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Professional Nurses’ Role in End-of-Life Care. Ethical Reflections on Patient-Nurse Interaction and Nurses’ Decision-Making in Breathlessness Situations

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Ethical Challenges for Healthcare Practices at the End of Life: Interdisciplinary Perspectives

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Notes

  1. 1.

    The authors translated all subsequent quotations from German to English.

  2. 2.

    This thought is strongly connected to the thoughts of Jankélévitch (see also Camier-Lemoine in this volume).

References

  • Aiken, L.H., D.M. Sloane, L. Bruyneel, K. Van den Heede, P. Griffiths, R. Busse, and W. Sermeus. 2014. Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. Lancet 383: 1824–1830.

    Article  Google Scholar 

  • Aiken, L.H., D. Sloan, P. Griffiths, et al. 2017. Nursing skill mix in European hospitals: Association with mortality, patient ratings, and quality of care. BMJ Quality & Safety 26: 559–568.

    Article  Google Scholar 

  • American Thoracic Society. 1999. Dyspnea. Mechanisms, assessment, and management: A consensus statement. American Journal of Respiratory and Critical Care Medicine 159: 321–340.

    Article  Google Scholar 

  • Aulbert, E., and D. Zech. 1997. Lehrbuch der Palliativmedizin. Stuttgart/New York: Springer.

    Google Scholar 

  • Bausewein, C. 2007. Leitfaden Palliativmedizin – Palliative Care. 3rd ed. München: Springer.

    Google Scholar 

  • Benner, P. 1994. Stufen zur Pflegekompetenz. From novice to expert. Bern: Hans Huber.

    Google Scholar 

  • Bobbert, M. 2002. Patientenautonomie und Pflege. In Begründung und Anwendung eines moralischen Rechts. Frankfurt am Main (Dissertationsschrift): Campus.

    Google Scholar 

  • Breuer, F. 2010. Reflexive Grounded Theory. Eine Einführung für die Forschungspraxis. 2nd ed. Wiesbaden: Springer.

    Google Scholar 

  • Bührmann, A.D. 2009. Intersectionality – ein Forschungsfeld auf dem Weg zum Paradigma? Tendenzen, Herausforderungen und Perspektiven der Forschung über Intersektionalität. Gender 1: 28–44. http://nbn-resolving.de/urn:nbn:de:0168-ssoar-393526. Accessed 21 Apr 2018.

    Google Scholar 

  • Burns, S.M., and B. Quatrata. 2013. Selecting advanced practice nurse outcome measures. In Outcome assessment in advanced practice nursing, ed. R.M. Kleinpell, 3rd ed., 73–92. New York: Springer.

    Google Scholar 

  • Currow, D.C., J. Smith, P.M. Davidson, P.J. Newton, M.R. Agar, and A.P. Abernethy. 2010. Do the trajectories of dyspnea differ in prevalence and intensity by diagnosis at the end of life? A consecutive cohort study. Journal of Pain and Symptom Management 39: 680–690.

    Article  Google Scholar 

  • Dederich, M., and M.W. Schnell, eds. 2011. Anerkennung und Gerechtigkeit in Heilpädagogik, Pflegewissenschaft und Medizin. Bielefeld: Transcript.

    Google Scholar 

  • DER: Deutscher Ethikrat. (2016). Patientenwohl als ethischer Maßstab für das Krankenhaus. Stellungnahme. https://www.ethikrat.org/fileadmin/Publikationen/Stellungnahmen/deutsch/stellungnahme-patientenwohl-als-ethischer-massstab-fuer-das-krankenhaus.pdf. Accessed 19 Feb 2020.

  • Dörner, K. 2001. Für eine Auflösung der Heime. Dr. Med. Mabuse 133: 22–29.

    Google Scholar 

  • Dunger, C. 2011. Pflegerische Entscheidungsfindung zum Einsatz komplementärpflegerischer Maßnahmen bei Patienten mit Atemnot am Lebensende. Eine qualitative Forschungsarbeit in Anlehnung an die Grounded Theory. Unpublished Master of Science Thesis. Universität Witten/Herdecke, Faculty of Health, Department of Nursing Science.

