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Meaning in Bone Marrow Transplant Nurses’ Work: Experiences Before and After a “Meaning-Centered” Intervention

Leung, Doris PhD, RN; Fillion, Lise PhD (Psychology), RN; Duval, Stéphane MPs (Psychology); Brown, Jocelyn MN, RN; Rodin, Gary MD, FRCPC; Howell, Doris PhD, RN

doi: 10.1097/NCC.0b013e318232e237

Background: When a clinical culture emphasizes cure, as in bone marrow transplantation (BMT) services, BMT nurses commonly experience enormous stress when patients are suffering or dying. In this context, it is unclear what meanings BMT nurses experience in their work and how they find meaning and sustain hope, given conflicting responsibilities to patients.

Objective: This study aimed to explore BMT nurses’ experiences of meaning and hope and the effects of a meaning-centered intervention (MCI) on these experiences using qualitative methodology.

Methods: Fourteen BMT nurses engaged in a 5-session MCI, with 7 members each participating in 2 groups. Semistructured qualitative interviews were conducted at 1 month before and after the intervention. Interpretive phenomenology guided data analysis.

Results: The BMT nurses in the Princess Margaret Hospital experienced meaning in their involvement with their patients’ suffering. The MCI seemed to inspire participants to engage more with patients and their suffering. Three subthemes reflected this influence: (a) greater awareness of boundaries between their personal and professional involvement, (b) enhanced empathy from an awareness of a shared mortality, and (c) elevated hope when nurses linked patients’ suffering with meaning.

Conclusions: This study confirms that patients’ suffering constitutes nurses’ search for meaning and hope in their work. The MCI offers a way in which to actively support nurses in this process.

Implications for Practice: Nurses can learn to be more responsive to patients’ suffering beyond limits of cure. A minimal intervention, such as the MCI, supports BMT nurses in finding positive personal meaning and purpose in their otherwise highly stressful work culture.

Author Affiliations: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario (Dr Leung and Howell); Laval University, Faculty of Nursing and Cancer Research Centre at the CHUQ, Quebec City (Dr Fillion and Mr Duval); Princess Margaret Hospital, University Health Network, Toronto, Ontario (Ms Brown and Drs Rodin and Howell), Canada.

Canadian Institute of Health Research-New Emerging Team (new emerging team) grant was awarded to Dr Gagnon and Dr Lise Fillion.

The authors have no conflicts of interest to disclose.

Correspondence: Doris Leung, PhD, RN, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Suite 130, Toronto, Ontario, Canada M5T 1P8 (

Accepted for publication August 15, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.