Coping methods for the dilemma and ambiguity of nurses considering treatment and care policies for end-stage renal disease patients on maintenance hemodialysis

Abstract

  This study aimed to clarify the coping methods for the dilemma and ambiguity of nurses considering treatment and care policies for end-stage renal disease (ESRD) patients on maintenance hemodialysis. Semi-structured interviews were conducted with nine nurses working in a dialysis department, regarding the cases in which they experienced dilemma and ambiguity while providing care to ESRD patients on maintenance hemodialysis, and how they dealt with it. The interviews were transcribed and the contents analyzed. The following coping methods, adopted by the nurses, were identified : [Confronting patients’ true feelings], [Promoting common understanding among patients, their families, and doctors], [Collaborating with doctors, despite conflicting beliefs, to ensure a better life for the patients], [Have a thorough dialog between medical professionals and care workers], [Observing the patients’ physical condition carefully to determine dialysis withdrawal], and [Settling with the terminal medical care system]. Nurses need to discuss ways to ensure a better quality of death―for ESRD patients on maintenance hemodialysis―with doctors and other healthcare professionals, and collaborate with them.