The Dilemma of Palliative Care Nurses: A Phenomenological Inquiry Into Their Lived Experience With Humanistic Care

Abstract

Background

Prior studies have outlined the roles and functions of palliative care nurses, yet a gap exists in understanding their lived experiences in delivering humanistic care. These nurses establish deep connections with patients and families, encountering emotional distress while witnessing their suffering. This emotional strain frequently leads to compassion fatigue and burnout. The purpose of this study was to explore humanistic nursing practices and the dilemmas faced by palliative care nurses in providing humanistic care.

Methods

A descriptive phenomenological approach was employed. Individual semi-structured interviews were conducted with 17 palliative care nurses working in Hong Kong, selected through snowball sampling. They shared their lived experiences of providing humanistic care in palliative settings, and the findings were analyzed using van Kaam's control explication method.

Results

Palliative care nurses shared both positive and negative experiences in their humanistic interactions with patients and families. They emphasized the profound influence of their care on preserving dignity and easing suffering while encountering challenges in forming meaningful connections amidst constraints such as heavy workloads that impede compassionate engagement. Four themes emerged, showcasing dilemmas confronted by nurses: juggling between “creating bonds” versus “maintaining distance,” choosing to “treasuring life more” versus “giving up life more easily,” balancing “patients’ interests” versus “families’ interests,” and weighing “patient rights” versus “public interest.” The findings highlighted the emotional complexities and burdens associated with providing humanistic care.

Conclusions

The findings illuminated the existential dimensions of humanistic nurse-patient interactions within Paterson and Zderad's theory, revealing key elements such as genuine presence, authentic self-awareness, and realizing caregiving potential. They underscored the need for better support for palliative care nurses, emphasizing improved education and practice to navigate complexities and deepen understanding of humanistic nursing principles.