Determining the process of providing quality end-of-life care to hospitalized adult medical patients: The perspectives of nurses

A grounded theory approach to data collection and analysis was used to develop a beginning model aimed at uncovering the social processes inherent in the delivery of end-of-life care from the perspective of nurses caring for dying patients on acute care medical units. Data were collected through interviews and participant observation with 10 nurses working on acute medical units at two tertiary university-affiliated hospitals. The basic social problem uncovered in the data was that of nurses striving to provide high quality end-of-life care on an acute medical unit while being pulled in all directions. The unifying theme of "creating a haven for safe passage" integrated the major sub-processes into the key analytic model in this study. "Creating a haven for safe passage" represents a continuum of behaviours and strategies, and includes the sub-processes of "facilitating and maintain a lane change"; "getting what's needed"; "being there"; and "manipulating the care environment". (Abstract shortened by UMI.).