The lived experience of emergency nurses caring for elderly patients who are dying from traumatic injuries

Ms Kimberley Ryan1,2, Dr Alan Barnard2, Mr James Hughes1, Dr Leanne Jack2
1Royal Brisbane Women’s Hospital, Emergency & Trauma Centre, Herston, Australia, 2Queensland University of Technology, Kelvin Grove, Australia

Emergency nurses are regularly exposed to dying patients. Recent increases in elderly trauma presentations to emergency departments (ED) have been attributed to the elderly population living a more active life with greater longevity than in past generations. The hazards of low-impact trauma precipitating elderly patient death particularly from falls are well established. The nursing care of an elderly patient dying from traumatic injuries adds complexity to emergency nursing that is fraught with ethical and sometimes contentious decisions. The purpose of this qualitative study was to explore, describe and interpret the lived experience of emergency nurses who have cared for elderly patients dying from traumatic injuries.

The study utilised a phenomenological design with a hermeneutic, interpretive inquiry. A convenience sample of 5 registered nurses with a minimum of 2 years clinical experience in caring for trauma patients were recruited from a large tertiary referral and major trauma hospital. One-on-one interviews that lasted between 1-2 hours for each participant were audio-recorded by the researcher. Interviews were transcribed and data analysis was conducted using van Manen’s lifeworld analysis of four existential themes, lived space, lived body, lived time and lived human relation to pervade the lifeworld’s of the participants. Interpretive analysis revealed 4 key essences that co-contributed and embodied the phenomenon; facilitation of a good death, participation, advocacy and human connection.

As it is predicted that EDs will continue to see increased numbers of elderly patients presenting that require end-of-life care, it is timely to explore what emergency nurses are experiencing as they are the facilitator of the dying experience for the patient. The needs of the emergency nurse in fulfilling this role needs to be acknowledged and no prior study has yet explored this issue.

Kimberley Ryan is an emergency nurse at the Emergency and Trauma Centre, Royal Brisbane Women’s Hospital.  She has over 20 years of extensive critical care nursing experience in hospitals across Australia and the UK. She has a variety of mixed methods research experience and has just completed a Master of Nursing at QUT. Her current research interests include death and dying in the Emergency department, and the emergency management of patients presenting with gastrointestinal bleeding.