Thesis Format
Alternative Format
Degree
Master of Science
Program
Nursing
Supervisor
Babenko-Mould, Yolanda
Abstract
Critical Care Outreach Team (CCOT) nurses are part of hospital emergency response teams, assessing and mobilizing resources for decompensating patients. Although a significant proportion of this role involves addressing end-of-life (EOL) issues, this role is ill-defined in the literature and in practice. The purpose of this interpretive descriptive study is to explore CCOT nurses’ involvement in EOL discussions. In-depth interviews were conducted with 11 participants across hospitals in Ontario. Thematic analysis identified six themes: the relational nature of the CCOT nurse role, acquiring skills to discuss EOL, impetus for CCOT nurse involvement, dynamic approaches to EOL discussions, the impact of CCOT nurse involvement, and “doing better”. Study findings point towards potential implications for educational, organizational practice, and policy strategies to support CCOT nurses engaging in EOL discussions.
Summary for Lay Audience
Critical Care Outreach Team (CCOT) nurses are an integral part of the CCOT team. They respond to medical emergencies within hospital settings, assessing patients and working within teams to determine a plan of care for the patient. Because of their involvement in patients’ care during times of transition, CCOT nurses naturally become involved in conversations about treatment decisions and end-of-life (EOL). While there is evidence that CCOT nurses are involved in EOL discussions in their daily practice, this is not well-defined in the literature. The purpose of this study was to explore CCOT nurses’ experiences with EOL discussions. Individual interviews were conducted with 11 nurses who self-identified as having experience in EOL decision-making conversations in hospital settings in Ontario. These interviews identified six main themes. The first theme, the relational nature of the CCOT nurse role, explores the CCOT nursing role as an independent practitioner and an integral team member, providing context to their involvement in EOL discussions. The second theme, acquiring skills to discuss EOL, sheds light on the lack of formal education nurses receive and highlights alternative ways CCOT nurses learn this skill. The third theme, impetus for CCOT nurse involvement, reveals circumstances that contribute to the CCOT nurses’ decision to engage in EOL conversations. The fourth theme, dynamic approaches to EOL discussions, outlines the non-prescriptive approach nurses take to discussing EOL, while also highlighting common strategies across individual participants. The fifth theme, the impact of CCOT nurse involvement, elucidates the impact of EOL discussions, highlighting how this affects the nurse and patients and families. Lastly, the sixth theme, “doing better,” highlights recommendations from participants for how EOL discussions can be improved. Findings from this study provide foundational information on the CCOT nurse role in EOL discussions that can be built upon in further research and point towards mechanisms that can be improved upon to better support the CCOT nurse, such as education, organizational practice changes and policy.
Recommended Citation
Gregorio, Marley B. Ms., "Critical Care Outreach Team Nurses' Roles in End-of-Life Discussions" (2024). Electronic Thesis and Dissertation Repository. 10310.
https://ir.lib.uwo.ca/etd/10310
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