MS Nursing thesis defence: "Avoiding Futility: How Nurses and Physicians Experience Emotions, Psychosocial Factors, and Their Professional Roles as Influencing the End-of-life Decision-Making Process”
By: Melissa deBoer
Supervisor: Dr. Rick Sawatzky
Second Reader: Dr. Sheryl Reimer-Kirkham
Third Reader: Dr. Pat Porterfield
Exam Chair: Dr. Barb Astle
Abstract: In this qualitative study, five critical care nurses and four critical care physicians were interviewed about their experiences of the end-of-life decision-making process in intensive care. For both professional groups, although operating from distinctly different vantage points, a shared mission and desire to avoid futility were foundational to undertaking the process, as well as the climactic aim to be achieved. This desire heavily shaped initiation and engagement of what was presented as an ambiguous decision-making process lacking formalized structures. Three themes emerged of elements that most influenced their variable experiences of the end-of-life decision- making process: moral weightiness, family receptiveness, and the individual philosophy of approach. These findings emphasize and provide explanation to the wide amount of subjective variability experienced in this value-laden decision-making process, and shed light on the competing emotional, psychological, and social interests that are both protected and made vulnerable for ICU nurses and physicians in the end-of-life decision-making process. It is of the essence that there be greater understanding of the end-of-life decision- making process in an intensive care context to provide better support to nurses and physicians.