The study by Jang et al. (2019) encompasses the findings from interviews of 12 nurses who work in an intensive care unit (ICU) at a university hospital in South Korea. The nurses were organized into two groups with up to five years of experience and more than five years (Jang et al., 2019). The point at five years of experience acts as a threshold that demonstrates the differences in the participants’ answers. The results of thematic analysis of the nurses’ exploration of end-of-life care (EoLC) in an ICU for dying patients revealed three major themes and 16 subthemes. The three major themes are dealing with the extreme change in human existence, care during the patient’s transition, and being prepared as an ICU nurse (Jang et al., 2019). The first theme refers to recognizing death as a complex phenomenon beyond the clinical definition of heart stopping and attending to the difference and similarities while dealing with death in ICU. The second theme explores spiritual aspects of dying patient care and recognition of the patients’ needs. The final theme addresses the nurses’ concerns with regards to spiritual care and its importance in ICU.
The study identified the problem within the undergraduate medical curriculum as spiritual care is not covered in most textbooks. However, the nurses with vast experience in ICU heavily emphasized the need to anticipate and address questions and feelings about life and death (Jang et al., 2019). Moreover, the research by Jang et al. (2019) found that the death of a patient is not addressed regularly in ICU settings. The participants confessed that prior to the research, they have not participated in similar discussions. In terms of EoLC, the participants recognized the importance of friendly contact with the patients and active presence until their death (Jang et al., 2019). Nevertheless, such needs are rarely addressed because of a lack of time and EoLC education.
The article is essential for nursing in the intensive care unit. It sheds light on the important and often frightening parts during work in ICU that is dealing with death. Although the importance of spiritual care was addressed in numerous other findings, this study records the first-hand experience of the nurses in the field. It describes the methods to attend to the patient’s needs and manage their end of life. The nurses participated voluntarily, and their responses were quoted in the paper to directly appeal to their integrity. The results are discussed and well-supported by the relevant supplementary research materials.
Participants of the study addressed the loneliness and fears experienced by the patient and the way to manage them. They suggested that the absence of family members fuels patients’ worries. They stressed the importance of empathic understanding to the patient and the provision of warm contact to overcome the fear and loneliness brought by the nearing death. The application of such patient-centered care may improve the patients’ quality of life despite the deterioration of physical well-being. Contemplations over the nature of death and the idea that there is a need to manage death throughout one’s life suggest fortification of mental health for everyone working in the field. In addition, provision of a safe environment for the family visits and farewell ceremony, preservation of patient’s dignity after death, and ethical aspects surrounding the care imply high communicational skills and self-control. These aspects are not regularly discussed by the medical staff; hence can be considered as a good pointer for future employment and diligence.
Jang, S. K., Park, W. H., Kim, H. I., & Chang, S. O. (2019). Exploring nurses’ end-of-life care for dying patients in the ICU using focus group interviews. Intensive and Critical Care Nursing, 52, 3-8.