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ICU Nurses' Experiences in Providing Terminal Care

Espinosa, Laura PhD; Young, Anne EdD; Symes, Lene PhD; Haile, Brenda DrPH, ACRN; Walsh, Teresa PhD

doi: 10.1097/CNQ.0b013e3181d91424

At least 1 in 5 Americans die while using intensive care service—a number that is expected to increase as society ages. Many of these deaths involve withholding or withdrawing life-sustaining therapies. In these situations, the role of intensive care nurses shifts from providing aggressive care to end-of-life care. While hospice and palliative care nurses typically receive specialized support to cope with death and dying, intensive care nurses usually do not receive this support. Understanding the experiences of intensive care nurses in providing care at the end of life is an important first step to improving terminal care in the intensive care unit (ICU). This phenomenological research study explores the experiences of intensive care nurses who provide terminal care in the ICU. The sample consisted of 18 registered nurses delivering terminal care in an ICU that participated in individual interviews and focus groups. Colaizzi's steps for data analysis were used to identify themes within the context of nursing. Three major themes consisted of (1) barriers to optimal care, (2) internal conflict, and (3) coping. Providing terminal care creates significant personal and professional struggles among ICU nurses.

The Methodist Hospital (Dr Espinosa) and College of Nursing, Texas Woman's University (Drs Espinosa, Young, Symes, Haile, and Walsh), Houston, Texas.

Corresponding: Laura Espinosa, PhD, College of Nursing, Texas Woman's University, 6700 Fannin St, Houston, TX 77030 (

The researcher gratefully thanks financial support from the Methodist Hospital Research Institute Scholars Program Research Grant and Texas Woman's University John Winston Research Grant, which made this research possible.

© 2010 Lippincott Williams & Wilkins, Inc.