Being a palliative nurse for persons with severe congestive heart failure in advanced homecare

Received 2 November 2004; received in revised form 1 April 2005; accepted 11 April 2005. published online 09 June 2005.

Abstract

Advanced homecare for persons with congestive heart failure is a ‘new’ challenge for palliative nurses. The aim of this study is to illuminate the meaning of being a palliative nurse for persons with severe congestive heart failure in advanced homecare. Narrative interviews with 11 nurses were conducted, tape-recorded, and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text. One meaning of being a palliative nurse is being firmly rooted and guided by the values of palliative culture. Being adaptable to the patient's way of life carries great weight. On one hand nurses live out this value, facilitating for the patients to live their everydaylife as good as possible. Being a facilitator is revealed as difficult, challenging, but overall positive. On the other hand nurses get into a tight corner when values of palliative culture clash and do not correspond with the nurses interpretation of what is good for the person with congestive heart failure. Being in such a tight corner is revealed as frustrating and giving rise to feelings of inadequacy. Thus, it seems important to reflect critical on the values of palliative culture.

Keywords: Congestive heart failure, Homecare, Nurse, Palliative, Phenomenological-hermeneutics

a Department of Nursing, Umeå University, S-90187, Umeå, Sweden

b HeartNet, Skeria 4, S-93177, Skellefteå, Sweden

c Department of Medicine-Geriatric, S-93186, Skellefteå County Hospital, Sweden

d Department of Public Health and Clinical Medicine, Umeå University, S-90187, Umeå, Sweden

Corresponding author. Department of Nursing, Umeå University, S-90187, Sweden. Tel.:+46 91210016; fax: +46 91210016.

1 Tel.: +46 907869120; fax: +46 907869851.

2 Tel.: +46 907869253; fax: +46 907869851.

3 Tel.: +46 910771113; fax: +46 91050234.

4 Tel.: +46 910585384; fax: +46 910585387.

PII: S1474-5151(05)00061-7

doi:10.1016/j.ejcnurse.2005.04.007

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