Experiences of palliative care nurses in the utilisation of palliative sedation in a hospice setting

Dwyer, Irene; McCarthy, Joan

Experiences of palliative care nurses in the utilisation of palliative sedation in a hospice setting

Files

Dwyer_and_McCarthy_2016.pdf(239.57 KB)

Published version

Date

2016-03-01

Authors

Dwyer, Irene

McCarthy, Joan

Publisher

BMJ Publishing Group

Published Version

10.1136/eoljnl-2015-000015

Abstract

Background: Palliative sedation, or bringing about a state of decreased or absent awareness (unconsciousness), is one of the therapies used in end-of-life healthcare settings in order to manage refractory symptoms such as pain, dyspnoea and distress. It is intended to relieve the burden of intolerable suffering of patients who are in the process of dying. Nurses are centrally involved in the utilisation of palliative sedation in end-of-life care; however, there is minimal research available in relation to their experiences in this regard. The dearth of research prompted this study. Aim: To explore the experiences of palliative care nurses in the utilisation of palliative sedation in end-of-life care. Methodology: A descriptive phenomenological methodology was adopted involving unstructured interviews. A purposive sample was used of 10 palliative care nurses with at least 1 year’s experience of working in a hospice setting in Ireland. The data were analysed using Colaizzi’s seven-stage phenomenological method. Findings: Data analysis led to the identification of four core themes: (1) information sharing, (2) timing of palliative sedation, (3) level of sedation and (4) palliative sedation as a last resort. The results indicate that the participants were generally satisfied with the processes that underpinned decisions to introduce palliative sedation. They saw it as a highly complex intervention, in part because it involved individuals with very complex conditions and symptoms. Conclusions: Palliative care patients, families and the general public in Ireland need to have greater understanding of the role of palliative sedation in the treatment of refractory symptoms at the end of life.

Keywords

End-of-life healthcare , Palliative care , Palliative care nurses , Palliative sedation

Citation

Dwyer, I. and McCarthy, J. (2016) 'Experiences of palliative care nurses in the utilisation of palliative sedation in a hospice setting', End-of-Life Journal, BMJ Journals, 6, pp. 1-9. doi: 10.1136/eoljnl-2015-000015