title: Nurses' involvement in end-of-life care of patients after a do not resuscitate decision on general medical units in Saudi Arabia.
abstract: OBJECTIVE
  To describe the essence of the nurses' lived experience and explore the meaning of their involvement in end-of-life care after a do-not-resuscitate decision has been made.
  
  
  METHODS
  The research design embraced qualitative, exploratory and descriptive approaches utilising aspects of phenomenology. Purposive sampling of twenty-six registered nurses was used. Data was collected using the reflective journaling technique and were analysed using an integrated approach. Field notes were also used as a mean to enrich the description of the findings contextually.
  
  
  METHODS
  Medical units in Saudi Arabia.
  
  
  RESULTS
  Three main themes emerged: exhausted medical treatment, continuity of nursing care and cultural considerations in nursing care. Related sub-themes were also identified as an extension to the description of the main themes.
  
  
  CONCLUSIONS
  The findings affirm that nurses working on medical units continue to maintain a constant level of care for patients and families after the do-not-resuscitate decision. Nurses found that caring for dying patients was a rewarding and worthwhile experience, albeit a challenging and demanding one. The findings suggest that improvement in end-of-life care would be best achieved by collaborative and interdisciplinary practices amongst the health care team members.
authors.affiliation: Acute Medical Unit, Ministry of National Guard Health Affairs, King Abdul-Aziz Medical City, Riyadh, Saudi Arabia. Electronic address: ghorii@ngha.med.sa.
authors.forename: Ibrahim K
authors.initials: IK
authors.lastname: Abu-Ghori
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: BodrickM@NGHA.MED.SA.
authors.forename: Mustafa M E
authors.initials: MM
authors.lastname: Bodrick
authors.affiliation: University of New England, Armidale, New South Wales, Australia. Electronic address: rhussain@une.edu.au.
authors.forename: Rafat
authors.initials: R
authors.lastname: Hussain
authors.affiliation: Faculty of Psychology, Islamic Online University, The Gambia. Electronic address: husseinrassool@gmail.com.
authors.forename: G Hussein
authors.initials: GH
authors.lastname: Rassool
mesh_terms: D006801:Humans; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D036301:Qualitative Research; D016414:Resuscitation Orders / Q000523:psychology; D012529:Saudi Arabia; D013727:Terminal Care / Q000379:methods* / Q000523:psychology
keywords: Do-not-resuscitate; End-of-life care; Nurses’ involvement; Nurses’ lived experience; Reflective journaling technique