title: The challenge of consolation: nurses' experiences with spiritual and existential care for the dying-a phenomenological hermeneutical study.
abstract: BACKGROUND
  A majority of people in Western Europe and the USA die in hospitals. Spiritual and existential care is seen to be an integral component of holistic, compassionate and comprehensive palliative care. Yet, several studies show that many nurses are anxious and uncertain about engaging in spiritual and existential care for the dying. The aim of this study is to describe nurses' experiences with spiritual and existential care for dying patients in a general hospital.
  
  
  METHODS
  Individual narrative interviews were conducted with nurses in a medical and oncological ward. Data were analyzed using a phenomenological hermeneutical method.
  
  
  RESULTS
  The nurses felt that it was challenging to uncover dying patients' spiritual and existential suffering, because it usually emerged as elusive entanglements of physical, emotional, relational, spiritual and existential pain. The nurses' spiritual and existential care interventions were aimed at facilitating a peaceful and harmonious death. The nurses strove to help patients accept dying, settle practical affairs and achieve reconciliation with their past, their loved ones and with God. The nurses experienced that they had been able to convey consolation when they had managed to help patients to find peace and reconciliation in the final stages of dying. This was experienced as rewarding and fulfilling. The nurses experienced that it was emotionally challenging to be unable to relieve dying patients' spiritual and existential anguish, because it activated feelings of professional helplessness and shortcomings.
  
  
  CONCLUSIONS
  Although spiritual and existential suffering at the end of life cannot be totally alleviated, nurses may ease some of the existential and spiritual loneliness of dying by standing with their patients in their suffering. Further research (qualitative as well as quantitative) is needed to uncover how nurses provide spiritual and existential care for dying patients in everyday practice. Such research is an important and valuable knowledge supplement to theoretical studies in this field.
authors.affiliation: Lovisenberg Diaconal University College, Lovisenberg gt. 15B 0456, Oslo, Norway ; MF, Norwegian School of Theology, Gydas vei 4, Majorstuen 0302, P.O. Box 5144, Oslo, Norway ; Religionspsykologisk Senter (Center for the Psychology of Religion) Innlandet Hospital, P.O. Box 68 2312, Ottestad, Norway.
authors.forename: Kirsten Anne
authors.initials: KA
authors.lastname: Tornøe
authors.affiliation: MF, Norwegian School of Theology, Gydas vei 4, Majorstuen 0302, P.O. Box 5144, Oslo, Norway ; Religionspsykologisk Senter (Center for the Psychology of Religion) Innlandet Hospital, P.O. Box 68 2312, Ottestad, Norway.
authors.forename: Lars Johan
authors.initials: LJ
authors.lastname: Danbolt
authors.affiliation: Department of nursing, Faculty of Public Health, Hedmark University College, P.O. Box 400 2418, Elverum, Norway ; Department of nursing Nesna University College, Nesna, 8700 Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Kvigne
authors.affiliation: Lovisenberg Diaconal University College, Lovisenberg gt. 15B 0456, Oslo, Norway.
authors.forename: Venke
authors.initials: V
authors.lastname: Sørlie
keywords: Care; Dying patients; Existential; Hospitals; Nurses’ challenges; Phenomenological hermeneutical; Spiritual