Recent publications demonstrate that pre-registration nurses are currently insufficiently prepared for end of life care (Croxon, Deravin, Anderson, 2018). Although it can be assumed that hospice nurses feel prepared, little is currently known about how they have become prepared (National Council for Palliative Care, 2016).
Aim To investigate hospice nurses’ experiences of how they have become prepared for end of life care.
Method A classic Grounded Theory method was used, ensuring that no pre-conceptions influenced the findings (Glaser & Strauss, 1967). Seventeen individual interviews, and one focus group of seven, were conducted to gather data. Constant comparison of the findings and analysis was conducted until theoretical saturation was reached (Glaser & Strauss, 1967). Findings were presented to the individuals involved in the focus group, and to experts in the field, for validation (Lincoln & Guba, 1985).
Results Analysis of the findings revealed that nurses felt they had become prepared through a feeling of ‘fitting’ with their workplace, colleagues and patients, through a shared ideal way to care for people at end of life. Comparison of findings with the literature, identified that the Person/Environment Fit (PEF) theory (Edwards & Billsberry, 2010) could be used to conceptualise these findings. According to PEF theory, people choose the environment that they feel fits their vocational ideals, as well as where they fit in with the organisation’s philosophy, their work group, job role and other individuals in the workplace (Edwards & Billsberry, 2010). However, as hospices evolve rapidly to ensure accessibility to more patients and families than ever before (Mathew, Gray & Thomas, 2018), participants commented on the changing work environment. People who felt a strong feeling of ‘fit’ on joining the hospice, do not always feel that fit is still there.
Conclusion As hospices continue to transform from a ‘Rolls Royce’ service for the minority, into a more modest style for all (Mathew, Gray & Thomas, 2018), the findings of this study demonstrate that, during transformation, hospices may need to take measures to maintain an ‘ideal’ way of caring, that people feel fits their vocational aspirations.
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