Dimensions of Futility at the End of Life: Nurses’ Experiences in Intensive Care Units

Abstract

Background and aims: The concept and meaning of futile care depends on the existing culture, values,<br />religion, beliefs, medical achievements, and emotional status of a country. In Iran, futile care has<br />become a challenge for nurses working in intensive care units (ICUs). Considering the differences<br />observed in defining futile care based on the patients' conditions and the nurses' personal values,<br />we aimed to define the dimensions of futility at the end of life from the viewpoints of nurses working<br />in ICUs. This qualitative phenomenological study was done to understand the experiences of nurses<br />working in ICUs with respect to the dimensions of futility.<br />Methods: this research was a qualitative phenomenological study. The statistical population of this<br />study included nurses working in the ICUs of 11 teaching hospitals and hospitals affiliated to the Social<br />Security Organization in Qazvin province, northwest of Iran. Personal interviews and observations of<br />25 nurses working in the ICUs of 11 hospitals were collected. All interviews were recorded and codes<br />and themes were extracted using Van Manen's analysis method.<br />Results: Initially 80 codes were extracted. During data analysis and comparison, the codes were<br />reduced to 65. Ultimately, one theme and 2 sub-themes, and 5 categories were emerged: “futile<br />medical orders, futile diagnostic procedures, and category of nursing which included futile nursing<br />interventions and irrelevant duties to nursing".<br />Conclusion: Considering that nurses play a key role in managing futile care, being aware of their<br />experiences in this regard could be the initial operational step for compiling useful care and<br />educational programs in ICUs.