Volume 3, Issue 1 (Winter 2016 -- 2017)                   JCCNC 2017, 3(1): 3-10 | Back to browse issues page

XML Print

1- Head of Continuous Professional Development, General Directorate of Erbil Health, Ministry of Health, Kurdistan Region Iraq, Iraq.
2- PhD Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
3- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:   (502 Views)

Background: As members of the health care team in Intensive Care Units (ICUs), nurses play a vital role in caring for critically ill patients. The demands of caring in such an environment put the nurses under huge pressure, especially when their patients die. This qualitative study explores the feelings and experiences of Kurdish intensive care nurses providing care for dying patients in the ICU. 
Methods: This qualitative study used inductive content analysis. The data were collected through in-depth semi-structured interviews with a purposive sample of 10 Kurdish registered nurses working in adult ICUs of Rezgary and Hawler Teaching hospitals (Erbil, Iraq).
Results: Three main categories, including emotional burden, encountering with obstacles, and personal growth emerged. In spite of their emotional burden and also the pressure imposed by heavy workload, the nurses’ personal growth was enhanced by the self-confidence and spiritual satisfaction they acquired by caring for ill and end stage patients and their families. 
Conclusion: Nurses’ religious beliefs and their special cultural background could partly modify their negative feelings and perceptions. However, in the long run, dealing with these pressures and negative environmental and organizational inhibitors could lead to burnout. All potential sources of emotional and psychological burden in these ICUs need to be minimized by appropriate planning. Nurses’ and their special cultural background could partly modify their negative feelings and perceptions.

Full-Text [PDF 528 kb]   (140 Downloads)    
Type of Study: Research | Subject: General
Received: 2016/07/12 | Accepted: 2016/11/27 | Published: 2017/08/20

