Burnout and Stress: A Phenomenological Study of ICU Nurses' Experiences Caring for Dying Patients

Burnout and Stress: A Phenomenological Study of ICU Nurses' Experiences Caring for Dying Patients

Author: 
Gloria Lewis
Program of study: 
Ed.D.
Abstract: 
Critical care nurses may experience burnout and stress because they are caring for an increasing number of dying patients in the intensive care setting. The purpose of the qualitative, existential phenomenological research study was to explore the experiences, perceptions, and needs of critical care nurses who provided care to dying patients receiving futile medical care and how their experiences may contribute to burnout and stress. Findings revealed that critical care nurses in the study experienced aversive memories associated with scents and sounds of death in intensive care, discomfort, ethical concerns, family issues, personal issues, and physician barriers, but burnout was not discussed. The sample consisted of four critical care nurses who worked in a hospital in Northern California. Data collection was conducted by unstructured interviews, and data analysis was accomplished using thematic analysis and additionally interpreted using NVivo 10 software. Authentic experiences when caring dying patients, barriers encountered while caring for dying patients and identifying resources for nurses caring for dying patients were three themes that emerged from the data analysis. Goodness of caring with intent to stay, meaningful engagement, death feelings/perceptions/scents/sounds, personal feelings, values neutral, advocating for patients, family issues, physician barriers, developing coping skills, colleague/communication support, and end-of-life education/training were the 11 sub-themes that were revealed during the data analysis. There is considerable need for continued research on how to develop and offer a range of supportive resources to help nurses care for themselves while caring for dying patients and their families, on integrating palliative care teams in intensive care units, and how health care organizations could benefit from developing palliative or comfort care units in their organizations.
Dedication: 
This dissertation is dedicated to my husband, Brian, and my four children, John, Matthew, Laura, and Chad, and to my mother, Marilyn, who died in 2009. My husband provided love, support, encouragement, and strength to complete my dissertation. His support allowed me to focus on my research study, and made my doctoral degree a reality. I want to thank all nurses who care for dying patients across all clinical settings because their stories and voices have been an inspiration to me. This dissertation is also dedicated to individuals of all ages who wish to pursue a higher degree, and that it is never too late to achieve a doctoral degree.
Acknowledgements: 
Many individuals assisted in the completion of this journey. I want to thank my mentor, Dr. Julie Ballaro, for her wise counsel and support, Dr. Anne Brett and Dr. Maria ReGester for their kind and supportive comments throughout the dissertation process. I also thank the Kaiser Diablo Service Palliative Care team in Northern California: Dr. Robert Johnson, Oncologist and Medical Director, Dr. Piyush Srivastava, Oncologist and Palliative Care Physician, Dr. John Valdin, Nephrologist and Palliative Care Physician, Dr. Eugene Chan, Gastroenterologist and Palliative Care Physician, Kathy Dalziel, Palliative Care Manager, nurses Arlene Boyd, Mary Lee Gates, Ariella Ben-David, Tammi, Rebecca, Julie Kennedy, Kris, and Tracy Schroeder social workers, Jon Palley and Malia List, and chaplains Rhea Gonzales, and Scott. They provided me encouragement, support, and wise learning throughout the five years I worked with the team as a palliative care nurse. Thank you to the nurses who volunteered to participate in the pilot study and the research study. I could not have done this without you. Thanks to all of my colleagues who have travelled this academic road and who have also provided support and encouragement over the past four years.