title: "No Right Place to Die": Nursing Attitudes and Needs in Caring for People With Serious Mental Illness at End-of-Life.
abstract: BACKGROUND
  Approximately 6% of the U.S. population suffer from a serious mental illness (SMI). People with SMI reportedly die 20 to 25 years earlier than the general population.
  
  
  OBJECTIVE
  To explore both hospice/palliative care nurses' and psychiatric/mental health nurses' attitudes and needs toward people with SMI at the end-of-life.
  
  
  METHODS
  A qualitative study following a phenomenological approach was used to interview hospice/palliative care nurses and psychiatric nurses about the experience of caring for people with SMI at the end-of-life; a total of 20 nurses were interviewed. Interviews were analyzed and coded, and themes were identified.
  
  
  RESULTS
  Six themes were identified: stigma of mental illness, effect of SMI symptoms on communication and trust, chaotic family systems, advocacy issues around pain and comfort, need for formal support, no right place to die.
  
  
  CONCLUSIONS
  Participants discussed the need for better education and collaboration between psychiatric and palliative care nurses as well as the need for ongoing support.
authors.affiliation: Betty D. Morgan, PhD, PMHCNS, BC, University of Massachusetts Lowell, Lowell, MI, USA Betty_Morgan@uml.edu.
authors.forename: Betty D
authors.initials: BD
authors.lastname: Morgan
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D064946:Hospice and Palliative Care Nursing / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000451:nursing* / Q000523:psychology; D009726:Nurses / Q000523:psychology* / Q000706:statistics & numerical data; D011568:Psychiatric Nursing / Q000379:methods*; D036301:Qualitative Research; D013727:Terminal Care / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data
keywords: end-of-life care; nursing attitudes; serious mental illness; stigma