Dimensions of Futility at the End of Life: Nurses’ Experiences in Intensive Care Units

Abstract

Background and aims: The concept and meaning of futile care depends on the existing culture, values, religion, beliefs, medical achievements, and emotional status of a country. In Iran, futile care has become a challenge for nurses working in intensive care units (ICUs). Considering the differences observed in defining futile care based on the patients’ conditions and the nurses’ personal values, we aimed to define the dimensions of futility at the end of life from the viewpoints of nurses working in ICUs. This qualitative phenomenological study was done to understand the experiences of nurses working in ICUs with respect to the dimensions of futility. Methods: this research was a qualitative phenomenological study. The statistical population of this study included nurses working in the ICUs of 11 teaching hospitals and hospitals affiliated to the Social Security Organization in Qazvin province, northwest of Iran. Personal interviews and observations of 25 nurses working in the ICUs of 11 hospitals were collected. All interviews were recorded and codes and themes were extracted using Van Manen’s analysis method. Results: Initially 80 codes were extracted. During data analysis and comparison, the codes were reduced to 65. Ultimately, one theme and 2 sub-themes, and 5 categories were emerged: “futile medical orders, futile diagnostic procedures, and category of nursing which included futile nursing interventions and irrelevant duties to nursing”. Conclusion: Considering that nurses play a key role in managing futile care, being aware of their experiences in this regard could be the initial operational step for compiling useful care and educational programs in ICUs. 

Keywords: Futility, End of life, Nurses, Intensive care unit,, Phenomenological study