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end of life, futile treatment, hematologic malignancies, nurses, qualitative



  1. Grech, Antonia MSc
  2. Depares, Joanna PhD
  3. Scerri, Josianne PhD


The aim of this study was to explore the experiences of nurses providing end-of-life care to patients with hematologic malignancies, in a hematology oncology setting, in an acute general hospital. A qualitative hermeneutic phenomenological design was used, and 2 sets of semistructured interviews were conducted with 5 female nurses. The transcribed texts were analyzed using Interpretative Phenomenological Analysis. Two main themes emerged: "battling against medical futility" and "struggling with the emotional burden of care." Nurses perceived that the transfer of these patients at end of life to intensive critical care settings, coupled with the particularly aggressive treatments and corresponding symptom burden, prevented them from experiencing a dignified death. Consequently, nurses struggled with a gamut of emotions that included feelings of helplessness, distress, and compassion fatigue. Providing nursing care at end of life was perceived to be particularly challenging with the younger patients or with those who reminded them of family members. The findings highlight the unique challenges experienced by these nurses and the need to support them in their work with patients having hematologic malignancies at end of life within a well-resourced setting.