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Attitudes of nurses to nursing care for terminally ill clients in the long term care Departments
SCHMIDOVÁ, Žaneta
Terminal phase means gradual and irreversible failure of vital functions and organs ending in death. This state directly precedes death. We can understand terminal stage as dying itself. "Nevertheless the term dying must in no case be reduced to terminal phase" (Kelnarová, 2007, p. 10). It is the most demanding phase for a nurse and the whole team caring about a dying patient (Theová, 2002).This thesis deals with mapping nursing care of clients at terminal stage and the possibilities of coping with the care of dying clients and their family members for nurses.The research part was elaborated in the form of qualitative research. The aim was to obtain high quality data to given topic. The technique of semi structured in-depth interview was chosen as the most suitable method. Each respondent was given a number. Lines were subsequently numbered to enable references. The data were analysed by the paper-and-pencil method and four categories were created. Ten subcategories were created within the given categories. The information obtained was processed in schemes. The interviews were performed from February to April 2014.The research sample consisted of six nurses working at a long-term care department. The nurses were intentionally chosen in various categories to get the most objective possible data. There was also one man working at the position of a nurse.The respondents' answers showed that nurses working at the long-term care department have basic knowledge of the issue, are able to get oriented in the problems of dying, the terminal stage length, are able to describe the frequency of meeting with a dying client. The nurses cope well with satisfying the needs of terminally ill clients, they do not omit any of the needs. The nurses are capable of having holistic approach to clients. They take the demands of the care about a dying client as a part of their work, they make no difference and care about a dying person as of any other client at their department. They describe their experience with the dying and their families, they only describe communication with a dying client and his/her family as problematic and sometimes they are not sure whether they act correctly and are afraid of hurting someone. They communicate with such a client and his/her family according to their best conscience and they hope that their approach is the right one. The research has also shown that the nurses are able to prevent the burnout syndrome, they understand that they have to care about themselves, they must like their work, have positive approach to life. They perceive burnout syndrome as a problem, they try to prevent it and if they feel symptoms of inconvenience and dissatisfaction with their job they try to find the better aspects and not to give up. Except for one respondent, who describes herself as burned out. This is however given by the respondent's personality itself.The research shows that nurses have sufficient knowledge of the problems of terminally ill clients at their department, that they are able to provide quality nursing care. They however admit that sometimes they are not completely sure whether they treat a client correctly not to hurt him/her in given situation. After this fact was discovered a brochure was prepared giving nurses instructions for general approach to dying clients and help them minimize negative impact on a client.
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