Moving between rooms - moving between life and death: Nurses' experiences of caring for terminally ill patients in hospitals

Aim. This study describes the meanings of generalist registered nurses' experiences of caring for palliative care patients on general wards in hospitals. Background. Earlier research shows that work with patients in palliative care is demanding. More research concerning palliative care is undertaken in oncological care, in hospice and in home-care settings than in general wards. It is therefore important to examine the palliative care in the context of acute-care settings to discover more about this phenomenon, to understand the experiences of nurses in this situation and to develop patient care. Design. Qualitative, descriptive and interpretive study. Method. Eight registered nurses in two different hospitals in Sweden were interviewed. The patients on these wards suffered from surgical and medical conditions, i.e. both curative and palliative care were administered. The interviews were analysed using a phenomenological hermeneutical approach inspired by Ricoeur's philosophy. Results. The registered nurses' experiences are presented as seven themes and a comprehensive, interpreted whole. This latter revealed the significance of contrasts, contradictions and movement between the material and psychological experiences of the room and nursing care in this care context. Conclusions. The registered nurses say that something momentous occurred during the care process and they showed a strong determination and commitment to being part of the ending of the patient's life circle, despite the situation often being one of stress. Relevance to clinical practice. The findings highlight the need for various forms of support for the nurses to meet their need for new and updated knowledge and support in existential matters. This may promote a better quality of care and confirm the nurses in their caring practice. Moreover, there is a need to introduce the hospice philosophy into acute-care settings in hospitals.