Nursing Students’ First Clinical Experience with a Dying Patient or the Dead: A Phenomenological Study (original) (raw)
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Background: Working in the intensive care unit can be traumatic for nursing personnel. Critical care nurses are faced with repeated exposure to death and dying as they are involved in caring for patients who are actively dying, have a terminal illness or face impending death. These nurses relate in different ways to the phenomena of death and dying within their nursing profession and their scope of practice. Critical care nurses often have a difficult time coping with the stress that comes with caring for those who are dying or relating to loved ones of those that are dying.
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Nurse educators are responsible for accompanying students towards becoming capable, competent professional nurses who are a credit to themselves, their patients, colleagues and profession. Student nurses need, therefore, to be taught to render comprehensive nursing care to patients in all stages of their lives, including when they are dying. Being confronted with human suffering and death is challenging and traumatic. Those exposed to such events on a daily basis need to have a solid foundation of self preservation to see past the pain of suffering and to bring light and hope to those in need. A young student nurse will only experience positive growth and development in these circumstances if she is also cared for and guided with understanding. The researcher utilized a qualitative, explorative, descriptive and contextual design based on the phenomenological approach to enquiry. The following question was asked at the beginning of each unstructured phenomenological interview: “How w...
Journal of Multidisciplinary Healthcare
This study aims to explore nursing students' perception and experience of end-of-life care (EoLC) in Indonesia, particularly in the family environment. Methods: This study used a qualitative research design to explore the experiences and perceptions of nursing students who have witnessed the dying of their family members. The study recruited 15 nursing students using a purposive sampling method, who were then invited to reflect and write their experiences in witnessing death of their families, and perceptions towards EoLC. The written reflections were analyzed using thematic analysis. Results: Thematic analysis showed that the experience of witnessing dying of a family member shaped nursing students' perceptions and attitudes towards EoLC. Some themes that emerged in this study included the importance of effective communication with patients and their families, symptom management, spiritual, emotional, and social support, as well as the need to improve nursing education and training. Conclusion: This present study shows that the experience of witnessing the death of a family member shapes nursing students' perceptions of EoLC in Indonesia. This present study provides recommendations that the students must be prepared emotionally and psychologically in caring EoL or dying patients. How attitude and readiness to care EoL patients are shaped by the experience in witnessing the dying family or loved one. As such, palliative and EoL curriculum should be included methods that allow desensitization and naturalization of dying for the students in order to make them ready to provide better EoLC for patients and their families. The results of this study can contribute to improving the quality of EoLC in Indonesia.
Death and caring for dying patients: exploring first-year nursing students' descriptive experiences
International Journal of Palliative Nursing, 2014
To describe first-year nursing students' experiences of witnessing death and providing end-of-life care. Methods: This study is part of a larger longitudinal project. Interviews (n=17) were conducted with nursing students at the end of their first year of education. To analyse the interviews (lived-experience descriptions), a thematic analysis, 'a search for meaning' (Van Manen, 1997) was applied.
The impact of death and dying on nursing students: an explanatory model
Journal of Clinical Nursing, 2014
Aims and objectives. To explore nursing students' experiences of death and dying in clinical practice. Background. The encounter with death constitutes one of the most stressful experiences reported by nursing students during their clinical training. In particular, it can be difficult for student nurses to cope with the patient's suffering, to provide postmortem care and to communicate with the patient and his/her family as death approaches. Although some research has been carried out in relation to this phenomenon, there remains a need to identify and understand the situations and experiences that are of most concern to students, those which may affect their ability to cope and, therefore, interfere with the care they are able to offer to the dying patient and his/her family. Design. Qualitative descriptive and hermeneutic study. Methods. Semi-structured interviews (n = 12) were conducted with nursing students. Data were collected in 2012-2013. Transcripts were analysed using Colaizzi's seven-step procedure. Findings. The analysis identified five themes: impact, training in end-of-life care, ethical issues, coping and learning/growth/healing connections. The central theme was the enormous impact the encounter with death had, while the other themes were a response to and/or modulators of this impact. An explanatory model was derived on the basis of the relationship between all these emergent themes.
