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Exploring the Role of Nurses in Advance Care Planning Within Long-Term Care Homes: A Qualitative Study.
- Source :
- SAGE Open Nursing; 4/29/2024, p1-10, 10p
- Publication Year :
- 2024
-
Abstract
- Background: Residents in long-term care homes (LTCHs) are often diagnosed with chronic, life-limiting illnesses, and it is now a common site to provide high levels of care and eventual death. There is an urgent need to address communication gaps and uncertainties surrounding resident's end of life preferences. Nurses are well situated to be key facilitators of necessary advance care planning (ACP), ensuring residents have discussions with family, substitute decision-makers and healthcare providers regarding future health and personal care preferences. However, LTCHs present unique challenges for nurses due to not only complex comorbidities but also staffing dynamics. Purpose: This study explored the experiences and perceptions of Registered Nurses (RNs) and Registered Practical Nurse (RPNs) in LTCHs regarding their role in engaging residents and families in ACP discussions. Methods: Qualitative interpretive descriptive methodology was used. Data were collected from two LTCHs in Southern Ontario with a sample of 15 nurses (7 RNs and 8 RPNs). Analysis involved review of semistructured interviews, field notes, and utilizing constant comparison within an inductive approach. Results: Power and authority dynamics in LTCH's was an overarching theme in the data, with four subthemes: (1) Nurses lacking clarity about ACP, (2) nurses' uncertainty regarding their role in ACP, (3) nurses feeling uncomfortable engaging in ACP discussions, and (4) nurses struggling to support families in ACP discussions. Conclusion: Recommendations for nurses, healthcare providers, LTCH administrators, and policy makers include: (1) development of policies which support, from a systemic level, nurses to feel safe while engaging in ACP; (2) reassessing LTCH's hierarchical structure, and clarifying RN, RPN, and interdisciplinary team members roles in ACP; (3) developing culture change that allows a team and person-centered approach to ACP; and (4) providing ongoing education and mentorship for nurses to manage family dynamics and expand their understanding of ACP beyond a biomedical lens. [ABSTRACT FROM AUTHOR]
- Subjects :
- NURSES
WORK
NURSE-patient relationships
PATIENTS' families
POWER (Social sciences)
CORPORATE culture
OCCUPATIONAL roles
MEDICAL personnel
QUALITATIVE research
DATA analysis
SELF-efficacy
INTERPROFESSIONAL relations
LONG-term health care
INTERVIEWING
FIELD notes (Science)
DECISION making in clinical medicine
UNCERTAINTY
DESCRIPTIVE statistics
NURSING
NURSING care facilities
NURSES' attitudes
RESEARCH methodology
COMMUNICATION
SOCIAL support
ADVANCE directives (Medical care)
EXPERIENTIAL learning
AUTHORITY
Subjects
Details
- Language :
- English
- ISSN :
- 23779608
- Database :
- Complementary Index
- Journal :
- SAGE Open Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 176930135
- Full Text :
- https://doi.org/10.1177/23779608241249335