title: Battling a Tangled Web: The Lived Experience of Nurses Providing End-of-Life Care on an Acute Medical Unit.
abstract: Meeting the heath care needs of patients at the end of life is becoming more complex. In Canada, most patients with life-limiting illness will die in hospitals, many on medical units. Yet, few studies have qualitatively investigated end-of-life care (EOLC) in this context, or from the perspectives of nurses providing EOLC. The purpose of this study was to seek to understand the lived experience of nurses on a medical unit providing EOLC to patients. Interpretive phenomenology guided the method and analysis. Individual face-to-face interviews were conducted with 10 nurses from 2 hospital medical units. The underlying essence of these nurses' experiences was that of "battling a tangled web." Battling a tangled web represented their struggles in attempting to provide EOLC in an environment that was not always conducive to it. Seven themes were generated from the analysis: caring in complexity, caught in a tangled web, bearing witness to suffering, weaving a way to get there: struggling through the process, creating comfort for the patient, working through the dying process with the family, and finding a way through the web. The findings contribute to an understanding of the experiences of nurses in providing EOLC on a medical unit including perceived facilitators and barriers.
authors.affiliation: The Ottawa Hospital, Ontario, Canada.
authors.forename: Irene
authors.initials: I
authors.lastname: Oliveira
authors.forename: Frances
authors.initials: F
authors.lastname: Fothergill-Bourbonnais
authors.forename: Christine
authors.initials: C
authors.lastname: McPherson
authors.forename: Brandi
authors.initials: B
authors.lastname: Vanderspank-Wright
mesh_terms: D000208:Acute Disease / Q000451:nursing*; D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D024802:Nurse's Role; D009864:Ontario; D013727:Terminal Care; D055815:Young Adult