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Cancer nurses face 'internal conflict' on end of life care

Cancer nurses often face an internal conflict between their need to help patients fight their disease and preparing them for the possibility of “letting go”, a small study shows.

University of Toronto researchers interviewed 19 nurses from two bone marrow transplant units.

They found nurses were often not certain how to respond to the distress of patients about dying, and suggested they would benefit from training to “negotiate more effectively the contradictory clinical tasks of fighting disease and preparing patients for the end of life”.

Writing in the Journal of Advaned Nursing, the authors said they had chosen to use the term “letting go” not to reflect nurses’ intents to abandon life but to release patients from perceived norms of the “curative culture”.

“Nurses experienced ‘bursting the bubble of hope’ by circumstances not in their control, and were often not certain whether or not to respond and how to respond to the distress of patients and families about death and dying,” they said.

“When feeling reassured of meeting patients’ and families’ expectations, nurses enabled patients and families to let go when further treatment was futile, prevented technological intrusions, and helped patients have ‘easier’ deaths,” they added.


Readers' comments (6)

  • michael stone

    No surprise at all - and the area of EoL as a whole is more complex than simply 'how nurses feel about the issues'.

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  • Surely they get training in the pysycholgical aspects of end of life care as well- for the patient obviously - but also the relatives & friends, as well as ward colleagues and oneself?

    If not why on earth not?

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  • Anonymous | 26-Oct-2012 2:46 pm

    i agree. this is the whole point of having nurses who are trained as experts working in specialist areas.

    i get the impression that trends are now going towards seeing nurses as generalists as they are cheaper to employ and can be put on any job.

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  • Are the patients fully informed of the nature of their disease?

    People should be aware of the possibility of dying and that planned treatment programmes do not offer guaranteed success.

    If patients are allowed to dismiss or not acknowledge these potential outcomes I can understand a nurses dilemma.

    However, to offer and provide treatment against anything less than full informed patient consent/knowledge is dishonest.

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  • Yes But

    Jenny Jones | 28-Oct-2012 7:43 am

    Nobody is very keen on talking about the actual dying part - that causes endless problems. But the problems are different depending on your riole and involvement.

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  • This is where Macmillan and Marie Curie nurses are priceless and peerless.

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