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dc.contributor.authorBublitz, Lorraine
dc.contributor.authorFowler, Kim-Leigh
dc.contributor.authorFulkco, Daniel
dc.contributor.authorHenderson, Saras
dc.contributor.authorGrealish, Laurie
dc.date.accessioned2017-12-07T00:04:29Z
dc.date.available2017-12-07T00:04:29Z
dc.date.issued2017
dc.identifier.issn1832-3804en_US
dc.identifier.urihttp://hdl.handle.net/10072/353453
dc.description.abstractBackground: As the population is ageing, and with the rising incidence of type 2 diabetes, the demographics of people on dialysis therapy are changing, with an older population living with multiple co-morbidities. As such, the meaning of haemodialysis (HD) has shifted from a short-term therapy for those awaiting a kidney transplant to a palliative therapy that focuses on quality of life. Methods: A narrative inquiry focused on nurses' experiences of caring for adult persons on HD approaching end of life. Registered and enrolled nurses working in HD inpatient and outpatient units at one tertiary level hospital service in Southeast Queensland constituted the sample. Results: Fifty-five of a possible 130 nurses (40% response) completed narratives. Just over half of the nurses had 10 or more years of nephrology nursing experience. Nurses experienced moral discomfort when challenges associated with: (1) poorly implemented end-of-life care; (2) contested decisions to start or stop HD; and (3) limited opportunities to settle disagreements within the service context. Conclusions: Nephrology nursing practice has not kept up with changing patient demographics, leaving nurses unprepared for the emotional and moral decisions to be made in everyday practice. It is timely to make explicit the palliative intent of HD therapy for persons with multiple co-morbidities, providing a space for advance care planning, open and supported discussions about quality of life, and transparent shared decision making when patients are considering to cease therapy.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherRenal Society of Australasiaen_US
dc.publisher.urihttp://www.renalsociety.org/journal/volume-13-no-2/en_US
dc.relation.ispartofpagefrom65en_US
dc.relation.ispartofpageto70en_US
dc.relation.ispartofissue2en_US
dc.relation.ispartofjournalRenal Society of Australasia Journalen_US
dc.relation.ispartofvolume13en_US
dc.subject.fieldofresearchNursing not elsewhere classifieden_US
dc.subject.fieldofresearchcode111099en_US
dc.titleNarrative survey of renal nurses - an enquiry of challenging clinical situations with adults on haemodialysis approaching end of lifeen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
dc.description.versionPublisheden_US
gro.rights.copyright© 2017 Renal Society of Australasia. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.en_US
gro.hasfulltextFull Text
gro.griffith.authorHenderson, Saras
gro.griffith.authorGrealish, Laurie A.


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