Over 2.5 million deaths occur in the United States (U.S.) annually. More than 42% of the deaths in the U.S. occur in patients in hospice programs. Nurses are present with patients more than any other health professional at the end of life is; however, studies of hospice nursing presence at the end of life are not found in the literature. Nursing presence has gained some recognition over the years as a valuable dimension in the patient experience, yet it remains an elusive and difficult phenomenon to describe. This study used a qualitative descriptive design to allow hospice nurses to describe their experiences of presence in the hospice setting. The axioms of naturalistic inquiry guided this research.
The study participants consisted of ten hospice nurses who had at least two years of hospice experience. Visits were made to three hospice programs in the Mid-Atlantic region to explain the study to the nurses and answer their questions. Informed, voluntary, written consent was obtained from each nurse participant prior to the interview. The interviews were recorded and transcribed. Unitizing the categories began after the first interview and continued until saturation of the data occurred. Inductive data analysis was used to sort the descriptive data into context and themes were generated. The trustworthiness of the study was supported through member checks and maintaining an audit trail, and reviewed by the researcher's dissertation committee.
Four major themes, ten sub-themes, and one additional finding resulted from an analysis of the data. The four major themes that emerged were 1) developing intimate relationships; 2) experiencing a higher calling; 3) coping with emotional challenges; and 4) feeling personal satisfaction with being a hospice nurse. The additional finding, thriving in a team environment, emerged as a prominent reason hospice nurses are able to provide presence and was included in the study.
The study extends the body of nursing knowledge about presence. The findings provide evidence that nurses are able to describe what presence means in the hospice context. Implications for nursing education are to guide teaching strategies, nursing practice, and patient care guidelines to be more effective. Practicing nurses will benefit from a comprehensive educational plan that includes presence. A clearer understanding of the power of presence will add support for hospice nurses to have the necessary tools to provide hospice care. Future research based on the findings may assist nurse researchers to develop instruments for use in empirical studies to assist hospice educators in developing strategies that will help hospice nurses.
|Advisor:||Krouse, Anne M.|
|School:||Widener University School of Nursing|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-B 74/10(E), Dissertation Abstracts International|
|Keywords:||End of life, Hospice, Hospice nurses, Nursing presence|
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