Nurses’ Experience Facing Terminally Ill Patients in Tunisian Intensive Care Units: A Qualitative Study

Abstract

Background: Palliative care is essential in Intensive Care Units (ICUs), where many patients face life-threatening conditions and may not survive. ICU nurses are at the frontline of End-Of-Life (EOL) care, requiring strong competencies in communication, empathy, and symptom management. They also face significant emotional and ethical burdens when caring for dying patients. A deeper understanding of their experiences is crucial to improving the quality and delivery of EOL care in critical care settings. This study aimed to explore the experiences of nurses caring for terminally ill patients in the Intensive Care Units (ICUs).

Methods: This qualitative descriptive study was conducted in the ICUs of Sahloul University Hospital in Sousse, Tunisia. Five experienced nurses from three different units were purposively selected. Data were collected through semi-structured interviews using a semi-structured interview guide, inspired by Jean Watson’s philosophy, which comprises fourteen open-ended questions examining perceptions, emotions, support practices, and barriers. Data were analysed inductively using Paille’s five-step model.

Results: The data analysis revealed five main themes: (1) The representation of the concept of "End-of-life" by healthcare staff, (2) The emotions experienced, (3) The specific support provided, (4) The barriers raised, and (5) The psychological support for the patient and family. These five themes covered fourteen sub-themes.

Conclusion: This Research emphasizes the need for strong interpersonal skills, patient-centred strategies, and effective communication with both family and patient, to improve care and support caregivers in their crucial roles to provide palliative care.