“Time and life is fragile” : An integrative review of nurses’ experiences after patient death in adult critical care

Journal article


Bloomer, Melissa, Ranse, Kristen, Adams, Leah, Brooks, Laura and Coventry, Alysia. (2023). “Time and life is fragile” : An integrative review of nurses’ experiences after patient death in adult critical care. Australian Critical Care. 36(5), pp. 872-888. https://doi.org/10.1016/j.aucc.2022.09.008
AuthorsBloomer, Melissa, Ranse, Kristen, Adams, Leah, Brooks, Laura and Coventry, Alysia
Abstract

Introduction: Providing bereavement support and care to families is an aspect of critical care nursing practice that can be rewarding, yet emotionally and psychologically challenging. Whilst significant research has focused on end-of-life care in critical care, less is known about nurses’ experiences after patient death.

Aim: The aim of this study was to synthesise research evidence on the experience of registered nurses after patient death in adult critical care.

Design: A structured integrative review of the empirical literature was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across the Cumulative Index Nursing and Allied Health Literature (CINAHL) Complete, Ovid Medline, PsycInfo, Embase, and Emcare databases. Records were independently assessed against inclusion and exclusion criteria. A process of forward and backward chaining was used to identify additional papers. All papers were assessed for quality. Narrative synthesis was used to analyse and present the findings.

Results: From the 4643 records eligible for screening, 36 papers reporting 35 studies were included in this review, representing the voices of 1687 nurses from more than 20 countries. Narrative synthesis revealed three themes: (i) postmortem care, which encompassed demonstrating respect and dignity for the deceased, preparation of the deceased, and the concurrent death rituals performed by nurses; (ii) critical care nurses' support of bereaved families, including families of potential organ donors and the system pressures that impeded family support; and (iii) nurses’ emotional response to patient death including coping mechanisms.

Conclusions: Whilst a focus on the provision of high-quality end-of-life care should always remain a priority in critical care nursing, recognising the importance of after-death care for the patient, family and self is equally important. Acknowledging their experience, access to formal education and experiential learning and formal and informal supports to aid self-care are imperative.

Keywordsbereavement; critical care; critical care nursing; death; dying; end-of-life care; grief; intensive care; review; self-care
Year2023
JournalAustralian Critical Care
Journal citation36 (5), pp. 872-888
PublisherElsevier Ltd
ISSN1036-7314
Digital Object Identifier (DOI)https://doi.org/10.1016/j.aucc.2022.09.008
PubMed ID36371292
Scopus EID2-s2.0-85141508659
Open accessPublished as ‘gold’ (paid) open access
Page range872-888
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online21 Aug 2023
Publication process dates
Accepted27 Sep 2022
Deposited04 Sep 2023
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