Nurses' Involvement in 'End-of-Life' Care after a 'Do-Not-Resuscitate' Decision on General Medical Units in Saudi Arabia

Abstract

There is paucity of research studies from Saudi Arabia on 'end-of-life' (EOL) care regarding hospitalised patients after a 'do-not-resuscitate' (DNR) decision has been made. The aim of this research study was to describe the lived experiences and explore the meaning of these experiences and the extent of nurses' involvement as team members in EOL care, in the context of a physician-led health care team. The research site was a large tertiary-level teaching hospital in Riyadh, Saudi Arabia and the research location was the general medical units that are frequent sites of death in EOL care after a DNR decision had been made. The research problem focused on involvement of nurses, who were largely non-Muslim, multinational and non-Arabic speaking, and local patients who were mainly Muslim and speak Arabic as their primary language. The research study design embraced qualitative, exploratory and descriptive approaches utilising aspects of phenomenology. Congruent with qualitative inquiry, the literature review commenced at the beginning of the research study and continued in an iterative manner after data collection, throughout data analysis, and during the thesis generation. Purposive sampling was used to recruit registered nurse participants who met the participation criteria in relation to direct experiences in EOL care after the DNR decision on general medical units. A total of twenty-six (26) registered nurses participated in this study by informed consent. Reflective journalling technique was selected as the most appropriate data collection method owing to its congruency with the professional nursing practice context of the hospital setting. Ethical research principles were upheld to maintain the rights of the participants, and in keeping with organisational permission to conduct the study.