BMC Health Services Research, 2013
The care of patients suffering from cancer and especially those facing the death trajectory appears to be complex and demanding not only for student nurses but for professional nurses as well. The educational models often used in nursing require students to face challenging care scenarios, sometimes with minimal or no supervision and guidance. These "worst case scenarios" can be traumatic experiences that can leave the student hopeless and disappointed of themselves and in many cases can "scar" their subsequent professional career. The literature demonstrates that this can be the result of the students' ill-preparation to care for cancer patients and deal with death and dying. The purpose of this study was to interpret the students' experiences of coming face-to-face with cancer care during their clinical placements. This is a hermeneutic phenomenological study influenced by the ideas of the French Philosopher Paul Ricoeur. Based on this philosophical enquiry the interpretation process included three stages: 1) naïve reading, 2) structural analysis and 3) comprehensive understanding. Data were collected through reflective/narrative diaries from the 4th grade undergraduate (pre-registration) nursing students practicing at oncology, hematology, pediatric oncology departments and hospices. Diaries of twelve students met the inclusion criteria and were included in the interpretation process. The study took place during January and May 2011. The interpretation yielded the following themes: a) Being part of the center's life, b) Being sympathetic, c) Being confronted by others, d) Being self-reflective, e) Being trapped in the system, f) Being caring towards the family and g) Being better in clinical practice. The students emphasized the need for appropriate preparation both at a theoretical and at a clinical level, as to better confront situations involving death and dying as well as learning techniques for crisis management. The students perceived the importance of adopting a policy that is both patient and family-centered in order to provide better care.
Experience of Nursing Students in Clinical Practice: A Qualitative Study
INTERNATIONAL JOURNAL OF NURSING
Background: Nursing is a profession which is based on practice. Clinical training plays a critical role in nursing students' achievement of professional competencies. The quality of nurse education depends on the quality of the clinical experience (Elliot, 2002; Napthine, 1996). The clinical experiences are central to the student's preparation (Penman and White, 2005; Papp et al, 2003). The Aim of the present study is to capture the nursing students' experience during their clinical training. A qualitative Phenomenological approach was used. Data was collected from all nursing students in King Saud Bin Abdul aziz University for health sciences (KSAU-HS), College of Nursing-Riyadh. The sample consisted of 172 nursing students were recruited. Two tools were used to collect data for the study. First tool was interview questionnaire sheet for socio demographic data and the second one was interview schedule conducted on focus groups according to their preference. Students expressed that they could practice on real situations. They experienced anxiety while communicating with male patients. Dealing with critical patients were the worst moments in their life. The study concluded that the students' reflections support that rigorous class room learning and the presence of instructor during clinical training prepare the students to face the challenges.
To be involved — A qualitative study of nurses' experiences of caring for dying patients
s u m m a r y Objective: The aim of this study was to describe nurses' experiences (Ntwo years) of caring for dying patients in surgical wards. Background: Palliative care is included in education for nurses. However, the training content varies, and nurse educators need to be committed to the curriculum regarding end-of-life situations. A lack of preparation among newly graduated nurses regarding dying and death could lead to anxiety, stress and burnout. Therefore, it is important to improve knowledge regarding end-of-life situations. Setting, Participants and Method: A qualitative descriptive study was carried out in two surgical wards in the southern part of Sweden. The study comprised six interviews with registered nurses and was analysed using manifest qualitative content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nurses' perspectives and thoughts regarding dying patients. Results: The results formed one category (caring—to be involved) and three subcategories (being supportive, being frustrated and being sensitive in the caring processes). Nurses were personally affected and felt unprepared to face dying patients due to a lack of knowledge about the field of palliative care. Their experiences could be described as processes of transition from theory to practice by trial and error. Conclusion: Supervision is a valuable tool for bridging the gap between theory and practice in nursing during the transition from novice to expert. Improved knowledge about palliative care during nursing education and committed nursing leadership at the ward level facilitate preparation for end-of-life situations.