International Journal of Africa Nursing Sciences (Jan 2022)
An exploration of nephrology nurses’ experiences of caring for dying patients with end Stage Kidney Disease (ESKD) following withdrawal of dialysis – A South African perspective
Abstract
Introduction: For Nephrology nurses, the fear and anxiety of impending death of a patient with End Stage Kidney Disease is very real. The literature highlights the near invisibility of impending death and the anxiety experienced by Nephrology nurses who care for patients with End Stage Kidney Disease. Following the deaths of their patients, nephrology nurses may suffer from a personal loss because of the prolonged countertransference in the relationship between them and their patients and often the family and other caregivers. Aim of the study: The study explores and describes Nephrology Nurses’ experiences of caring for dying patients with End Stage Kidney Disease following withdrawal of dialysis. Methodology: A qualitative research design using a phenomenological approach was found to be appropriate for this study. Data was collected through phenomenological conversations and analysed using Colaizzi’s seven step inductive method.A purposive heterogeneous sampling method was used to select eight Nephrology nurses who met the inclusion criteria in the research setting at two private renal dialysis centres in Cape Town, South Africa.The phenomenological conversations were guided by a leading question and a set list of conversational prompts. The phenomenological conversations were digitally recorded and transcribed verbatim. Results: After the feedback sessions, four main themes emerged: emotional trauma, detachment, loss of altruistic values in nursing, and being-with-death. Conclusion: Irrespective of the participants extensive involvement in treating patients with End Stage Kidney Disease, there was immense emotional trauma with no support from hospital management. It was evident from an ontological perspective that the participants realised the reality of their own death. It is recommended that the educational aspects of death and dying are incorporated in curricula. This study endorses the need for further research into patients with End Stage Kidney Disease and how to better care for them at end-of-life.
