This study was conducted to understand the meaning of the DNR experiences of nurses.
Methods
The data were collected through in-depth interviews, observation, and field records with five nurses from November 2009 to February 2011. The data were analyzed using narrative inquiry methodology.
Results
Three fundamental themes were derived from data analysis as following: ‘faithfulness to care for comfort,’ ‘helping for peaceful farewells between the patient and the family,’ ‘reflecting one's lives with a collision of feeling toward the death.’
Conclusion
The results indicate that nurses take a role of an advocate in caring for DNR patients and being concerned about their families' conflict and anguish. In addition, this study indicates the importance of education on living will, advanced directives and preparation for the death tailored to the public including healthcare professionals.
This article is doctor's thesis from Ewha Womans University.
REFERENCES
1. Bacchetta MD, Eachempati SR, Fins JJ, Hydo L, Barie PS. Factors influencing DNR decision-making in a surgical ICU. J Am Coll Surg. 2006;202:995-1000.
2. Bellini S, Damato EG. Nurses' knowledge, attitudes/beliefs, and care practices concerning do not resuscitate status for hospitalized neonates. J Obstet Gynecol Neonatal Nurs. 2009;38:195-205.
3. Chang Y, Huang CF, Lin CC. Do-not-resuscitate orders for critically ill patients in intensive care. Nurs Ethics. 2010;17:445-455.
10. Hilden HM, Louhiala P, Honkasalo ML, Palo J. Finnish nurses' views on end-of-life discussions and a comparison with physicians' views. Nurs Ethics. 2004;11:165-178.
11. Holzapfel L, Demingeon G, Piralla B, Biot L, Nallet B. A four-step protocol for limitation of treatment in terminal care. An observational study in 475 intensive care unit patients. Intensive Care Med. 2002;28:1309-1315.
12. Hong SY. An empirical study for model development concerning Advance Directives. J Korean Gerontol Soc. 2010;30(4):1197-1211.
13. Jacobson JA, Kasworm E. May I take your order: A user-friendly resuscitation status and medical treatment plan form. Qual Manag Health Care. 1999;7:13-20.
14. Keating NL, Landrum MB, Rogers SO, Baum SK, Virnig BA, Huskamp HA, et al. Physician factors associated with discussions about end-of-life care. Cancer. 2010;116:998-1006.
15. Ko HJ. A study on ethical attitude of nurses about do-not-resuscitate (DNR) and change in nursing activities after DNR. Gwangju: Chosun University; 2004. Unpublished master's thesis.
16. Kwon BK, Bae H. A narrative analysis of ethical issues regarding end of life care decision. Korean J Med Ethics. 2011;14(2):157-170.
17. Kwon BK, Koh YS, Yun YH, Heo DS, Seo SY, Kim HC, et al. A study of the attitudes of patients, family members, and physicians toward the withdrawal of medical treatment for terminal patients in Korea. Korean J Med Ethics. 2010;13(1):1-16.
18. Lee MH, Kang HS. The relationship among attitude toward DNR orders, depression and self-esteem in the elderly. J Korean Gerontol Soc. 2007;27(2):323-334.
19. Lee YB. Nurses' and doctors' perceptions, experiences, and ethical attitudes on DNR. J Korean Clin Nurs Res. 2007;13(2):73-85.
20. Markson L, Clark J, Glantz L, Lamberton V, Kern D, Stollerman G. The doctor's role in discussing advance preferences for end-of-life care: Perception of physicians practicing in th VA. J Am Geriatr Soc. 1997;45:399-406.
21. Ok J, Yi M. Understanding the experiences of family members who make do-not-resuscitate decisions for cancer patients. Korean J Med Ethics. 2012;15(1):34-51.
22. Purdy IB. Embracing bioethics in neonatal intensive care, Part I: Evolving toward evidence-based ethics. Neonatal Netw. 2006;25:33-42.
23. Robinson F, Cupples M, Corrigan M. Implementing a resuscitation policy for patients at the end of life in an acute hospital setting: Qualitative study. Palliat Med. 2007;21:305-312.
25. Sinuff T, Cook DJ, Rocker GM, Griffith LE, Walter SD, Fisher MM, et al. DNR directives are established early in mechanically ventilated intensive care unit patients. Can J Anaesth. 2004;51(10):1034-1041.
26. Smith CB, Bunch L. Do not resuscitate does not mean do not treat: How palliative care and other modalities can help facilitate communication about goals of care in advanced illness. Mt Sinai J Med. 2008;75:460-465.
27. Song T, Kim KP, Koh YS. Factors determining the establishment of DNR orders in oncologic patients at a university hospital in Korea. Korean J Med. 2008;74(4):403-410.
28. Varon J, Marik PE. Cardiopulmonary resuscitation in patients with cancer. Am J Hosp Palliat Care. 2007;24:224-229.
29. Westphal DM, McKee SA. End-of-life decision making in the intensive care unit: Physician and nurse perspectives. Am J Med Qual. 2009;24:222-228.
30. Yi , Oh SE, Choi EO, Kwon IG, Kwon SB, Cho KM, et al. Hospital nurses' experience of do-not-resuscitate in Korea. J Korean Acad Nurs. 2008;38(2):298-309.
Burnout and Related Factors of Nurses Caring for DNR Patients in Intensive Care Units, South Korea Sohyune Sok, Hyebeen Sim, Bokhee Han, Se Joung Park International Journal of Environmental Research and Public Health.2020; 17(23): 8899. CrossRef
Long-term Care Hospital Nurses' Awareness and Ethical Attitudes toward DNR Kye Ha Kim, Sun Jin Jeong Journal of Korean Gerontological Nursing.2019; 21(2): 61. CrossRef
Lived Experience of Primary Decision - Makers Regarding Do-Not-Resuscitate Instruction: Using Parse's Method Eun Young Lee, Sung Rae Shin Korean Journal of Adult Nursing.2019; 31(5): 540. CrossRef
Effects on Turnover Intention due to Terminal Care Stress of Nurses Working in Long-term Care Hospitals Shin-young Ha, Jun-Ah Song Journal of Korean Gerontological Nursing.2018; 20(3): 217. CrossRef
Withdrawal of Life-Sustaining Treatment from Children: Experiences of Nurses Caring for the Children So Yeon Park, Hyeon Ok Ju, Ga Eon Lee Child Health Nursing Research.2017; 23(3): 364. CrossRef
Attitudes and Type Analysis of Cardiopulmonary Resuscitation among Hospital Nurses in Emergency Room and Intensive Care Units Eun-Ho Ha, Kyoung-Soon Hyun Korean Journal of Adult Nursing.2017; 29(5): 484. CrossRef
Intensive Care Nurses’ Experiences of Death of Patients with DNR Orders Ji Yun Lee, Yong Mi Lee, Jae In Jang The Korean Journal of Hospice and Palliative Care.2017; 20(2): 122. CrossRef
Predictors of Agreement With Writing Advance Directives Among Older Korean Adults Jaewon Park, Jun-Ah Song Journal of Transcultural Nursing.2016; 27(6): 574. CrossRef
Factors Influencing Performance of End-of-life Care by ICU Nurses Mun Jung Ko, So-Hyun Moon Journal of Korean Academy of Psychiatric and Mental Health Nursing.2016; 25(4): 327. CrossRef
E-SUBMISSION
