title: Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Auckland, School of Nursing, Private Bag 92019, Auckland Mail Centre, 1142, New Zealand. Electronic address: na.anderson@auckland.ac.nz.
authors.forename: Natalie Elizabeth
authors.initials: NE
authors.lastname: Anderson
authors.affiliation: University of Plymouth, School of Nursing and Midwifery, United Kingdom. Electronic address: bridie.kent@plymouth.ac.nz.
authors.forename: Bridie
authors.initials: B
authors.lastname: Kent
authors.affiliation: University of Auckland, Department of Psychology, New Zealand. Electronic address: g.owens@auckland.ac.nz.
authors.forename: R Glynn
authors.initials: RG
authors.lastname: Owens
mesh_terms: D000328:Adult; D001293:Attitude to Death; D003643:Death; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D013727:Terminal Care
keywords: Death; Dying; End of life care; Nursing; Nursing education; Qualitative research