End-of-life care is a section of palliative care, which delves into patients with life frightening conditions and a life expectancy fewer than 12 months. It is an important care as it helps patients to die peaceably, comfortably, and with dignity (Medical Education, 2013). Critical Care Unit (CCU) nurses experience stressful end-of-life situations due to its fast change from curative care to end-of-life care, and thus, the interventions chosen are of higher significance. Many patients in the CCU are critically ill and cannot plan for their end-of-life care. Hence, CCU nurses are of importance in guiding them and their families through care in the last days of their life. This paper will highlight personal experience with end-of-life situations, identifying the nurse’s emotions during the process and its impacts on nursing practice.
Critical care nurses and hospice staff provide special healthcare services as they ensure care acceleration through effective management of a patient’s symptoms and ensuring all their last wishes are met. Consequently, they calm family members and friends of the patients in their upsetting loss.
As a care professional, I have had many upsetting and uplifting care situations. Seeing parents say goodbye to their offspring is the most upsetting of all the situations I have experienced, especially one instance when a family lost twins from a fatal car crash. It was a sad and challenging moment to see as the mother of two (both dying) watched his sons die. The patients were brought into our facility (Intensive Care Unit) in critical conditions during my shift and they required specialized attention as they were extremely vulnerable. Consequently, we were to offer support to the family, especially the mother who had the most painful situation. The main intention was taking the fear out of death from both the patients and the family, which was not an easy task, especially seeing the mother cursing why that had to happen.
Scholtz et al., (2016) notes that making key decisions, availability of stressful conditions, and ethical quandaries form the basis of end-of-life care, which intensively centers on all the facets of life support and basic nursing care. It, therefore, links the principles of observational and insightful nursing, instinctive interpretation, and quick reaction to every change in the condition of the patient (Price, 2013). Furthermore, the discovered importance of patient-centered care to the provision of quality healthcare further adds up to the existing intellectual and physical challenges experienced by Critical Care Unit nurses. The main requirements of nurses are meeting the patient’s psychological, spiritual, and physical needs, where Critical Care Unit nurses should symbolize the dimensions of the spirit, the body, and the mind to function effectively and holistically within end-of-life working environment.
CCU and ICU nurses are affected by various challenges within their working environment in their attempt to offer quality care to terminally ill patients. The experience they get from the working conditions plays an important role in their desire to maintain their profession. Therefore, an unhealthy work environment for end-of-life care personnel has profound negative effects on the successful retention and recruitment of CCU nurses.
The greatest challenge that I faced from my most affecting experience was dealing with the emotions as it felt to me that I was indeed losing my kids. I came to realize that talking to colleagues was of massive help and it greatly made me forget the situation and mature up to handle other similar scenarios. Many people have believed that end-to-life care is a sad experience. But actually as indicated by Brunault et al., (2014), there exists a great atmosphere and team spirit that positively impacts on the patients, their families, and the staff at the facility (especially our hospital). As such, the situation had a minimal negative impact on my career, and together with the support from colleagues, I am more than happy with my profession.
Brunault, P., Fouquereau, E., Colombat, P., Gillet, N., El-Hage, W., Camus, V., & Gaillard, P. (2014). Do transactive memory and participative teamwork improve nurses’ quality of work life?. Western Journal of Nursing Research, 36(3), 329-345.
Medical Education. (2013). End-of-Life Care | CEU for Nurses | Wild Iris Medical Education | NursingCEU.com. Retrieved from http://www.nursingceu.com/courses/442/index_nceu.html
Price, A. M. (2013). Caring and technology in an intensive care unit: an ethnographic study. Nursing in Critical Care, 18(6), 278-288.
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.