Critical Care Nurses and End-of-Life Care

Monday, July 11, 2011

Amelia R. Malcom, RN, BSN, CCRN
School of Nursing, Brenau University, Gainesville, GA

Learning Objective 1: The learner will be able to describe at least two barriers that critical care nurses have to delivering quality end-of-life care.

Learning Objective 2: The learner will be able to describe at least two modules offered in the End-of-Life Nursing Education Consortium course.

Purpose: The aim of this study was to ascertain whether an educational intervention tailored to critical care nurses decreased moral distress and improved attitudes about taking care of an end-of-life client thereby helping the nurse to transition to palliative care in a curative environment.    Critical Care environments are high stress and aim towards curative methods and the newest technologies.  Lack of educational course offerings and curriculum in nursing programs adds to stress and attitudes of taking care of an end-of-life patient.

Methods: A convenience sample of critical care nurses from four community hospitals were invited to attend the End-of-Life Nursing Education Consortium Course tailored to critical care nurses. The two-day course included modules on: palliative care, symptoms management, pain management, cultural considerations, ethical issues, loss, grief and bereavement, communication, achieving quality palliative care, and end of life care.  Nineteen critical care nurses and three students participated. The only inclusion criteria were that the participants attended the entire course. The Corley’s Moral Distress Scale (MDS) and the Frommhelt Attitude toward the Care of the Dying Scale (FATCOD) were given immediately before and six weeks after the course.

 Results:   In the pretest survey all twenty-two participants completed the MDS scale and FATCOD scale with complete participation.  Pretest surveys are completed.  Posttest survey results are pending and should be completed by January.  Data analysis is ongoing.

 Conclusion:   While data analysis is ongoing, this study showed barriers that many critical care nurses encounter trying to attend educational courses.  This also showed the barriers that many educators face in trying to get attendants to their courses.  There is much room to research this global phenomenon.  Moral distress, burnout, and attitude all impact patient, family, and nurse outcomes.