Newly Graduated Registered Nurses' Perceptions About And Use Of Principles Of Palliative Care In Acute Care Settings: An Interpretive Phenomenology Study

Abstract

LATRINA T. GEYER NEWLY GRADUATED REGISTERED NURSES’ PERCEPTIONS ABOUT AND USE OF PRINCIPLES OF PALLIATIVE CARE IN ACUTE CARE SETTINGS: AN INTERPRETIVE PHENOMENOLOGY STUDY Under the direction of LANELL M. BELLURY, PhD, RN, AOCNS, OCN

The terms serious or life-threatening illness now included in current palliative care literature indicate the broadened scope of palliative care. However, the change in defining terminology has not consistently translated to a broadened understanding or advanced clinical practice for many healthcare professionals in acute care settings. The purpose of this research study was to discover NGRNs’ perceptions, meanings, and use of principles of PC for seriously ill patients in acute care settings. The research question for this study was: What are NGRNs’ lived experiences of providing PC for seriously ill patients in acute care settings? A conceptual framework adapted from Kolcaba’s (2003) comfort theory and Benner’s (1984) competencies of the helping role were developed for this study. Interpretive phenomenology research design was utilized. A purposive sample of 12 NGRNs participated in this study. Using Saldaña’s coding methods, and guided by van Manen’s (1990) thematic analysis, four themes and six subthemes were developed: 1) Trying to Figure Out What the Balance Is; 2) Working in the Dark; 3) It’s Just Who I Am; and 4) The Kairos Effect. Newly graduated registered nurses’ common and valued experiences demonstrated insight and understanding of comfort (interventions) and comfort (outcomes) for seriously ill patients in acute care settings, as well as professional formation in nursing practice. The lived experience of providing palliative care for these NGRNs included experiencing a continuum between extreme measures and giving up and the weighty emotionally and ethically taxing nature of caring for seriously ill patients. The NGRNs also applied principles of palliative care daily and found the experience rewarding, validating, and important for professional formation. The innovative framework was useful in understanding the lived experiences of NGRNs and, further research is needed to apply the framework in additional practice settings and nursing populations. Additional research is also indicated to explore whether the findings were influenced by organizational factors including structured transition to practice programs and organizational culture.