Attitudes of nursing staff towards involvement in medical end-of-life decisions: a national survey study

Abstract

Objectives: To investigate nursing staff attitudes towards involvement and role in end-of-life decisions (ELDs) and the relationships with sociodemographic and work-related characteristics.

Methods: Survey study among nationally representative Dutch research sample consisting of care professionals. Nursing staff working in hospitals, home care, nursing homes or homes for the elderly were sent ELD-questionnaire.

Response: 66% (n=587). Most respondents had been involved in ELD. Three quarters wanted to be involved in whole ELD process; 58% agreed that decisions to withhold/withdraw treatment ought to be discussed with the nurses involved; 64% believed patients would talk rather to nurses than physicians; 72% thought physicians are usually prepared to listen to nurses' opinions. Hospital and highly educated nursing staff indicated relatively more often that they want to be involved in ELD.

Conclusion: Majority of nursing staff want to be involved in ELD. Work setting and educational level are determining factors in attitudes of nursing staff regarding involvement in ELD.

Practice implications: Awareness on the important role nurses have and want to have in ELD should be raised, and taken into account in trainings on end-of-life care for nurses and physicians and development of guidelines for communication about ELD between patients, nursing staff and physicians.

Keywords: Attitude of health personnel; Decision making/ethics; Nurse's role; Nurse–patient relations/ethics; Nursing staff/psychology; Palliative care; Questionnaires; Religion; Terminal care; Withholding Treatment/ethics.