Relational ethics of delirium care: Findings from a hospice ethnography. Issue 3 (24th March 2018)

• Record Type: Journal Article
• Authors: Wright, David Kenneth; Brajtman, Susan; Macdonald, Mary Ellen
• Is Part Of: Nursing inquiry. Volume 25:Issue 3(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-03-24
• Subjects: death and dying -- ethics -- nursing practice -- palliative care -- qualitative methods; Nursing -- Periodicals; 610.73
• DOI: 10.1111/nin.12234
• Languages: English
• ISSNs: 1320-7881

Abstract

Abstract : Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients' comfort and dignity were deemed most at stake and therefore commanded nurses' primary attention. This overarching commitment to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients' subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care.