Open Access

Nursing students’ experiences of caring for dying patients and their families: a systematic review and meta-synthesis

   | Dec 31, 2019

Cite

Themes and sub-themes on the experiences.

ThemeSub-theme
Students with dying patientsInadequacy in symptom control and comfort supply
Inability in therapeutic communication
Last offices
Students with patients’ familiesMore concern for families
Students with surroundingsNursing preceptors’ supporting
Other medical staff’s effects
Over-workload in the clinic
Students with themselvesEmotional challenges and coping
Personal and professional growth

The example of meta-synthesis for one theme of nursing students for caring for dying patients and their families.

CodesSub-themeTheme
Fear/shock AnxiousEmotional challengesStudents with themselves
Being on a roller coaster
Satisfactory
Exhausting
Shatter in pieces
Awkward
Impotent
Trapper
Helpless
Angry
Self-doubt
Guilty
MediatedCoping
Detachment
Switch off
Reject
Quit
Cry
Talk and share

Descriptions of the included studies.

StudyObjectiveMethodsSampleData collectionData analysisMain topics
Kiger3Explore the student nurses' involvement with death image and the experienceGrounded theoryn = 24, nursing studentsIndividual interviewsComparative analysis(1) Entry images of death; (2) experience-mediated image of death (rewarding experience and coping); (3) processes of image development affirmation and transformation
Beck4Explore the meaning of nursing students' experiences in caring for dying patientsPhenomenologyn = 26, sophomore- and junior-level nursing studentsHandwriting papersColaizzi's phenomenological methodology: a content analysis(1) Nursing students experienced a gamut of emotions when caring for dying patients; (2) contemplating the patient's life and death occurred as nursing students cared for their patients; (3) supporting the dying patient's family became an integral part of nursing students' care; (4) nursing students experienced helplessness regarding their role as patient advocates; (5) nursing care for dying patients entailed providing comfort physically, mentally, and spiritually; (6) when caring for dying patients, student nurses' learning flourished
Cooper and Barnett5Examine what aspects of caring for dying patients cause anxiety in students nurses during their first year of trainingQualitative descriptionn = 38, first-year student nursesReflective diaries, focus groupColaizzi's phenomenological methodology: a content analysis(1) Coping with the physical suffering of patients; (2) the severing of the relationship with the patient; (3) not knowing what to do or say; (4) the type of death; (5) CPR; (6) last offices; (7) coping mechanisms; (8) interventions that may improve the student experience
Van Rooyen et al.6Explore and describe how nursing students experience the accompaniment of the dying patient and care of the patient after deathPhenomenologyn = 6, the first two years of student nursesIndividual interviewsTesch's descriptive analysis method(1) Student nurse experienced intrapersonal turmoil due to feeling and emotions invoked by nursing the dying patient; (2) student nurse experienced turmoil in interpersonal relationships due to conflict resulting from expectations related to a role model not being met; (3) student nurse experienced a need to find or to create meaning through a transcendental relationship
Allchin7Identify and clarify the characteristics of students' experiences in providing care for dying persons and their familiesHermeneutic phenomenologyn = 12, junior- level nursing studentsIndividual interviewsGiorgi's method(1) Initial hesitancy and discomfort; (2) reflective musings; (3) personal and professional benefits
Terry and Carroll8Investigate first-year nursing students' encounters with patient deathDescriptive phenomenologyn = 14, first-year studentsFocus groupContent analysis(1) Abandonment: students encountered the first death in clinical practice early in their training and could feel abandoned by staff or be guilty of abandoning the patient or relatives through not knowing what to do; (2) emotional distress often resulted from the feelings of abandonment and embraced both personal distress and distress for the patients and their families
Wang et al.9Explore the experience of hospice care of the student nursesHermeneutic phenomenologyn = 30, bachelor degree nursing studentsIndividual interviewsVan Manen's category analysis(1) Students showed great fear when facing patients death; (2) students lacked knowledge of hospice care; (3) students showed a great desire for the knowledge; (4) the ways for students to acquire hospice care information were limited
Sadala and da Silva10Understand how nursing undergraduates perceive themselves while care delivery to terminal patients and expose the meaning of their experiencePhenomenologyn = 14, nursing graduatesIndividual interviewsContent analysis(1) Facing the situation of caring for a terminal patient; (2) the relationship with the patient and his/her family; (3) reflection about the experience
Huang et al.11Elucidate the experiences of first encountering death by nursing studentsDescriptive qualitative methodn = 12, nursing studentsIndividual interviewsColaizzi's seven-step method(1) Providing care during the dying period (feelings of dread and terror, hardship of experiencing patients' life fading away, and devotion to patients care and self-affirmation); (2) facing the moment of patient death (state of being scared or trapped, emotional breakdown); (3) adaptation after patient death (accept or avoidance, growth or escape)
