Difficulties Faced by Nurses Newly Assigned to a Palliative Care Ward: Based on Interviews at 3 Points after Their Assignment

Abstract

Objective: To clarify the care-related difficulties faced by nurses newly assigned to a palliative care ward, and develop future perspectives on education and support for such nurses. Methods: Semi-structured interviews were conducted with 4 nurses at 3 points: 1) immediately, 2) 10 months, and 3) 1 year and 6 months after their assignment to the palliative care ward. The obtained data were analyzed, adopting the content analysis method developed by K. Krippendorff. Results: The difficulties faced by the nurses at each point included: 1) [realizing their own insufficient understanding of palliative care and repeating trials and errors to appropriately manage each situation] and [considering methods to benefit the most from their knowledge related to general wards, while developing anxiety over differences between such wards and this one]; 2) [becoming aware of the significance of active listening to patients with a short life expectancy and realizing their limited skills for it] and [difficulties and dilemmas caused by conflicts related to care policies]; and 3) [difficulty in making judgment regarding care due to an insufficient confirmation of patients’ intentions] and [becoming aware of the importance of establishing favorable relationships with patients/families]. Conclusion: Education and support for nurses newly assigned to palliative care wards should be continuously provided on a step-by-step basis through approaches, such as improving their active listening skills in the early stages, confirming their knowledge of interpersonal support and bioethics, and providing opportunities for them to examine each case.