Withdrawing life-support treatment in the intensive care unit: The perceptions of critical care nurses

Abstract

Critically ill patients admitted to the intensive care units (ICUs) require treatment methods to support their vital functions of respiration and circulation by means of modalities such as mechanical ventilation and inotropic support. However, when these treatment options are maximised and the patient’s condition remains unchanged, a decision might be taken to withdraw treatment. Critical care nurses caring for these patients receiving withdrawal of life-support treatment are faced with diverse perceptions and emotions. The objectives of the study were to explore and describe the perceptions of nurses with regard to the withdrawal of life-support treatment in intensive care units. A qualitative research design using a semi-structured interview, with a purposive sample of nurses, was used to explore their perceptions of withdrawing lifesupport treatment in the intensive care unit. Data collected were thematically analysed, using Tesch’s method. Ten nurses in the intensive care unit participated in the study. Three major themes were identified, namely: (1) mixed emotions and challenges; (2) communication and relationships with families; (3) suggestions regarding an inclusive process. The study concluded that critical care nurses find withdrawing life-support treatment in the intensive care unit difficult and stressful. A need for support for critical nurses in this context was expressed.

Keywords: Withdrawal of treatment, life-support treatment, intensive care unit, perceptions, critical care nurses.