Nursing students’ experiences of caring for dying patients: A phenomenological study at Mulago Hospital

Abstract

Introduction: Nursing education cannot exist without clinical practice. Research shows that, clinical practice puts much pressure on nursing students to care for dying patients and their immediate families. Consequently, experienced hospice nurses must provide guidance and support to nursing students. Main Objective: The main objective of this study was to explore the nursing students’ experiences of caring for dying patients at Mulago hospital. Specifically, the study explored perceptions of nursing students towards caring for dying patients, their emotional and psychological experiences as well as their coping strategies of the negative experiences when caring for the dying patients. Methodology: This was a phenomenological study conducted among nursing students at Makerere University. Purposive sampling was used to conduct a phenomenological qualitative study. Data was collected using an interview guide, audio recorded, and transcriptions thematically analyzed using Atlas. ti version 6. Results: The four major themes that emerged from the data included perceptions towards caring for dying patients, from which two sub themes were derived (being informed about physical process and change in ideas), psychological and emotional experiences , from which one subtheme about feelings expressed was derived, clinical experiences, from which five sub themes were derived, (health professional’s attitude towards patients, relatives, student attitude towards patients, relatives, challenges faced) and Coping mechanisms from which two sub themes (internal and external coping mechanisms) were derived. Conclusion: The psychological, emotional and clinical experiences of nursing students in clinical placement to care for dying patients vary due to different perceptions, understanding of the physical process of care, changes in ideas which inform their different coping strategies. The clinical placement contributes to learning, experience and building of confidence among nurses amidst unstable emotions and challenges they face. However, to ensure that the gains from the clinical placement outweigh the negative consequences, regular focused supportive mentorship and adequate preparation of nurses by senior health professionals is required for individual students. Caring for the dying patients is a necessary, that should not be undermined by the nurses and health professionals but promotion of appropriate coping strategies should be emphasized at respective teaching hospitals and universities.