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.