Beckstrand Renea L, Rohwer Jonathan, Luthy Karlen E, Macintosh Janelle L B, Rasmussen Ryan J
Provo, UT.
Provo, UT.
J Emerg Nurs. 2017 Jan;43(1):40-48. doi: 10.1016/j.jen.2015.08.017. Epub 2015 Sep 26.
Rural emergency nurses face unique obstacles to providing quality end-of-life (EOL) care. Stories provided by emergency nurses embody their most difficult EOL care obstacles.
A questionnaire was sent to 53 rural hospitals. Respondents were asked to share stories that epitomized the obstacles faced while providing EOL care in the rural emergency setting.
The lack of an ideal death (eg, the nurse personally knows the patient, issues with family members, and unknown patient wishes) was the top obstacle. Other reported obstacles were insufficient ED staff and power struggles between nurses and physicians.
Rural emergency nurses often provide EOL care to friends and family members, whereas their urban counterparts are likely to transfer care to nurses with no relation to the dying patient. Not only does caring for patients whom the nurse knows or is related to cause great distress to rural emergency nurses, but this unfortunately common situation also may prevent patients from receiving the highest quality EOL care.
乡村急诊护士在提供高质量临终关怀方面面临独特障碍。急诊护士讲述的故事体现了他们在临终关怀中最困难的障碍。
向53家乡村医院发放了调查问卷。受访者被要求分享那些概括了在乡村急诊环境中提供临终关怀时所面临障碍的故事。
缺乏理想的死亡状态（例如，护士认识患者本人、与家庭成员存在问题以及患者意愿不明）是首要障碍。其他报告的障碍包括急诊科工作人员不足以及护士与医生之间的权力斗争。
乡村急诊护士经常为朋友和家人提供临终关怀，而城市的同行则可能将护理工作转交给与濒死患者无关的护士。照顾护士认识或与之相关的患者不仅会给乡村急诊护士带来极大困扰，而且这种不幸常见的情况还可能使患者无法获得最高质量的临终关怀。
