The Personal Transition of Emergency Room Nurses When the Focus of Care Changes From Curative to End-of-Life

Tuesday, 19 November 2013: 10:40 AM

Roberta Rolland, MS, RN, FNP
Decker School of Nursing, Binghamton University, Binghamton, NY

Learning Objective 1: The learner will be able to discuss the core component of transition experienced by nurses when the focus of care changes to end-of-life.

Learning Objective 2: The learner will be able to identify rural characteristics influencing nurses personal transition when the focus of care changes from curative to end-of-life.

With the advances in technology and medicine, we are seeing more aggressive efforts and extreme measures to treat the gravely ill and severely injured. When curative efforts are exhausted and the focus of care changes to end-of-life; the nurse’s focus must change as well. Curative efforts involve intense concentration, fast paced and predominately clinically focused (Badger, 2005).  End-of-life care involves a calmer pace using interpersonal skills and is predominately psychosocially focused (O’Brien, 2002).

Rural health care professionals face obstacles including limited resources and isolation that may add to the challenges of two extremes of care back to back. For this reason, rural characteristics outlined by Lee and Winters (2006) was explored as well. 

Nursing as Caring theory was used to guide the research (Boykin & Schoenhofer, 2001).  Urban (n=4) and rural (n=6) emergency room nurses were interviewed using a grounded theory approach. MAXQDA 10 computer program was used with the qualitative data analysis. Analysis is currently underway.

Education and resources are important to help yield a smoother and more productive transition process (Meleis, 2010). Results of this study may be helpful with developing education and resources to help nurses transition when the focus of care changes to end-of-life.

Badger, J. (2005). A descriptive study of coping strategies used by medical intensive care unit nurses during transitions from cure- to comfort-oriented care, Heart & Lung. 34(1), 63-68. doi: 10.1016/j.hrtlng.2004.08.005

Boykin, A., & Schoenhofer, S.O. (2001). Nursing as Caring: A Model for Transforming Practice. Sudbury, MA; Jones and Bartlett Publishers.

Lee, H. L., & Winters, C. A. (2006). Rural nursing: Concepts, theory, and practice (2nd Ed).New York: Springer Publishing Company.

Meleis, A.I. (2010). Transitions theory: Middle-range and situational-specific theories in nursing research and practice. New York: Springer Publishing Company.

O’Brien, N. (2002). Nursing care at the end of life. Sacramento,: CME Resource.