Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec;15(12):1459-1464.
doi: 10.1513/AnnalsATS.201804-284OC.

Dying Patient and Family Contributions to Nurse Distress in the ICU

Lindsay Lief  1   2 , David A Berlin  1   2 , Renee C Maciejewski  1   2 , Li Westman  1 , Amanda Su  1 , Zara R Cooper  3 , Daniel J Ouyang  1 , Geraldine Epping  4 , Heather Derry  1 , David Russell  1 , Eliza Gentzler  1 , Paul K Maciejewski  1   2   5 , Holly G Prigerson  1   2
Affiliations

Dying Patient and Family Contributions to Nurse Distress in the ICU

Lindsay Lief et al. Ann Am Thorac Soc. 2018 Dec.

Abstract

Rationale: Caring for patients at the end of life is emotionally taxing and may contribute to burnout. Nevertheless, little is known about the factors associated with emotional distress in intensive care unit (ICU) nurses.

Objectives: To identify patient and family factors associated with nurses' emotional distress in caring for dying patients in the ICU.

Methods: One hundred nurses who cared for 200 deceased ICU patients at two large academic medical centers in the Northeast United States were interviewed about patients' psychological and physical symptoms, their reactions to those patient experiences (e.g., emotional distress), and perceived factors contributing to their emotional distress. Logistic regression analyses modeled nurses' emotional distress as a function of patient symptoms and care.

Results: Patients' overall quality of death (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.31-7.25), suffering (OR, 2.34; CI, 1.03-5.29), and loss of dignity (OR, 2.95; CI, 1.19-7.29) were significantly associated with nurse emotional distress. Some 40.5% (79 of 195) of nurses identified families' fears of patient death, and 34.4% (67 of 195) identified families' unrealistic expectations as contributing to their own emotional distress.

Conclusions: Patients' emotional distress, physical distress, and perceived quality of death are associated with nurse emotional distress. Unrealistic family expectations for the patient may be a source of nurse emotional distress. Improving patients' quality of death, including enhancing their dignity, reducing their suffering, and promoting acceptance of an impending death among family members may improve the emotional health of nurses.

Keywords: critical care; end of life; intensive care unit; nurse emotional distress.

PubMed Disclaimer

Comment in

References

    1. Mealer ML, Shelton A, Berg B, Rothbaum B, Moss M. Increased prevalence of post-traumatic stress disorder symptoms in critical care nurses. Am J Respir Crit Care Med. 2007;175:693–697. - PubMed
    1. Costa DK, Moss M. The cost of caring: emotion, burnout, and psychological distress in critical care clinicians. Ann Am Thorac Soc. 2018;15:787–790. - PMC - PubMed
    1. Leckie JD. I will not cry. Ann Am Thorac Soc. 2018;15:785–786. - PubMed
    1. Poncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med. 2007;175:698–704. - PubMed
    1. Mealer M, Moss M. Moral distress in ICU nurses. Intensive Care Med. 2016;42:1615–1617. - PMC - PubMed

Publication types

LinkOut - more resources