1. Abdulla, S., et al., 2014. Nurses' attitude toward the care of dying cases in the cardiac center in Erbil city. Zanco Journal of Medical Sciences, 18(2), pp. 763–8. doi: 10.15218/zjms.2014.0030 [DOI:10.15218/zjms.2014.0030]
2. Adams, A. & Bond, S., 2000. Hospital nurses' job satisfaction, individual and organizational characteristics. Journal of Advanced Nursing, 32(3), pp. 536-43. doi: 10.1046/j.1365-2648.2000.01513.x [DOI:10.1046/j.1365-2648.2000.01513.x]
3. Adeb-Saeedi, J., 2002. Stress amongst emergency nurses. Australian Emergency Nursing Journal, 5(2), pp. 19–24. doi: 10.1016/s1328-2743(02)80015-3 [DOI:10.1016/S1328-2743(02)80015-3]
4. Beckstrand, R. L. & Kirchhoff, K. T., 2005. Providing end-of-life care to patients: Critical care nurses' perceived obstacles and supportive behaviors. American Journal of Critical Care, 14(5), pp. 395-403. PMID: 16120891 [PMID]
5. Beckstrand, R. L., Callister, L. C. & Kirchhoff, K. T., 2006. Providing a "good death": Critical care nurses' suggestions for improving end-of-life care. American Journal of Critical Care, 15(1), pp. 38-45. PMID: 16391313 [PMID]
6. Calvin, A. O., Kite-Powell, D. M. & Hickey, J. V., 2007. The neuroscience ICU nurse's perceptions about end-of-life care. Journal of Neuroscience Nursing, 39(3), pp. 143–50. doi: 10.1097/01376517-200706000-00004 [DOI:10.1097/01376517-200706000-00004]
7. Carlson, L. E. & Bultz, B. D., 2003. Benefits of psychosocial oncology care: Improved quality of life and medical cost offset. Health and Quality of Life Outcomes, 1(1), p. 8. doi: 10.1186/1477-7525-1-8 [DOI:10.1186/1477-7525-1-8]
8. Chang, E. M., et al., 2005. Role stress in nurses: Review of related factors and strategies for moving forward. Nursing and Health Sciences, 7(1), pp. 57–65. doi: 10.1111/j.1442-2018.2005.00221.x [DOI:10.1111/j.1442-2018.2005.00221.x]
9. Dunn, K. S., Otten, C. & Stephens, E., 2005. Nursing experience and the care of dying patients. Oncology Nursing Forum, 32(1), pp. 97–104. doi: 10.1188/05.onf.97-104 [DOI:10.1188/05.ONF.97-104]
10. Efstathiou, N. & Clifford, C., 2011. The critical care nurse's role in end of life care: Issues and challenges. Nursing in Critical Care, 16(3), pp. 116-23. doi: 10.1111/j.1478-5153.2010.00438.x [DOI:10.1111/j.1478-5153.2010.00438.x]
11. Elo, S. & Kyngäs, H., 2008. The qualitative content analysis process. Journal of Advanced Nursing, 62(1), pp. 107–15. doi: 10.1111/j.1365-2648.2007.04569.x [DOI:10.1111/j.1365-2648.2007.04569.x]
12. Emami, A. & Nasrabadi, A. N., 2007. Two approaches to nursing: a study of Iranian nurses. International Nursing Review, 54(2), pp. 137–43. doi: 10.1111/j.1466-7657.2007.00517.x [DOI:10.1111/j.1466-7657.2007.00517.x]
13. Espinosa, L., et al., 2010. ICU nurses' experiences in providing terminal care. Critical Care Nursing Quarterly, 33(3), pp. 273–81. doi: 10.1097/cnq.0b013e3181d91424 [DOI:10.1097/CNQ.0b013e3181d91424]
14. Ferrell, B. R., Coyle, N. & Paice, J. 2015. Oxford textbook of palliative nursing. Oxford: Oxford University Press. doi: 10.1093/med/9780199332342.001.0001 [DOI:10.1093/med/9780199332342.001.0001]
15. Frommelt, K. H. M., 2003. Attitudes toward care of the terminally ill: An educational intervention. American Journal of Hospice and Palliative Medicine, 20(1), pp. 13–22. doi: 10.1177/104990910302000108 [DOI:10.1177/104990910302000108]
16. Gélinas, C., et al., 2012. Stressors experienced by nurses providing end-of-life palliative care in the intensive care unit. Canadian Journal of Nursing Research, 44(1), pp. 18-39. PMID: 22679843 [PMID]
17. Hansen, L., et al., 2009. Nurses' perceptions of end-of-life care after multiple interventions for improvement. American Journal of Critical Care, 18(3), pp. 263-71. doi: 10.4037/ajcc2009727 [DOI:10.4037/ajcc2009727]
18. Hays, M. A. et al., 2006. Reported stressors and ways of coping utilized by intensive care unit nurses. Dimensions of Critical Care Nursing, 25(4), pp. 185–93. doi: 10.1097/00003465-200607000-00016. [DOI:10.1097/00003465-200607000-00016]
19. Holloway, I. & Galvin, K., 2010. Qualitative research in nursing and healthcare. New Jersey: John Wiley & Sons.
20. Hov, R., Hedelin, B. & Athlin, E., 2007. Good nursing care to ICU patients on the edge of life. Intensive and Critical Care Nursing, 23(6), pp. 331–41. doi: 10.1016/j.iccn.2007.03.006 [DOI:10.1016/j.iccn.2007.03.006]
21. Keane, A., Ducette, J. & Adler, D. C., 1985. Stress in ICU and non-ICU nurses. Nursing Research, 34(4), p. 231-6. doi: 10.1097/00006199-198507000-00012 [DOI:10.1097/00006199-198507000-00012]
