The impact of death and dying on the personhood of senior nurses at the National Cancer Centre Singapore (NCCS): a qualitative study

Chiam, M (通讯作者),Natl Canc Ctr Singapore, Div Canc Educ, 11 Hosp Dr, Singapore 169610, Singapore.
2022-5-20
Background A nurse's role in caring for the dying is fraught with ethical, professional, and psychosocial challenges that impact how they perceive their roles as professionals. When unsupported, nurses caring for the dying experience burnout, career dissatisfaction and leave the profession. Better understanding of how caring for the dying affects the professional identity formation (PIF) of nurses will guide efforts to better support nurses. Methods Guided by new data on the subject, we adopt the theoretical lens of the Ring Theory of Personhood (RToP) to evaluate how caring for the dying impacts the values, beliefs, principles, professional identities and personhood of nurses. We employ Krishna's Systematic Evidence-Based Approach (SEBA) to guide the design and piloting of the semi-structured interview tool. Results Analysis of interviews with eight senior nurses in Supportive, Palliative and Oncology care revealed three domains: Identity 1) Formation; 2) Conflict and 3) Refinement. Identity Formation occurs early in a nurse's career, upon entering a new specialist field, and at the start of Supportive, Palliative and Oncology care. Identity Formation reveals significant changes to how self-concepts of professional identities are tied to individual concepts of personhood. Caring for the dying, however, resulted in Conflicts between values, beliefs, and principles within regnant concepts of personhood and their professional duties. These conflicts are captured as conflicts within ('disharmony') and/or between ('dyssynchrony') the rings of the RToP. These conflicts can result in changes to self-concepts of personhood and professional identities. Identity Refinement sees experience and timely support helping nurses attenuate the impact of difficult experiences. This reduces the risk of burnout and mitigates changes to their professional identities. Identity Refinement helps them develop a 'rooted identity' which remains relatively consistent in the face of adversity. Conclusions Ongoing Identity Construction amongst nurses, particularly in caring for the dying, underscore the host organisation's role in ensuring structured, longitudinal, accessible, and personalised assessments and support of nurses, especially when they are prone to dyssynchrony and disharmony whilst caring for the terminally ill. Further study into assessment methods and the role of the environment is critical.
BMC PALLIATIVE CARE
卷号:21|期号:1
ISSN:1472-684X|收录类别:SCIE
语种
英语
来源机构
National University of Singapore; National Cancer Centre Singapore (NCCS); National Cancer Centre Singapore (NCCS); National University of Singapore; National University of Singapore; University of Liverpool; National University of Singapore
被引频次(WOS)
1
被引频次(其他)
1
180天使用计数
0
2013以来使用计数
1
出版年
2022-5-20
DOI
10.1186/s12904-022-00974-9
学科领域
循证公共卫生
关键词
Nurses Oncology Palliative Medicine Personhood Professional Identity Formation
WOS学科分类
Health Care Sciences & Services Health Policy & Services