    Google Scholar 

  • Dunger, C., and C. Bausewein. 2019. Pflege bei Atemnot – Gleichzeitigkeit und Unsicherheit als Ordnungsstrukturen von Entscheidungshandeln. In Pflege bei Atemnot am Lebensende. Methodische Anwendung einer Rahmenanalyse, ed. M.W. Schnell, C. Dunger, and C. Schulz-Quach, vol. 7, 15–152. Wiesbaden: Springer.

    Chapter  Google Scholar 

  • Dunger, C., and M.W. Schnell. 2012. Pflegerische Entscheidungsfindung am Lebensende. Pflegezeitschrift 65: 170–175.

    Google Scholar 

  • ———. 2018. Kulturelle Fremdheit und Diversität am Lebensende. pflegen: palliativ 40: 11–13.

    Google Scholar 

  • Dunger, C., M.W. Schnell, and C. Bausewein. 2017. Nurses’ decision-making in ethically relevant clinical situations using the example of breathlessness: Study protocol of a reflexive grounded theory integrating Goffman’s framework analysis. British Medical Journal Open 7: e012975.

    Google Scholar 

  • ———. 2019. Gleichzeitigkeit und Entscheidungshandeln im pflegerischen Alltag. Pflege & Gesellschaft 24: 331–349.

    Google Scholar 

  • Flick, U., E. von Kardorff, and I. Steinke. 2000. Qualitative Forschung: ein Handbuch. Reinbek: Rowohlt-Taschenbuch Verl.

    Google Scholar 

  • Glacher, M., and K.M. Lex. 2020. Advanced nursing practice in Austria under consideration of outcome measurement. Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen (ZEFQ) 155: 11–16.

    Article  Google Scholar 

  • Goethals, S., C. Gastmans, and B.D. de Casterle. 2010. Nurses’ ethical reasoning and behaviour: A literature review. International Journal of Nursing Studies 47: 635–650.

    Article  Google Scholar 

  • Goffman, E. 1971. Relations in public: Microstudies of the public order. New York: Basic Books.

    Google Scholar 

  • ———. 1974. Frame analysis: An essay on the organization of experience. New York: Northeastern University Press.

    Google Scholar 

  • Gysels, M., C. Bausewein, and J.J. Higginson. 2009. Caring for a person in advanced illness and suffering from breathlessness at home: Threats and resources. Palliative and Supportive Care 7: 153–162.

    Article  Google Scholar 

  • Höhmann, U., M. Schilder, A. Metzenrath, and M. Roloff. 2010. Problemlösung oder Problemverschiebung? Nichtintendierte Effekte eines Gesundheitsförderungsprojektes für Pflegende in der Klinik. Ergebnisausschnitte einer Evaluation. Pflege & Gesellschaft 15: 108–124.

    Google Scholar 

  • Höhmann, U., O. Lauxen, and L. Schwarz. 2018. Gestaltungskompetenzen im Pflegealltag stärken. In Arbeitsprozessintegrierte Kompetenzentwicklung in der Pflege. Frankfurt am Main: Mabuse-Verlag.

    Google Scholar 

  • Hold, J.L. 2017. A good death. Nursing Ethics 24 (1): 9–19.

    Article  Google Scholar 

  • International Council of Nurses (ICN), 2001–2020. NP/APN network, definition and characteristics of the role. https://international.aanp.org/Practice/APNRoles. Accessed 22 Feb 2021.

  • Jacelon, C.S. 2004. Older adults and autonomy in acute care: Increasing patients’ independence and control during hospitalization. Journal of Gerontological Nursing 30 (11): 29–36.

    Article  Google Scholar 

  • Kersting, K. 2013. “Coolout” in der Pflege. Frankfurt am Main: Mabuse-Verlag.

