A qualitative analysis of the experiences of heart failure specialist nurses working with patients with end stage heart failure

Literature Review. This aimed to systematically and critically appraise, as well as synthesise, qualitative research exploring the psychological impact on nurses of working within palliative care. Eleven papers were identified. Studies presented a number of quality issues. The taxonomy suggested that nurses develop a palliative care persona as a way of being, both personally and professionally. This fostered nursing resilience. Further research could explore the notion of a persona, with training, practice and support implications for nurses. Research Report. This aimed to identify and explore the experiences of heart failure specialist nurses who work with patients with end stage heart failure, to understand how such experiences affected nurses, how they approached their work, and how they were supported. A qualitative design was used, with semi- structured interviews undertaken and analysed using Interpretative Phenomenological Analysis. Three superordinate themes were elicited: Keeping the Rhythm Going, relating to aspects of routine care; The Rhythm Peters Out (A Good Death), relating to tasks at end of life; and Winding up the String, relating to the impact of working with the dying. Participants appeared to profess a „professional face‟, rejecting the emotional impact of working with the dying. The perpetual physical effort of caring for patients at end of life was articulated, as were high expectations of achieving a „good death‟. Being managed from an acute context seemed to undermine delivery of an alternative model of care within the community. Recommendations regarding training, supervision and bridging two approaches of care were made. Critical Appraisal. This section offers a reflection upon the whole research process, with reference to the research diary. Implications in terms of being a researcher and a clinician were made.