Acute Care Nurses' Perceptions of Barrier to End of Life Care in Geriatrics

Graduation Date


Document Type

Master's Thesis

Document Form


Degree Name

Master of Science



Department or Program Chair

Barbara Ganley, PhD

Thesis Advisor

June Wilson, PhD, RN


Approximately 50 to 60 percent of the elderly population is dying in a hospital or a long-term care facility. Many patients who are dying in the hospital setting have unmet needs. Nursing perception of the quality of end of life care was studied and revealed a basic social problem; while nurses strive to provide high-quality end of life care, they feel pulled in many directions. There is a gap in knowledge of the barriers experienced by acute care nurses caring for the hospitalized elderly at the end of life. The objective of this research was to explore the barriers experienced by acute care nurses in providing care for the elderly at the end-of life and understand how these nurses perceived and processed these barriers. Seven nurses from a single entity hospital organization were recruited with varying degrees of acute care and end of life care experiences. A phenomenological approach was utilized for this research. Participants were interviewed face to face, and responses were voice recorded. Transcripts were analyzed for themes and subthemes. Themes that emerged from the interviews were: (1) The conflicting interest between patient and family, (2) role unpreparedness, under which lack of advocacy and personal guilt emerged as subthemes, (3)‘“caught in the middle” phenomena, (4) lack of education and training, and (5) the gatekeepers phenomena.

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