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Navigating communication with families during withdrawal of life‐sustaining treatment in intensive care: a qualitative descriptive study in Australia and New Zealand
Author(s) -
Bloomer Melissa J,
Endacott Ruth,
Ranse Kristen,
Coombs Maureen A
Publication year - 2017
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13585
Subject(s) - nursing , qualitative research , intensive care , focus group , content analysis , medicine , psychology , intensive care unit , psychiatry , sociology , social science , intensive care medicine , anthropology
Aims and objectives To explore how nurses navigate communication with families during withdrawal of life‐sustaining treatment in intensive care. Background Death in the intensive care unit is seldom unexpected and often happens following the withdrawal of life‐sustaining treatment. A family‐centred approach to care relies on the development of a therapeutic relationship and understanding of what is happening to the patient. Whilst previous research has focused on the transition from cure to palliation and the nurse's role in supporting families, less is known about how nurses navigate communication with families during treatment withdrawal. Design A qualitative descriptive approach was used. Semi‐structured focus group s were conducted with adult critical care nurses from four intensive care units, two in Australia and two in New Zealand. Results Twenty‐one nurses participated in the study. Inductive content analysis revealed five key themes relating to how nurses navigate family communication: (1) establishing the WHO ; (2) working out HOW ; (3) judging WHEN ; (4) assessing the WHAT ; and (5) WHERE these skills were learnt. Conclusions Navigating an approach to family communication during treatment withdrawal is a complex and multifaceted nursing activity that is known to contribute to family satisfaction with care. There is need for support and ongoing education opportunities that develop the art of communication in this frequently encountered aspect of end‐of‐life care. Relevance to clinical practice How nurses navigate communication with families during treatment withdrawal is just as important as what is communicated. Nurses need access to supports and education opportunities in order to be able to perform this vital role.