Nurses' experiences of palliative end-of-life care in patients at risk of a carotid blowout syndrome: A qualitative exploration

Abstract

Purpose: Hospital nurses play an important role in providing palliative end-of-life care, for example for patients with carotid blowout. In such cases, dying is a severe event in which exsanguination occurs. Little is known about nurses' experiences regarding care to patients at risk of a carotid blowout. This study aims to explore thoughts, experiences, and opinions of nurses about what they consider to be quality end-of-life nursing care for patients and their relatives, specifically those at risk of carotid blowout syndrome and the impact of providing such care on their professional and emotional well-being.

Methods: This study employed a qualitative design using audio-recorded, semi-structured focus group interviews. Three focus groups were conducted, comprising 11 nurses who worked on a head and neck unit. Interview transcripts were analyzed using thematic analysis.

Results: Participants reported nursing priorities in end-of-life carotid blowout care, comprising patients' wishes, emotional support, preparing patients and dying care. Participants mentioned that a carotid blowout event was rare and impactful. A comprehensive protocol and scenario-based training facilitated the provision of end-of-life care. This study identified areas for improvement, such as the opportunity for moral support and debriefing after a blowout event for involved nurses.

Conclusion: Remarkable knowledge emerged about nurses' experiences regarding end-of-life care and frequently used nursing interventions. Being prepared and having a workable protocol to deliver end-of-life care emerge as key. This exploratory study facilitates discussion of areas important to nurses providing end-of-life care in rare and impactful conditions.

Keywords: Carotid artery diseases; Focus groups; Nursing process; Qualitative research; Terminal care.