The dilemma of palliative care nurses: A phenomenological inquiry into their lived experience with humanistic care

Background: Previous research has delineated the roles and functions of palliative care nurses, but a gap remains in comprehending their lived experiences in delivering humanistic care. These nurses establish deep connections with patients and families, encountering emotional distress while witnessing their suffering. This emotional strain frequently leads to compassion fatigue and burnout. This study was conducted to fill the literature gap by examining the humanistic nursing practices and the dilemmas that palliative care nurses face when providing humanistic care. Methods: A descriptive phenomenological approach was adopted. Individual semi-structured interviews were conducted with 17 palliative care nurses working in Hong Kong public hospitals. They were invited to share their lived experiences of providing humanistic care in palliative care settings. Interview findings were analyzed using Van Kaam’s control explication method. Results: The findings of this study revealed both positive and negative experiences encountered by palliative care nurses in their humanistic interactions with patients and families. Nurses emphasized the significant impact of their presence and care on patients and families, highlighting the importance of preserving dignity and alleviating suffering. The study underscored the challenges nurses face in forming genuine connections amid various constraints, such as heavy workloads and patient-related obstacles that impede compassionate engagement. Four themes emerged, showcasing dilemmas confronted by nurses: juggling between "creating bonds" versus "maintaining distance", choosing to "treasuring life more" versus "giving up life more easily", balancing "patients' interests" versus "families' interests", and weighing "patient rights" versus "public interest". The findings illuminated the complexities and emotional burden inherent in delivering humanistic care in palliative care. Conclusions: The study's findings have offered deeper insights into Paterson and Zderad's Humanistic Nursing Theory, shedding light on the existential aspects of humanistic nurse-patient interactions. The study has uncovered the intricacies of the theory's fundamental elements, including genuine presence, authentic self-awareness, and the realization of potential in caregiving. It highlights the necessity for improved support and training for palliative care nurses, advocating for enhanced education and practice to navigate the complexity of end-of-life care and enhance the understanding of humanistic nursing principles.