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The experiences of Registered Nurses in delivering end-of-life care for vulnerable older adults: an interpretive phenomenological analysis

Shanahan, Denise 2018. The experiences of Registered Nurses in delivering end-of-life care for vulnerable older adults: an interpretive phenomenological analysis. Cardiff University.
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Abstract

Background The 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. Method Data 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. Consistent 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. Findings Much 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'. Facilitation 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. The 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.

Item Type: Thesis (Other)
Status: Unpublished
Schools: Healthcare Sciences
Date of First Compliant Deposit: 2 January 2019
Last Modified: 02 Jan 2019 16:29
URI: http://orca-mwe.cf.ac.uk/id/eprint/117875

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