Peer-Reviewed Journal Details
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Dwyer I, McCarthy J
End-of-Life Journal – BMJ Journals
Experiences of palliative care nurses in the utilisation of palliative sedation in a hospice setting
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ABSTRACT Background Palliative sedation, or bringing about a state of decreased or absent awareness (unconsciousness), is one of the therapies used in end-of-life healthcare settings in order to manage refractory symptoms such as pain, dyspnoea and distress. It is intended to relieve the burden of intolerable suffering of patients who are in the process of dying. Nurses are centrally involved in the utilisation of palliative sedation in end-of-life care; however, there is minimal research available in relation to their experiences in this regard. The dearth of research prompted this study. Aim To explore the experiences of palliative care nurses in the utilisation of palliative sedation in end-of-life care. Methodology A descriptive phenomenological methodology was adopted involving unstructured interviews. A purposive sample was used of 10 palliative care nurses with at least 1 year’s experience of working in a hospice setting in Ireland. The data were analysed using Colaizzi’s seven-stage phenomenological method. Findings Data analysis led to the identification of four core themes: (1) information sharing, (2) timing of palliative sedation, (3) level of sedation and (4) palliative sedation as a last resort. The results indicate that the participants were generally satisfied with the processes that underpinned decisions to introduce palliative sedation. They saw it as a highly complex intervention, in part because it involved individuals with very complex conditions and symptoms. Conclusions Palliative care patients, families and the general public in Ireland need to have greater understanding of the role of palliative sedation in the treatment of refractory symptoms at the end of life.
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