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Hospice palliative care is aimed at relieving suffering and improving the quality of life for people living with, or dying from, advanced illness or who are bereaved. Hospice palliative care meets not only physical needs, but also psychological, social, cultural, emotional, and spiritual needs of each person and family.
The COVID-19 pandemic placed the hospice philosophy and associated values under pressure. Care provided by hospice nurses shifted from interdisciplinary and holistic care to a focus on avoiding the spread of infectious disease. Restrictive visitor policies and the use of personal protective equipment both disrupted the usual social interactions involved in delivering interdisciplinary hospice palliative care.
To better understand the impact of the pandemic on hospice nurses, Bové and colleagues (2023) conducted a phenomenological study of providing end-of-life (EOL) care. The purpose of this study was to elucidate nurses’ lived experience of providing EOL care to patients admitted in an inpatient hospice setting during the COVID-19 pandemic.
The study participants included 10 nurses working in an inpatient hospice setting during the COVID-19 pandemic in Denmark. The nurses’ experience working in hospice palliative care ranged from 18 months to 14 years. Semi-structured interviews were conducted, beginning with a few pre-determined questions and probing with follow-up questions. Interviews were recorded, transcribed an analyzed.
Nurses described the experience of providing EOL care during the pandemic as having an existential dimension related to being a hospice nurse and a practical dimension related to providing EOL care. Being a hospice nurse refers to the experience of being a qualified nurse and choosing to work compassionately with patients and families in the context of imminent death. The dimension of providing EOL care relates to nurses’ clinical experiences in meeting physical, psychological, social, cultural, emotional, and spiritual needs.
The pandemic disrupted the traditional movement between these two dimensions resulting in insecurity and unfamiliarity with care. Nurses indicated that they experienced internal struggles resulting from the wish to both follow rules and restrictions while also continuing to provide compassionate, holistic care. This struggle caused nurses to question clinical judgment and decision-making processes, resulting in a loss of job satisfaction.
The results of this study highlight the importance of remaining attentive to hospice nurses’ mental health and well-being.
Source: Bové, H. M., Noer, V. R., & Mousing, C. A. (2023). Being a Hospice Nurse in Times of the COVID-19 Pandemic: A Phenomenological Study of Providing End-of-Life Care. Journal of Hospice and Palliative Nursing: JHPN: the Official Journal of the Hospice and Palliative Nurses Association.
