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Nurturing the dying at home : the experience of shift care nursing Knill, Carolyn

Abstract

The purpose of this study was to develop a theoretical conceptualization that explains the experience of shift care nursing and how shift care nurses care for themselves so they can continue providing home palliative care to their clients. Shift care nurses are palliative care nurses who provide 12-hour shifts of care in a client's home. In this grounded theory study, the data was comprised of unstructured interviews and group discussions. Analysis included open, axial, and selective coding of the data using constant comparison as well as Strauss and Corbin's coding paradigm. What shift care nurses do is conceptualized as a process of nurturing the dying at home. Nurturing the dying is composed of four dimensions: opening, witnessing, connecting and being present with the dying person and family. Being present forms the foundation for the other three dimensions. Strategies shift care nurses use to facilitate this process are positioning, becoming what the dying person and family need, teamworking, and tending the self. Characteristics of the shift care nurse, continuity, role expectations, knowledge base of team members, and family dynamics can be limiting or facilitating factors for the shift care nurses. The outcomes of nurturing the dying vary along a continuum of congruity to dissonance, which describes the degree of congruity between the shift care nurses' expectations for the experience and the reality of actual happenings.

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