Objective: The objective of the present study is to clarify outcomes expected to be gained from sharing the experience of end-of-life care provision with a peer group of dialysis staff.

Method: Action research qualitative approach was employed, targeting on staff working in dialysis facilities that agreed on entire participation throughout the research.

Results: The following 5 phases are identified: [1] Dialysis staff realize that they do not have opportunity to express their feelings or thoughts over end-of-life care. [2] Difficulties in preparing advance directives make dialysis staff realize the importance of everyday involvement with patients. [3] Dialysis staff pour out and share emotion regarding care for dialysis patients facing nearing death. [4] End-of-life care for dialysis patients practiced jointly among clinical engineer and nurse. This change, the first endeavor at the facility, developed into a concerted effort of end-of-life care practice with the entire dialysis staff supporting each other. [5] Dialysis staff seek to continue their own forum for discussing end-of-life care for dialysis patients.

Discussion: This study offered new insight that end-of-life care is an extension of everyday care. The meetings that served as a secure opportunity for the dialysis staff allowed them to reveal and share their honest emotion. Furthermore, this change is considered representing a transformation from a task-oriented organization that operates based on doctors’ instructions to a more autonomous organization of cooperative practice with consultation with doctors. These findings provide practical suggestions toward a new team approach for end-of-life care.

The purpose of this study was to clarify the emotional experiences of nurses caring for patients with acute spinal cord injury. Semi-structured interviews were conducted with five nurses who had experience nursing spinal cord injury patients in acute care mixed wards. As a result of the data analysis, seven categories of emotional experiences were extracted as background for the specificity of the disease of spinal cord injury and the characteristics of an acute care mixed ward. These nurses were hesitant to get involved because they feared for the future of their patients who had sustained spinal cord injuries. However, the emotional experience of “witnessing the positive changes in the patient during hospitalization” increased her orientation toward the patient. This suggests that the nurses moved from empathy to a process of building a supportive relationship with the patient. It also can be speculated that in the acute care mixed ward, nurses have a coping behavior that [the sense of inadequacy due to multiple tasks must be discounted], and that they unconsciously use strategies to transform their own feelings and cognitions about negative emotions. It is necessary for nurses to know their own emotions and thought patterns.