Intensive care nurses' experiences of withdrawal of life-sustaining treatments in intensive care patients: A qualitative study

Abstract

Objective: To explore the experience of intensive care nurses when participating in the withdrawal of life-sustaining treatments from intensive care unit patients.

Design and methods: A qualitative descriptive and explorative design. Data were collected in 2017 and 2018 by interviewing nine intensive care nurses. The data were analysed by using systematic text condensation.

Setting: The nine intensive care nurses interviewed worked in four different intensive care units located in one university hospital and one local hospital.

Main outcome measures: Experiences when participating in the process of withdrawing life-sustaining treatments.

Findings: Three categories emerged from the data analysis: ICU nurses' experiences of stress in the process of treatment withdrawal; a requirement for interdisciplinary support and cooperation; and elements to achieve a dignified treatment withdrawal process.

Conclusion: The intensive care nurses experienced challenges and emotional reactions when patients were overtreated or when they had to participate in treatments they did not agree with. They considered debriefings to be helpful in dealing with emotions. Thorough planning, good communication, pain relief, and the creation of a peaceful environment were perceived as important elements in achieving a dignified treatment withdrawal process.

Keywords: End-of-life care; ICU nurses’ role; Intensive care nurses; Withdrawal of life support; Withdrawal of life-sustaining treatment; Withdrawal of treatment.