Journal of East-West Nursing Research (동서간호학연구지)

East-west Nursing Research Institute, Kyung Hee University (경희대학교 동서간호학연구소)
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The Conflicts in Nurses Caring DNR (do-not-resuscitate) Patients

심폐소생술 금지(DNR) 환자를 돌보는 간호사의 갈등

  • 김현아 (경희대학교 간호과학대학) ;
  • 김귀분 (경희대학교 간호과학대학)
  • Received : 2011.11.21
  • Accepted : 2011.12.24
  • Published : 2011.12.31
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Abstract

Purpose: The purpose of the study was to explore the meaning of conflicts in nurses caring DNR (do-not-resuscitate) patients. Methods: The participants were 7 nurses caring DNR patients. Data were gathered using in-depth interviews. The interviews were recorded and transcribed verbatim. Colaizzi method was used to analyze the data. Results: The significant results can be categorized into 7 concept descriptions and 5 theme clusters by analyzing the interviews. The major theme clusters for the experiences of nurses were 'Pity about exceptional nursing actions', 'Pity about the unilateral decision making', 'Pity about halfhearted family love', 'Pity about unprepared circumstance for deathbed', and 'Pity about the absent guideline for DNR'. Conclusion: The finding of this study will help nurses resolve conflicts in caring DNR patients and provide a scientific basis for developing nursing intervention strategies for DNR patients.

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References

  1. Cardenas-Turanzas, M., Gaeta, S., Ashoori, A., Price, K. J., & Nates, J. L. (2011). Demographic and clinical determinants of having Do Not Resuscitate orders in the intensive care unit of a comprehensive cancer center. Journal of Palliative Medicine, 14, 45-50. https://doi.org/10.1089/jpm.2010.0165
  2. Choe, J. Y., & Kwon, V. K. (2009). The current debates and social trends regarding euthanasia and the withdrawal of life-sustaining treatment in Korea. Korean Journal of Medical Ethics, 12, 127-142.
  3. Choi, J. E., Jung, Y., Kim, B. H., Jeon, H. W., & Kim, Y. S. (2007). The subjectivity of attitudes toward life support care. Journal of Korean Academy of Nursing, 37, 1166-1176.
  4. Colaizzi, P. F. (1978). Psychological research as the phenomenological views. In R. Valle, & M. King (Eds.), Existential phenomenological alternative for psychology (pp.48-71). New York, NY: Oxford University Press.
  5. Ebell, M. H., & Eaton, T. A. (1992). Flow chart for the interpretation of Do Not Resuscitate order statutes. The Journal of Family Practice, 35, 141-143.
  6. Grudzen, C. R., Koenig, W. J., Hoffman, J. R., Boscardin, W. J., Lorenz, K. A., & Asch, S. M. (2009). Potential Inpact of a verbal prehospital DNR policy. Prehospital Emergency Care, 13, 169-172. https://doi.org/10.1080/10903120802471923
  7. Guba, E., & Lincoln, Y. (1989). Forth generation evaluation. Sage, Newbury Park, California.
  8. Hong, S. A. (2010). An empirical study for model development concerning advance directives. Journal of the Korean Gerontological Society, 30, 1197-1211.
  9. Kang, H. Y., & Yom, Y. H. (2003). Awareness and experience of nurses and physicians on DNR. The Journal of Korean Nursing Administration Academic Society, 9, 447-458.
  10. Kim, J. H. (2009). The job stress, perception and training needs on the end-of-life care among cancer unit nurses. Unpublished master's thesis. The Yonsei University, Seoul.
  11. Kim, K. Y. (2005). Death with dignity. Seoul: Newest Medicine Company.
  12. Kim, S. H. (2004). Decision making process in Do-Not-Resuscitate orders for patients with cancer. Korean Journal of Nursing Query, 13, 127-143.
  13. Kim, S. K. (2006). Experience of family & nurse related to the process of DNR decision. Unpublished master's thesis. The Yonsei University, Seoul.
  14. Koh, Y. S., Heo, D. S., Yun, Y. H., Moon, J. L., Park, H. W., Choung, J. T., et al. (2011). Characteristics and issues of guideline to withdrawal of a life-sustaining therapy. Journal of the Korean Medical Association, 54, 747-757. https://doi.org/10.5124/jkma.2011.54.7.747
  15. Lee, B, H. (2010). A study on the physician's withdrawal of life-sustaining treatment in criminal law. Unpublished doctor' thesis. The Han-Yang University, Seoul.
  16. Lee, J. K., Cho, K. H., Won. J. O., & Lee, H. R. (1994). Survey on the experience and the attitude of training residents about DNR orders in tertiary teaching hospitals. The Journal of the Korean Academy of Family Medicine, 15, 322-332.
  17. Lee, M. H., & Kang, H. S. (2007). The relationship among attitude toward DNR orders, depression and self-esteem in the elderly. Journal of Korean Gerontological Society, 27, 323-334.
  18. Lee, N. I. (2004). Phenomenology and analytics. Seoul: Seoul National University Press.
  19. Lee, Y. B. (2007). Nurses' and doctors' perceptions, experiences, and ethical attitudes on DNR. Clinical Nursing Research, 13(2), 73-85.
  20. Lorraine, F. (2007). DNR does not mean no care. Journal of Neuroscience Nursing, 39(5), 294-296. https://doi.org/10.1097/01376517-200710000-00006
  21. Sinuff, T., Giacomini, M., Shaw, R., Swinton, M., & Cook, D. J. (2009). Carenet. "Living with dying": The evolution of family members' experience of mechanical ventilation. Critical Care Medicine, 37, 154-158. https://doi.org/10.1097/CCM.0b013e318192fb7c
  22. Song, K. O., & Jo, H. S. (2010). Ethical awareness and attitudes of patients' families towards DNR(Do-Not-Resuscitate). Journal of Korean Clinical Nursing Research, 16(3), 73-84.
  23. Sung, M. H., Park, J. H., Jung, K. E., & Han, H. R. (2007). ICU nurses' awareness and attitudes to the ethical dilemma associated with DNR. Clinical Nursing Research, 13, 109-122.
  24. Tsang, J. Y. C. (2010). The DNR order: What does it mean? Clinical Medicine Insights: Circulatory, Respiratiry and Pulmonary Medicine, 4, 15-23.
  25. Wilson, D. M. (1996). Highlighting the role of policy in nursing practice through a comparison of ''DNR'' policy influences and ''No CPR'' decision influences. Nursing Outlook, 44, 272-279. https://doi.org/10.1016/S0029-6554(96)80083-2
  26. Yi, M. S., Oh, S. E., Choi, E. O., Kwon, I. G., Kwon, S. B., Cho, K. M., et al. (2008). Hospital nurses' experience of Do-Not-Resuscitate in Korea. Journal of Korean Academy of Nursing, 38, 298-309. https://doi.org/10.4040/jkan.2008.38.2.298
  27. Yuen, J. K., Reid, M. C., & Fetters, M. D. (2011). Hospital do not resuscitate orders why they have failed and how to fix them. Journal of General Internal Medicine, 26, 791-797. https://doi.org/10.1007/s11606-011-1632-x