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Sharing living and dying: A balancing act between vulnerability and a sense of security: enrolled nurses' experiences of working in the sitting service for dying patients at home
Örebro University, School of Health and Medical Sciences.
School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden; Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
Department of Nursing, Gjövik University College, Gjøvik, Norway; Department of Palliative care Research, Ersta Sköndal University College, Stockholm, Sweden.
2011 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 9, no 3, p. 295-303Article in journal (Refereed) Published
Abstract [en]

Objective: To describe enrolled nurses’ (ENs’) experiences of working in a sitting service for dying patients at home (which in this article will be referred to as SSH).

Methods: The ENs, who participated in this study, had permanent jobs in community care/ primary care, but were also employed part-time in a special home-sitting-service organisation in a municipality in the south of Sweden. Data were collected by four focus group interviews with 17 enrolled nurses. Qualitative content analysis was used to analyse the data.

Results: Care-giving in SSH was a balancing act between a sense of security and a feeling of vulnerability. Feeling secure and valued, and that one is developing both professionally and personally stemmed from working in partnership, whereas a feeling of vulnerability was associated with managing closeness and distance, being a mediator, having responsibility and feeling guilty, feeling hindered from doing good, facing loneliness and in affecting private lives.

Significance of the results: SSH makes it possible for people who are terminally ill to remain at home until they die. If the SSH organisation were not an option for dying patients and their families, the pressure on the healthcare organisation would be dramatically increased.

Place, publisher, year, edition, pages
Cambridge: Cambridge University Press, 2011. Vol. 9, no 3, p. 295-303
Keywords [en]
enrolled nurses, end-of-life care, respite care, sitting service
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-21761DOI: 10.1017/S1478951511000241ISI: 000309995700007PubMedID: 21838950Scopus ID: 2-s2.0-84855365420OAI: oai:DiVA.org:oru-21761DiVA, id: diva2:505116
Available from: 2012-02-24 Created: 2012-02-23 Last updated: 2018-05-03Bibliographically approved
In thesis
1. Utmaningar, utsatthet och stöd i palliativ vård utanför specialistenheter
Open this publication in new window or tab >>Utmaningar, utsatthet och stöd i palliativ vård utanför specialistenheter
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to study palliative end-of-life care outside specialist palliative care settings, from an organizational perspective and from professionals’ and relatives’ experiences. In Study I 174 individuals were identified retrospectively from nursing records and palliative care identification forms as being in a palliative phase. Data were analyzed with descriptive and analytic statistical methods. In Study II a total of nine nurses working in primary home care, community care, and hospitals were interviewed. Phenomenological methodology was used to analyze data. In Study III 17 enrolled nurses, who worked in community or primary care and in a sitting service organization, participated in four focus group interviews. Data were analyzed with qualitative content analysis. In Study IV seven relatives from four families were interviewed twice. They had each cared in the private home for a dying family member who had received sitting service. Direct interpretation and categorical aggregation were used to analyze data. The results highlight challenges in palliative care, vulnerable situations, and a need of support (I–IV). Individuals’ needs for both palliative care and sitting service were identified, including those of a smaller part of the population who actually received the sitting service. (I). Registered nurses’ responsibilities included care at the same time for individuals in both palliative and curative phases. This created vulnerable situations for the nurses, since their ambitions concerning the care did not correspond to available resources (II). The enrolled nurses’ task was to manage ongoing life and dying in different care settings, to meet individual needs and still provide equivalent care. Despite experiences of vulnerable situations, they felt safe (III). Relatives experienced care situations differently, related to differences in families, the illness trajectory, the need for support, and the support offered. Without sufficient support, vulnerable situations occurred, which made the relatives feel insecure (IV). Thus, care situations in palliative end-of-life care can be experienced in different ways, with different levels of vulnerability. One implication of the research might be to suggest that professional caregivers, to supplement the relatives’ own resources with support tailored to the individual’s and the family’s needs

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 88
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 34
Keywords
vulnerability, support, challenges, palliative care, relatives, registered nurses, enrolled nurses, end-of-life care
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-21411 (URN)978-91-7668-860-1 (ISBN)
Public defence
2012-03-16, Örebro universitet, Hörsal P2, Prismahuset, Fakultetsgatan 1, Örebro, 13:00
Opponent
Supervisors
Available from: 2012-01-30 Created: 2012-01-30 Last updated: 2017-10-17Bibliographically approved

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Wallerstedt, BirgittaAndershed, Birgitta

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