Article Text
Abstract
Background Recent publications have made it very clear that pre-registration training is not adequately preparing nurses for end of life care (The Democratic Society, 2015; National Council for Palliative Care, 2016). Although the proposed NMC curriculum changes (Nursing & Midwifery Council, 2017) address this for future student nurses, many nurses are already in practice without preparation, and will not benefit from curriculum change. Currently, few nurses outside of palliative care settings have access to any end of life care education (Cavaye & Watts, 2014).
Aim To identify the attributes a prepared nurse will possess, and the antecedents of becoming prepared, with intent to inform education strategies.
Method A concept analysis using Walker and Avant’s (Walker & Avant, 2013) model was conducted to ensure rigour, and standardise the findings. Several clinical databases were searched to find appropriate literature to inform the concept analysis.
Results Attributes of a prepared nurse can be divided into two core areas; being educationally ready and having a willing attitude. The seven individual key attributes are:
Able to assess the dying patient and plan care
Has advanced ability to communicate with empathy
Able to identify and manage physical symptoms
Able to recognise and deal with dying and death
Understands the holistic elements of dying
Understands and is comfortable to deal with the effects of loss and bereavement on patients, families and self
Is self–aware and self–competent.
Antecedents are: education, having a willing attitude towards the dying, exposure to death and dying, experience of care of the dying, and seeing a dead body. Empirical referents need to measure self-competence, knowledge and attitudes.
Conclusion This concept analysis will demonstrate that future education needs to be focused on those nurses who are already qualified, but lack previous end of life education. All nurses, both pre-registration and post-registration, also need to have opportunities to care for the dying, and perform care after death, in a safe environment where exposure to death can be supported.