title: The impact of unrelieved patient suffering on palliative care nurses.
abstract: OBJECTIVE
  to describe the impact of unrelieved patient suffering on nurses working with palliative care patients.
  
  
  METHODS
  This was a qualitative descriptive design using semi-structured interviews.
  
  
  METHODS
  nine experienced palliative care nurses were interviewed.
  
  
  RESULTS
  nurses acknowledged that the term 'suffering' generally was not used in the workplace. The nurses identified that only a small group of patients died with suffering that could be classified as 'unrelieved' but that the impact of these patients' suffering on themselves was enormous. Nurses describe the impact in terms of perceptions of suffering (difficult situation), feelings (helplessness, distress, feelings of failure), bearing the burden (alcohol consumption, headaches) and effects on their relationship with family. The nurses identified several factors that increased the personal impact of unrelieved patient suffering. The most important strategy for ameliorating the impact of unrelieved patient suffering was informal support from work colleagues.
  
  
  CONCLUSIONS
  the nurses' stories indicate that the personal impact of unrelieved patient suffering could be reduced through acknowledgement of this suffering and better formal and informal support mechanisms.
authors.affiliation: School of Nursing and Public Health, Edith Cowan University, Pearson Street, Churchlands WA 6018 Australia. k.white@ecu.edu.au
authors.forename: Kate
authors.initials: K
authors.lastname: White
authors.forename: Lesley
authors.initials: L
authors.lastname: Wilkes
authors.forename: Karen
authors.initials: K
authors.lastname: Cooper
authors.forename: Michael
authors.initials: M
authors.lastname: Barbato
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D002983:Clinical Competence / Q000592:standards; D017281:Cost of Illness; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D020380:Needs Assessment; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000523:psychology*; D016272:Occupational Health; D010166:Palliative Care / Q000523:psychology*; D036301:Qualitative Research; D020377:Self Efficacy; D012944:Social Support; D013315:Stress, Psychological / Q000451:nursing* / Q000517:prevention & control / Q000523:psychology; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D035502:Trust