The phenomenon of caring for older patients who are dying from traumatic injuries in the emergency department: An interpretive phenomenological study

• Published in: Journal of nursing scholarship Vol. 54; no. 5; pp. 562 - 568
• Main Authors: Ryan, Kimberley, Windsor, Carol, Jack, Leanne
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2022
• Subjects: Age differences; Comorbidity; Data analysis; Death & dying; death and dying; Emergency services; end of life; End of life decisions; Exegesis & hermeneutics; Hospice care; Injuries; Interviews; Mortality; Nurses; Nursing care; Older people; Palliative care; Patients; Phenomenology; Physical trauma; Qualitative research; Time; Trauma; Australia; phenomenology; trauma; end of life; death and dying
• ISSN: 1527-6546; 1547-5069
• DOI: 10.1111/jnu.12764

Purpose To gain greater understanding of what it means to care for older patients dying from traumatic injuries in the emergency department. Design A Heideggerian phenomenological design using the methods of Van Manen. Methods In‐depth, face‐to‐face interviews were conducted with five emergency nurses who worked in an emergency department in Australia. Interview data were interpreted using a Heideggerian hermeneutic approach and guided by Van Manen’s lifeworld analysis focusing on the experiential aspects of lived time (temporality) and lived space (spatiality) in the phenomenon. Findings The older patient reflects the passage of chronological time. This temporal aspect shaped the participant experience as there was a sudden awareness of the impact of the injuries sustained on the fragile physical condition of the patients. There was an unexpectedness and unpreparedness which was related to a precognitive assumption that the older patient would die from an age‐related comorbid condition. Also of significance was the sacred liminal space in which the nurses worked to facilitate the dying patient transition from life to death. Conclusions The existential dimensions of temporality and spatiality revealed new insights into what it means to care for elderly patients dying from traumatic injuries. Temporal aspects were shaped by the longevity of the lives of patients and spatiality explored the liminal space where participants were morally guided to deliver end of life care with dignity and respect for a long‐lived life taken by trauma. Clinical relevance The findings may contribute to further understanding of what shapes the experience for emergency nurses delivering EOL care in the ED, with specific relevance and focus on the older patient with traumatic injuries. Hermeneutic research may also encourage clinicians to explore phenomena to reveal new understandings that will inform further dialogue and future research.