Sanford et al.12Examine the experiences of nursing students caring for cancer patientsDescriptive qualitative methodn = 15, undergraduate baccalaureate nursing studentsFocus groupMorse and Field method(1) Caring for patients and their families; (2) interaction between students and healthcare providers; (3) students experiences with dying patients; (4) students' prior experiences with cancer
Parry13Understand how a student nurse might feel when confronted with a dying patientPhenomenologyn = 5, nursing studentsFocus groupContent analysis(1) Emotional influence: shock/fear, speed of deterioration of the patient, symptoms observed, own perception versus reality, need to cry; (2) role of mentor: relationship with mentor, culture of mentor, support from mentor; (3) relationships: with patient, link to own family, support mechanism, with patient's family, dignity; (4) skills: what to say, lack of perceived preparation, last offices
Lu and Shi14Describe the experience of undergraduate nursing students who had provided hospice carePhenomenologyn = 14, nursing studentsIndividual interviewsColaizzi's seven-step method(1) The feelings when facing the dying patient: sadness, empathy, helplessness, fear, and nervousness; (2) the feeling for the last office: taking it as one of the duties of a nurse, but doing it without initiative; (3) the knowledge on hospice care was not enough
Charalambous and Kaite15Interpret the students' experiences of coming face-to-face with cancer careHermeneutic phenomenologyn = 12, the fourth-year nursing studentsReflective diariesContent analysis(1) Being part of the center's life; (2) being sympathetic; (3) being confronted by others; (4) being self-reflective; (5) being trapped in the system; (6) being caring toward the patients family; (7) being better in clinical practice
Munoz-Pino16Describe the experiences endured by the third- and fourth-year student nurses upon their first care encounter with a terminal ill patientDescriptive qualitative methodn = 31, the third- and fourth-year nursing studentsWritten testimoniesContent analysis(1) Enriching experience, life learning is accomplished personally and professionally; (2) feelings and emotions upon the first encounter; (3) loving care; (4) sense to nursing; (5) importance of the interdisciplinary healthcare staff and the comprehensive care model; (6) incorporation of the family in caring; (7) need for communication skills
Adesina et al.17Explore a cohort of third-year undergraduates attitudes, experiences, knowledge, and education concerning end-of-life careA combination of open-ended qualitative and closed quantitative questionsn = 87, the third-year nursing studentsOpen-ended questionnaireThematic analysis(1) The importance of the students' values and beliefs; (2) the influence of experience; (3) their views on what constitutes a good or bad death; (4) their knowledge of ethics and legislation surrounding end-of-life care; (5) how they perceived their level of education and knowledge
Kristina et al.18Describe first-year student nurse's experiences of witnessing death and providing end-of-life careHermeneutic phenomenologyn = 17, the first-year nursing studentsInterviewVan Manen's thematic analysis(1) The thought of death is more frightening than the actual experiences; (2) daring to approach the dying patient and offering something of oneself; (3) the experience of not sufficing in the face of death; (4) being confronted with one's own feelings
Sampaio et al.19Understand the phenomenon experienced by nursing students in view of death and dyingPhenomenologyn = 7, senior nursing studentsInterviewContent analysis(1) Facing death and dying in academic practice; (2) acknowledging impotence in the face of death; (3) glimpsing the possibility of solicitude; (4) interacting with the patients family in view of the loss; (5) experiencing spirituality in the face of dying
Colley20Detect the senior nursing students' perceptions of caring for patients at the end-of-lifePhenomenologyn = 71, senior nursing studentsNarrative questionsStudents (1) have confidence in the provision of physical care, (2) lack confidence in the provision of emotional care, (3) experience stress and lack of knowledge when caring for patient families, (4) have concern they will be too emotionally involved, and (5) feel personal experiences enhance their confidence
Österlind et al.21To describe nursing students' perceptions of caring for dying people after the first yearPhenomenologyn = 17, the third-year nursing students(1) From abstract to reality, (2) from scary to natural, (3) increased knowledge can give bad conscience, (4) time limits versus fear of end-of-life conversations, and (5) meeting with relatives
Garrino et al.22Explore student nurses' experience of caring for dying persons and their families and how this experience was influenced by their undergraduate educationPhenomenologyn = 18, undergraduate nursing studentsNarrative interviewGiorgi's qualitative phenomenological methodology(1) Emotions and feelings, (2) reactions and coping strategies, (3) growth in personal and professional awareness, and (4) the professional nursing model

Quality assessment of the included articles.

ResearchQARI items
(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)
Kiger3UYYYYUYYYY
Beck4YYYYYUUYYY
Cooper and Barnett5YYYYYUYYYY
Van Rooyen et al.6YYYYYYYYYY
Allchin7YYYYYUUYYY
Terry and Carroll8YYYYYUUYYY
Wang et al.9YYYYYUUYYY
Sadala and da Silva10YYYYYUUYYY
Huang et al.11YYYYYUYYYY
Sanford et al.12YYYYYUUYYY
Parry13YYYYYUUYYY
Lu and Shi14YYYYYUUYYY
Charalambous and Kaite15YYYYYUUYYY
Muñoz-Pino16YYYYYUUYYY
Adesina et al.17YYYYYUUYYY
Kristina et al.18YYYYYUUYYY
Sampaio et al.19YYYYYUUYYY
Colley20UYYYYUUYYY
Österlind et al.21YYYYYUUYYY
Garrino et al.22YYYYYUUYYY
eISSN:
2544-8994
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Assistive Professions, Nursing