University of Auckland, School of Nursing, Private Bag 92019, Auckland Mail Centre, 1142, New Zealand.
University of Plymouth, School of Nursing and Midwifery, United Kingdom.
Int J Nurs Stud. 2015 Mar;52(3):695-704. doi: 10.1016/j.ijnurstu.2014.12.005. Epub 2014 Dec 25.
Death and dying are inevitable life encounters, but a nurse's first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses.
A purposeful, self-selected sub-sample of a larger study of New Zealand registered nurses, took part in individual face-to-face semi-structured interviews. Interpretative phenomenological analysis was utilised to seek to understand participants' experiences. Thematic analysis was undertaken to identify emerging themes, with participants' own words used as theme headings, where their phrases provided succinct or powerful descriptors.
A diverse participant group of twenty, currently practising, New Zealand registered nurses provided rich and detailed descriptions of their earliest memorable experience with patient death. Participants from a variety of training backgrounds described patient deaths, which occurred in a range of settings - some only a few months prior, others - more than thirty years ago. Seven emergent themes, and features of more positive, or negative experiences were identified: Event Significance; Emotional Challenges; Sharing the Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits.
For participants in this study, there was considerable evidence that their earliest memorable patient death was a significant event. Furthermore, although most participants' experiences were characterised by emphatic or poignant description, there was most often a balance of challenges and rewards.
死亡和濒死是不可避免的生命经历，但护士对患者死亡的首次体验可能会带来相当大的认知、情感和临床挑战。本文报告了一项研究第二阶段的结果；第一阶段已在其他地方报告过。这一阶段探讨了新西兰注册护士最早的难忘患者死亡经历。
一项对新西兰注册护士的更大规模研究的有目的、自我选择的子样本参加了面对面的半结构化访谈。采用解释性现象学分析来寻求理解参与者的经验。进行了主题分析以确定新出现的主题，使用参与者自己的话作为主题标题，他们的短语提供了简洁或有力的描述。
来自各种培训背景的 20 名目前从事的新西兰注册护士提供了他们最早的难忘患者死亡经历的丰富而详细的描述。参与者来自各种环境——有些是在几个月前，有些则是三十多年前——描述了患者的死亡。确定了七个新兴主题以及更积极或消极体验的特征：事件意义；情感挑战；分享经验；学习；准备不足；对死亡的反应和发现益处。
对于这项研究的参与者来说，有相当多的证据表明，他们最早的难忘患者死亡是一个重大事件。此外，尽管大多数参与者的经历以强烈或辛酸的描述为特征，但通常还是存在挑战和回报的平衡。