22. Kirchhoff, K. T., et al., 2000. Intensive care nurses' experiences with end-of-life care. American Journal of Critical Care, 9(1), pp. 36-42. PMID: 10631389 [PMID]
23. Kongsuwan, W. et al., 2010. Thai Buddhist intensive care unit nurses' perspective of a peaceful death: An empirical study. International Journal of Palliative Nursing, 16(5), pp. 241–7. Doi: 10.12968/ijpn.2010.16.5.48145 [DOI:10.12968/ijpn.2010.16.5.48145]
24. Kuokkanen, L., Leino-Kilpi, H. & Katajisto, J., 2003. Nurse empowerment, job-related satisfaction, and organizational commitment. Journal of Nursing Care Quality, 18(3), pp. 184–92. doi: 10.1097/00001786-200307000-00004 [DOI:10.1097/00001786-200307000-00004]
25. Lichtman, M., 2012. Qualitative research in education: A user's guide. California: SAGE Publications.
26. McMillen, R. E., 2008. End of life decisions: Nurses perceptions, feelings and experiences. Intensive and Critical Care Nursing, 24(4), pp. 251–9. doi: 10.1016/j.iccn.2007.11.002 [DOI:10.1016/j.iccn.2007.11.002]
27. Messmer, P. R., Jones, S. G. & Taylor, B. A., 2004. Enhancing knowledge and self-confidence of novice nurses: The "Shadow-A-Nurse" ICU program. Nursing Education Perspectives, 25(3), pp. 131-6. PMID: 15301461 [PMID]
28. Moore, Z. & Price, P., 2004. Nurses' attitudes, behaviours and perceived barriers towards pressure ulcer prevention. Journal of Clinical Nursing. 13(8), pp. 942-51. doi: 10.1111/j.1365-2702.2004.00972.x [DOI:10.1111/j.1365-2702.2004.00972.x]
29. Naidoo, V., 2014. Experiences of critical care nurses of death and dying in an intensive care unit: A phenomenological study. Journal of Nursing & Care, 3(4). doi: 10.4172/2167-1168.1000179 [DOI:10.4172/2167-1168.1000179]
30. Nelson-Marten, P., Braaten, J. & English, N. K., 2001. Promoting good end-of-life care in the intensive care unit. Critical Care Nursing Clinics of North America, 13(4), pp. 577-85. PMID: 11778345 [PMID]
31. Nikbakht Nasrabadi, A. & Emami, A., 2006. Perceptions of nursing practice in Iran. Nursing Outlook, 54(6), pp. 320–27. doi: 10.1016/j.outlook.2006.06.001 [DOI:10.1016/j.outlook.2006.06.001]
32. Nikbakht Nasrabadi, A., Emami, A. & Parsa Yekta, Z., 2003. Nursing experience in Iran. International Journal of Nursing Practice, 9(2), pp. 78–85. doi: 10.1046/j.1322-7114.2003.00404.x [DOI:10.1046/j.1322-7114.2003.00404.x]
33. Oberle, K. & Hughes, D., 2001. Doctors' and nurses' perceptions of ethical problems in end of life decisions. Journal of Advanced Nursing, 33(6), pp. 707-15. doi: 10.1046/j.1365-2648.2001.01710.x [DOI:10.1046/j.1365-2648.2001.01710.x]
34. Payne, S., Seymour, J. & Ingleton, C., 2008. Palliative care nursing: Principles and evidence for practice: Principles and evidence for practice. New York: McGraw-Hill Education.
35. Polit, D. F. & Beck, C. T., 2008. Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins.
36. Prompahakul, C. & Nilmanat, K., 2011. Factors relating to nurses' caring behaviors for dying patients. Nurse Media Journal of Nursing, 1(1), pp. 15-27. doi: 10.14710/nmjn.v1i1.744
37. Rafii, F., Nikbakht Nasrabadi, A. & Karim, M. A., 2015. End-of-life care provision: Experiences of intensive care nurses in Iraq. Nursing in Critical Care, 21(2), pp. 105–12. doi: 10.1111/nicc.12219 [DOI:10.1111/nicc.12219]
38. Rafii, F., Oskouie, F. & Nikravesh, M., 2007. Caring behaviors of burn nurses and the related factors. Burns, 33(3), pp. 299–305. doi: 10.1016/j.burns.2006.10.397 [DOI:10.1016/j.burns.2006.10.397]
39. Salih, A. A, et al., 2014. Nurses' attitude toward the care of dying cases in the cardiac center in Erbil city. Zanco Journal of Medical Sciences. 18, pp. 763–768 doi: 10.15218/zjms.2014.0030 [DOI:10.15218/zjms.2014.0030]
40. Thacker, K. S., 2008. Nurses' advocacy behaviors in end-of-life nursing care. Nursing Ethics, 15(2), pp. 174-85. doi: 10.1177/0969733007086015 [DOI:10.1177/0969733007086015]
41. Valiee, S., Negarandeh, R. & Dehghan Nayeri, N., 2012. Exploration of Iranian intensive care nurses' experience of end of life care: A qualitative study. Nursing in Critical Care, 17(6), pp. 309-15. doi: 10.1111/j.1478-5153.2012.00523.x [DOI:10.1111/j.1478-5153.2012.00523.x]
42. Valiee, S., Peyrovi, H. & Nikbakht Nasrabadi, A., 2014. Critical care nurses' perception of nursing error and its causes: A qualitative study. Contemporary Nurse, 46(2), pp. 206–13. doi: 10.5172/conu.2014.46.2.206 [DOI:10.5172/conu.2014.46.2.206]
43. Williams, R., et al., 2003. A bereavement after-care service for intensive care relatives and staff: The story so far. Nursing in Critical Care, 8(3), pp. 109–15. doi: 10.1046/j.1478-5153.2003.00017.x [DOI:10.1046/j.1478-5153.2003.00017.x]