    Google Scholar 

  • Kleinschmidt, H. 2004. Pflege und Selbstbestimmung: Pflegerische Interaktionen und ihre aktive Mitgestaltung durch den Patienten – eine empirisch deskriptiv-analytische. Bern: Hans Huber.

    Google Scholar 

  • Lake, S.E., C. Moss, and J. Duke. 2009. Nursing prioritization of the patient need for care: A tacit knowledge embedded in the clinical decision-making literature. International Journal of Nursing Practice 15 (5): 376–388.

    Article  Google Scholar 

  • Levinas, E. 1995. Zwischen uns. Versuche über das Denken an den Anderen. München: Hanser.

    Google Scholar 

  • Luce, J., and J.A. Luce. 2001. Perspectives on care at the close of life. Management of dyspnea in patients with far-advanced lung disease: “Once I lose it, it’s kind of hard to catch it …”. Journal of the American Medical Association 285: 1331–1337.

    Article  Google Scholar 

  • McMillen, R.E. 2008. End of life decisions: Nurses’ perceptions, feelings and experiences. Intensive and Critical Care Nursing 24: 251–259.

    Article  Google Scholar 

  • Menche, N. 2014. Pflege Heute. 6th ed. München: Urban & Fischer.

    Google Scholar 

  • Myny, D., D. Van Goubergen, M. Gobert, K. Vanderwee, A. Van Hecke, and T. Defloor. 2011. Non-direct patient care factors influencing nursing workload: A review of the literature. Journal of Advanced Nursing 67: 2109–2129.

    Article  Google Scholar 

  • Schewior-Popp, S., F. Sitzmann, and L. Ullrich. 2009. Thiemes Pflege: Das Lehrbuch für Pflegende in Ausbildung. 11th ed. Stuttgart: Thieme.

    Google Scholar 

  • Schnell, M.W. 2008. Ethik als Schutzbereich. Kurzlehrbuch für Pflege, Medizin und Philosophie. Bern: Hans Huber.

    Google Scholar 

  • ———. 2017. Ethik im Zeichen vulnerabler Personen: Leiblichkeit – Endlichkeit – Nichtexklusivität. Weilerswist: Velbrück Wissenschaft.

    Book  Google Scholar 

  • ———. 2018. Diversität und Lebensende: Zwischen Philosophie und Palliative Care. Imago Hominis 2: 90–105.

    Google Scholar 

  • Schober, M. 2018. Global emergence of nurse practitioner/advanced practice nursing roles. Journal of the American Association of Nurse Practitioners 30 (4): 182–184.

    Article  Google Scholar 

  • Schulz, C., A. Karger, and M.W. Schnell. 2011. Diversitätskompetenz am Lebensende. In Diversity. Transkulturelle Kompetenz in klinischen und sozialen Arbeitsfeldern, ed. E. Keuk, C. Ghaderi, L. Joksimovic, and D.M. David, 242–255. Stuttgart: Kohlhammer.

    Google Scholar 

  • Selman, L., T. Beynon, I.J. Higginson, and R. Harding. 2007. Psychological, social and spiritual distress at the end of life in heart failure patients. Current Opinion in Supportive and Palliative Care 1: 260–266.

    Article  Google Scholar 

  • Simon, S.T., I.J. Higginson, H. Benalia, M. Gysels, F.E. Murtagh, J. Spicer, and C. Bausewein. 2013. Episodes of breathlessness: Types and patterns – A qualitative study exploring experiences of patients with advanced diseases. Palliative Medicine 27: 524–532.

    Article  Google Scholar 

  • Soeffner, H.-G. 1986. Handlung Szene Inszenierung. Zur Problematik des “Rahmen” Konzepts. In Sprache der Gegenwart, ed. W. Kallmeyer, 73–91. Düsseldorf: Schwann.

    Google Scholar 

  • Solano, J., B. Gomes, and I.J. Higginson. 2006. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease. Journal of Pain and Symptom Management 31: 58–69.

    Article  Google Scholar 

  • Spirig, R., E.M. Panfil, G. Meyer, and B. Schrems. 2010. 10 Jahre Advanced Nursing Practice in der Schweiz: Rückblick und Ausblick. Pflege 23 (6): 363–373.

