Stories from the front: Narratives of critical care nurses caring for the dying elderly

The purpose of this qualitative study was to explore the meaning that caring for dying elderly patients has for experienced critical care nurses who are women. This study was concerned with a nursing narrative, how critical care nurses' stories created a voice for this most powerful and personal experience though the course of their careers.;Eight in depth interviews were conducted with four, experienced critical care nurses. The participants practiced adult critical care nursing in a teaching hospital in the Northeastern United States.;The interview data were analyzed using three methods identified in the narrative research literature: Labov's (1972, 1997) method of structural analysis of personal narratives; Personal Narrative Group (1989) method which analyzes the content of personal narratives of women and Agar & Hobbs, (1989) coherence method which identifies recurrent themes between and across stories in the personal narratives.;Using the Labov (1972, 1997) method revealed the emergence of three core narratives which represented the transformation in the moral identity of the participants over the course of their critical care nursing careers. Support stories emerged that acted as scaffolding for the development of the core narratives.;Two types of narratives were revealed using the PNG (1989) method. Narratives of acceptance of social norms and expectations were present in the stories the participants told as new and inexperienced critical care nurses. Narratives of awakening and resistance were emblematic of their experiences as seasoned critical care nurses. Using Agar Hobbs, (1989) method revealed the emergence of three major themes and eighteen sub themes.;The stories of the critical care nurses revealed their efforts to humanize the dying of their elderly patients. Managing the dying process of elderly patients in the intensive care unit was revealed to be ethically and emotionally distressing for the nurses in this study. Creating an environment that will provide a peaceful death for elderly patients in the ICU will necessitate a new model that emphasizes collaborative decision-making and the integration of palliative care precepts.