Nurses Must Be Experienced, Feel Competent When Providing End-of-Life Care
Many nurses feel unprepared to provide the spiritual component of end-of-life care.
What Was Learned
Dr Minton and colleagues discovered that the respondents were relatively comfortable guiding their patients through the end-of-life process. However, the nurses said they learned these skills on the job, rather than as part of their nursing education. Individual scores ranged from 26 to 106, with lower scores indicating a higher comfort level (average score, 47.9).2
Rural nurses, in general, were more comfortable guiding patients through palliative and end-of-life care planning than their urban counterparts. These findings may be because of the close proximity in which nurses live and work in these rural areas. Given this proximity, the nurses are integral to that community, explained study co-investigator Mary Isaacson, PhD, RN, who worked as a nurse in a rural setting.
Dr Minton said mentoring is crucial for students and nurses for building competency and comfort in initiating and sustaining communication. "Even though our sample was overall comfortable with this communication, they nonetheless ranked several of the topics as difficult or very difficult. This finding suggests that even experienced nurses must be mindful and intentional about this communication." Dr Minton told Oncology Nurse Advisor.
Implications for Nurses
The researchers contend that there is an urgent need to prepare undergraduate and graduate students to assess and support a patient's spiritual needs. They theorize that addressing spiritual care content as a clinical and educational priority can help promote a patient-centered approach for spiritual care. The authors write that these are factors that should be considered when shaping nursing curricula, policies, guidelines, and assessment tools.
"If we consider the demographics of the general nursing population and also review the literature regarding nurses and end-of-life communication, our findings could perhaps be generalized. Nurses and most healthcare professionals know that they need to have these conversations with patients and families. Unfortunately, they are ill equipped to do so," Dr Isaacson told Oncology Nurse Advisor.
Dr Isaacson said she and her colleagues at the College of Nursing at South Dakota State University now plan to test their assessment tool with nurses from diverse backgrounds and other members of their healthcare team, such as physicians, pharmacists, social workers, and chaplains.
1. Minton ME, Isaacson MJ, Varilek BM, et al. A willingness to go there: nurses and spiritual care. J Clin Nurs. 2018;27(1-2):173-181.
2. Experienced nurses comfortable guiding patients through end-of-life planning [news release]. South Dakota State University; December 1, 2017. http://www.newswise.com/articles/view/686054/, Accessed January 8, 2018.