Abstract
BackgroundA majority of people in Western Europe and the USA die in hospitals. Spiritual and existential care is seen to be an integral component of holistic, compassionate and comprehensive palliative care. Yet, several studies show that many nurses are anxious and uncertain about engaging in spiritual and existential care for the dying. The aim of this study is to describe nurses’ experiences with spiritual and existential care for dying patients in a general hospital.MethodsIndividual narrative interviews were conducted with nurses in a medical and oncological ward. Data were analyzed using a phenomenological hermeneutical method.ResultsThe nurses felt that it was challenging to uncover dying patients’ spiritual and existential suffering, because it usually emerged as elusive entanglements of physical, emotional, relational, spiritual and existential pain. The nurses’ spiritual and existential care interventions were aimed at facilitating a peaceful and harmonious death. The nurses strove to help patients accept dying, settle practical affairs and achieve reconciliation with their past, their loved ones and with God. The nurses experienced that they had been able to convey consolation when they had managed to help patients to find peace and reconciliation in the final stages of dying. This was experienced as rewarding and fulfilling. The nurses experienced that it was emotionally challenging to be unable to relieve dying patients’ spiritual and existential anguish, because it activated feelings of professional helplessness and shortcomings.ConclusionsAlthough spiritual and existential suffering at the end of life cannot be totally alleviated, nurses may ease some of the existential and spiritual loneliness of dying by standing with their patients in their suffering. Further research (qualitative as well as quantitative) is needed to uncover how nurses provide spiritual and existential care for dying patients in everyday practice. Such research is an important and valuable knowledge supplement to theoretical studies in this field.
Highlights
A majority of people in Western Europe and the USA die in hospitals
Cure oriented hospital environments tend to focus on the physical aspects of illness, even though clinical research and experience shows that dying patients are confronted with complex and unique challenges that threaten their physical, emotional, and spiritual integrity and wellbeing [1,2,3,4,5]
Aim The aim of this study is to describe nurses’ experiences with spiritual and existential care for dying patients in a general hospital
Summary
A majority of people in Western Europe and the USA die in hospitals. The evidence on death and dying in Western Europe and the USA suggests that a majority of people die in hospitals [1]. Cure oriented hospital environments tend to focus on the physical aspects of illness, even though clinical research and experience shows that dying patients are confronted with complex and unique challenges that threaten their physical, emotional, and spiritual integrity and wellbeing [1,2,3,4,5]. It is crucial that nurses are able to discern spiritual and existential distress and its effects on overall family health; and that they are able to integrate a family perspective in their spiritual care interventions [11]
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