Mrs Alison Hession1,2, Dr Tim Luckett2, Professor David Currow3, Dr Michael Barbato4
1NSLHD Palliative and Supportive Care Network, Hornsby, Australia, 2Faculty of Health, University of Technology Sydney, Sydney, Australia, 3Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia, 4Department of Palliative Care, Port Kembla Hospital, Port Kembla, Australia
Biography:
Alison is a Clinical Nurse Consultant – Palliative care at Hornsby-Kuringai Hospital. Alison has a passion for the provision of quality holistic end-of-life care in the acute care setting and is currently a PhD candidate researching acute care nurses’ encounters with patients experiencing end-of-life dreams and visions.
Abstract:
Background: End-of-life dreams and visions (ELDVs) are common experiences for the dying that have been reported over human history. Research to date has explored healthcare professionals’ encounters with patients having ELDVs in palliative care units and long-term care facilities. However, more than 50% of end-of-life care is provided in hospitals by acute care nurses whose experience of people for whom they are caring having ELDVs is currently unknown.
Aim: To explore the attitudes and beliefs towards ELDVs of acute care nurses who have cared for people who are dying.
Methods: A qualitative approach was taken, using semi-structured interviews. Acute care nurses from medical and surgical wards within a 200-bed metropolitan hospital who had contact with people receiving end-of-life care were invited to participate. Nurses were asked to recall encounters with ELDVs in detail, including their clinical and emotional response and communication with others.
A thematic analysis was applied, using a mainly inductive approach.
Results: Thirteen interviews have been conducted. Preliminary themes include:
Distinguishing ELDVs from delirium is interpersonal as well as clinical,
Response to ELDVs changes with experience from task-orientation to watch and see,
ELDVs are a source of connection between nurses and the patient and their family; and
Further guidance and support regarding ELDVs would be welcomed.
Conclusions: ELDVs may be under-recognised or misinterpreted as delirium in hospitals. Acute care nurses require further guidance and support to recognise ELDVs, respond appropriately and provide holistic end-of-life care.