    Article  Google Scholar 

  • Strauss, A.L. 1998. Grundlagen qualitativer Sozialforschung: Datenanalyse und Theoriebil-dung in der empirischen soziologischen Forschung. München: Fink.

    Google Scholar 

  • Strauss, A.L., and J. Corbin. 1996. Grounded theory: Grundlagen Qualitativer Sozialforschung. Weinheim: Beltz.

    Google Scholar 

  • Strübing, J. 2004. Grounded Theory: Zur sozialtheoretischen und epistemologischen Fundierung des Verfahrens der empirisch begründeten Theoriebildung. Wiesbaden: Springer.

    Book  Google Scholar 

  • Thompson, C., D. McCaughan, N. Cullum, T.A. Sheldon, A. Mulhall, and D.R. Thompson. 2001. Research information in nurses’ clinical decision-making: What is useful? Journal of Advanced Nursing 36 (3): 376–388.

    Article  Google Scholar 

  • Ulrich, C.M., C. Taylor, K. Soeken, P. O’Donnell, A. Farrar, M. Danis, and D. Grady. 2010. Everyday ethics: Ethical issues and stress in nursing practice. Journal of Advanced Nursing 66 (11): 2510–2519.

    Article  Google Scholar 

  • van Belle, E., J. Giesen, T. Conroy, et al. 2020. Exploring person-centred fundamental nursing care in hospital wards: A multi-site ethnography. Journal of Clinical Nursing 29: 1933–1944.

    Article  Google Scholar 

  • Vogd, W. 2004. Ärztliche Entscheidungsfindung im Krankenhaus. Komplexe Fallproblematiken im Spannungsfeld von Patienteninteressen und administrativ-organisatorischen Bedingungen. Zeitschrift für Soziologie 33: 26–47.

    Article  Google Scholar 

  • Weidner, F. 2004. Professionelle Pflegepraxis und Gesundheitsförderung. Frankfurt am Main: Mabuse-Verlag.

    Google Scholar 

  • Weingartner, V., C. Bausewein, I.J. Higginson, C. Scheve, F.E. Murtagh, R. Voltz, and S.T. Simon. 2013. Characterizing episodic breathlessness in patients with advanced disease. Journal of Palliative Medicine 16: 1275–1279.

    Article  Google Scholar 

  • Wettreck, R. 2001. „Am Bett ist alles anders“ – Perspektiven professioneller Pflegeethik. Münster/Hamburg/London: LIT-Verlag.

    Google Scholar 

  • Wiechula, R., T. Conroy, A.L. Kitson, R.J. Marshall, N. Whitaker, and P. Rasmussen. 2016. Umbrella review of the evidence: What factors influence the caring relationship between a nurse and patient? Journal of Advanced Nursing 72 (4): 723–734.

    Article  Google Scholar 

  • World Health Organization. 2002. Definition of Palliative Care. http://www.who.int/cancer/palliative/definition/en/. Accessed 3 Mar 2020.

  • Zomorodi, M., and M.R. Lynn. 2010. Instrument development measuring critical care nurses’ attitudes and behaviors with end-of-life care. Nursing Research 59: 234–240.

    Article  Google Scholar 

  • Zwerink, M., M. Brusse-Keizer, P.D. van der Valk, G.A. Zielhuis, E.M. Monninkhof, J. van der Palen, P.A. Frith, and T. Effing. 2014. Self management for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews: Cd002990.

    Google Scholar 

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Dunger, C., Schnell, M.W. (2022). Professional Nurses’ Role in End-of-Life Care. Ethical Reflections on Patient-Nurse Interaction and Nurses’ Decision-Making in Breathlessness Situations. In: Seidlein, AH., Salloch, S. (eds) Ethical Challenges for Healthcare Practices at the End of Life: Interdisciplinary Perspectives. Philosophy and Medicine, vol 141. Springer, Cham. https://doi.org/10.1007/978-3-030-83186-8_12

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