Hospice nurses in Utah: A qualitative study of their views on hospice nursing philosophy and practice

The concept of modern hospice care was conceived by Dame Cicely Saunders, a British nurse who later trained as a social worker and doctor. Her mandate was to offer holistic care consisting of physical, emotional, spiritual and psychological support to dying people enabling them to live fully to the end of life. Hospice care has developed differently in the UK and the USA. This qualitative study, undertaken by a British nurse who has worked in end of life care in both countries, set out to discover how hospice care was perceived and delivered by seven hospice nurses in Utah. Emergent themes were consistent with early ideas of hospice care, and included supportive and comfort care that was directed by the patient and their family; unlike acute care, hospice care was accepting of death. Nurses felt that dealing constantly with dying was hard, but not necessarily stressful; they discussed coping mechanisms. The merits of the interdisciplinary team were praised as both a support to the family and the nurses. The reasons underpinning the routine taking of vital signs was investigated, with the conclusion being that it is done mainly to meet the perceived needs of the family of the patient. Documentation was seen as unwanted necessity, performed mainly for legal reasons. All nurses reported that hospice nursing was extremely rewarding, despite the inherent repeated loss and grief.