Nurses “Storytelling” about end of life care for haematology patients

Purpose
Research suggests that end of life care for many haematology patients remains in the acute hospital setting. Many patients are unlikely to have palliative care support as the dying trajectory is often complicated by invasive treatments. Timely referral to Palliative Care can often be sabotaged by catastrophic haemorrhage, sepsis and dependency upon blood products. Patients living in rural and remote regions are further subject to relocation issues including isolation. The aim of this study was designed to gain insight into nurse's perception and beliefs towards the provision of palliative care for haematology patients.

Methodology
Haematology patients referred to Palliative Care between 2004 and 2006 were identified from the database. The qualitative study used thematic analysis to examine influences impacting upon physical, psychosocial and spiritual domains encompassing patient care. Nurses participated in focus groups using selected case study and individual storytelling to guide discussion and generate attitudes. Nurses were encouraged to tell their story.

Results
Findings indicate that nurses focused primarily upon the disease and viewed palliative care as symptom control in the dying phase. The nurses expressed feelings of frustration in dealing with complex decisions around end of life care and often overwhelmed by the complexity of the treatment plans. The management of patient care is further complicated by long term relationships with the family.

Conclusion
Although nurses exhibited commitment to providing comfort and care for their patients their predominant view of palliative care is symptom management. The importance of maintaining quality of life was recognised but the means for achieving this was hard to define. This poster asserts the importance of using storytelling as a means of reflective practice and as a way of promoting dialogue amongst nurses.