Decker Kelly, Lee Susan, Morphet Julia
Monash University, School of Nursing and Midwifery, Peninsula Campus, McMahons Road, Frankston, Victoria 3199, Australia; Alfred Health, Emergency & Trauma Centre, Commercial Road, Melbourne, Victoria 3004, Australia.
Monash University, School of Nursing and Midwifery, Peninsula Campus, McMahons Road, Frankston, Victoria 3199, Australia.
Australas Emerg Nurs J. 2015 May;18(2):68-74. doi: 10.1016/j.aenj.2014.11.001. Epub 2015 Apr 4.
Managing death in the emergency department is a challenge. Emergency nurses are expected to provide care to numerous patient groups in an often fast-paced, life-saving environment. The purpose of this study was to describe the experiences of emergency nurses in providing end-of-life care, which is the care delivered to a patient during the time directly preceding death.
Data were collected from 25 emergency nurses during three focus group interviews. The interviews were transcribed and analysed using the qualitative techniques of grounded theory.
Ten categories emerged from the data that described a social process for managing death in the emergency department. The categories were linked via the core category labelled 'dying in the emergency department is not ideal', which described how the emergency department was an inappropriate place for death to occur. To help manage the influence of the environment on end-of-life care, nurses reported strategies that included moving dying patients out of the emergency department and providing the best care that they could.
The results of this study highlight nurses' belief that the emergency department was not an appropriate place for death to occur. Despite being frequently exposed to death and dying, the actions and attitudes of emergency nurses implied the need or desire to avoid death in the emergency department.
在急诊科处理死亡情况是一项挑战。急诊护士需要在节奏通常很快的、挽救生命的环境中为众多患者群体提供护理。本研究的目的是描述急诊护士提供临终关怀的经历,临终关怀是指在患者死亡前的直接时间段内提供的护理。
在三次焦点小组访谈中收集了25名急诊护士的数据。访谈内容进行了转录,并运用扎根理论的定性技术进行了分析。
数据中出现了十个类别,描述了急诊科处理死亡的社会过程。这些类别通过核心类别“在急诊科死亡并不理想”相互关联,该核心类别描述了急诊科是一个不适合发生死亡的地方。为帮助管理环境对临终关怀的影响,护士们报告了一些策略,包括将濒死患者转移出急诊科,并提供他们所能提供的最佳护理。
本研究结果凸显了护士们认为急诊科并非适合发生死亡的地方这一观点。尽管经常接触死亡和濒死情况,但急诊护士的行为和态度表明他们有在急诊科避免死亡的需求或愿望。