotional aspects for
the deaths. They try to give the patients who are in the intensive care units the best possible care to fight for their
lives.
For the family of the dead patients
The nurses who are involved in giving critical care have made efforts for making the investments in themselves
that are based on the learning of the several forms of the therapeutic practices that basically manages the emotional
labor that are related to the dying patients and also for their own members of the family. The nurses who tend to
invest for the investment in the therapeutic investments that are more likely to achieve a higher rate of success in
the creation of the positive form of relationships with the patients and their family members.
Your Name/ID here
IMPORTANCE OF REGISTERED NURSES
Your 4 Primary Research References
Bailey, C., Murphy, R. & Porock, D., 2011,
'Professional tears: developing emotional
intelligence around death and dying in emergency
work' Journal of clinical nursing, 20(23‐24),
pp.3364-3372.
Katherine A. Hinderer, 2012, 'Reactions to Patient
Death The Lived Experience of Critical Care
Nurses''DIMENSCRIT CARE NURSE, 31(4),
King, P.A. & Thomas, S.P., 2013,
'Phenomenological study of ICU nurses’
experiences caring for dying patients' Western
Journal of Nursing Research, 35(10), pp.1292-
1308.
Ranse, K., Yates, P & Coyer, F., 2012, 'End-of-life
care in the intensive care setting: a descriptive
exploratory qualitative study of nurses’ beliefs and
practices.Australian Critical Care, 25(1), pp.4-12.

Part B (500 words approx) 2017 v1
Reflect on your learning in Nursing Project. Describe how you think this knowledge could influence your clinical practice as a newly qualified Registered Nurse. Write in 3rd
person and use references from the course, as relevant.
The proximal form of reality with the death of patient is typically very difficult for the patients and their families. These are the choices may have a quality-of-life dimension. Nurses are frequently in a position to provide guidance for patients and
families confronting difficult decisions and adapting to painful realities (Efstathiou & Walker, 2014).
It is very much common for the patient’s death to follow the withdrawal of the potentially life-of the prolonging therapies. There is no form of the ethical, legal and moral difference for stopping the therapy and it can never starting it. Providers should
not be able to never start the therapies that are not willing to discontinue (Efstathiou & Walker, 2014). A decision about the care at the end of a person’s life is often involved in the quality of the considerations of life. The nurses are always to be
obligated for providing the effective care that generally includes the various promotion of the comfort, the relief of pain and the other symptoms, and the support for the patients, the families, and the others who are close to the patient and their families.
Throughout the effectual position of the statement, the term “family” includes all those factors and people who are linked by the biological phenomenon or the affection. Family is the sole to the patients. Something if ill happens with the patients, the
main effect goes to the family of the patient (King,& Thomas, 2013). While the nurses should make every effort for providing the aggressive form of symptom of the management at the end of life, it is never possible ethically for the permissible for a
nurse to act by the omission or the commission, including, but not limited to, medication administration, with the intention of ending a patient’s life. Standards for the excellent form of care for the patients at the end of life should be always evidence
based, and should always integrate the national and the international standards of care that are given by the nurses.
However, being a registered nurse it is the duty of the nurses to channelize the other nurse and train them that how they can provide proper help to the obese patients. They have derived from various test, that the best way to treat the obese patients with
the help of behavior modification. However, if the patient is going through some problems like that of that depression and they binge eat due to depression the best way to treat them is through the method of cognitive behavioral therapy. Therefore, by
making the nurses aware of the various techniques there can be a surety that the patients who are suffering from problems due to obesity can be cured.

Reference List
Bailey, C., Murphy, R. & Porock, D., 2011, 'Professional tears: developing emotional intelligence around death and dying in emergency work' Journal of clinical nursing, 20(23‐24), pp.3364-3372.
Bauer-Wu, S & Fontaine, D 2015, ‘Prioritizing Clinician Wellbeing’ Global Advances in Health and Medicine, vol. 4, no. 5, pp. 16-22.
Boerner, K., Burack, O.R., Jopp, D.S. and Mock, S.E., 2015, Grief after patient death: Direct care staff in nursing homes and homecare. Journal of pain and symptom management, 49(2), pp.214-222.
Coetzee, S. & Klopper, H 2010, ‘Compassion fatigue within nursing practice: a concept analysis’. Nursing and Health Studies, vol. 12, no. 2, pp. 235–243.
de Boer, J., van Rikxoort, S., Bakker, A.B. and Smit, B.J., 2014, Critical incidents among intensive care unit nurses and their need for support: explorative interviews. Nursing in critical care, 19(4),
pp.166-174.
Efstathiou, N & Walker, W 2014, ‘Intensive care nurses’ experiences of providing end-of-life care after treatment withdrawal: a qualitative study’, Journal of Clinical Nursing, vol. 23, pp. 3188-3196.
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Hinderer, KA 2012, 'Reactions to patient death: the lived experience of critical care nurses', Dimensions of Critical Care Nursing, vol. 31, no. 4, pp. 252–259.
Kain, V 2013, ‘An exploration of the grief experiences of neonatal nurses: A focus group study’. Journal of Neonatal Nursing, vol. 19, pp. 80-88.
Katherine A. Hinderer, 2012, 'Reactions to Patient Death
King, P.A. & Thomas, S.P., 2013, 'Phenomenological study of ICU nurses’ experiences caring for dying patients' Western Journal of Nursing Research, 35(10), pp.1292-1308.
Nursing and Midwifery Board of Australia 2016, Registered Nurse Standards for Practice, NMBA, Canberra, viewed 23 February 2017
http://www.nursingmidwiferyboard.gov.au/search.aspx?q=Registered%20Nurse%20Standards%20for%20Practice
Ranse, K., Yates, P & Coyer, F., 2012, 'End-of-life care in the intensive care setting: a descriptive exploratory qualitative study of nurses’ beliefs and practices.Australian Critical Care, 25(1), pp.4-12.
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