Guiding the Process of Dying: The Personal Impact on Nurses

Dianne White, MS, RN; Mary Ann Meeker, DNS, RN, CHPN


Journal of Hospice and Palliative Nursing. 2019;21(5):390-396. 

In This Article


A qualitative descriptive analysis[15] of how acute care nurses were personally affected by EOL care experiences was undertaken. Nurses were recruited by means of university Listservs of registered nurses (RNs) and by network sampling. Initial screening for eligibility required individuals to be licensed as an RN, working in a hospital setting on an inpatient unit with experience in caring for patients whose care plan was designated as comfort measures only or comfort care only. Nurses with less than 1 year of experience were excluded.

The researchers' university provided institutional review board approval. With written informed consent, 26 individual, semistructured interviews were completed. Most were face-to-face, with 4 by telephone as preferred by the participant. Questions included asking participants to describe their experience with patients whose care became guided by comfort measures only; interactions with patients' families; and situations, if any, where they disagreed with care decisions. Interviews that averaged 1 hour in length were audio recorded, transcribed verbatim, and verified by the researchers prior to the start of data analysis.

Data were analyzed using an inductive content analysis approach.[16] Analysis began with line-by-line open coding and continued with the development of categories and subcategories. Atlas.ti 7.5 (Scientific Software Development; GmbH, Berlin, Germany) was used to assist data management. Memos were written to document thought processes and decisions made throughout the analysis, which strengthened dependability.[17] To aid in understanding and interpretation of the data, diagrams were sketched throughout the coding and analysis process and evolved over time.

Deliberation regarding positioning and labeling of categories and subcategories was ongoing. Categories were identified and formulated during regular research meetings with both authors until consensus was reached, establishing credibility.[18] Data analysis was shared and discussed with a multidisciplinary research team to increase trustworthiness.[17] Prolonged immersion in the data enhanced rigor.