Intensive care nurses? experiences of death in the ICU and the implications for postgraduate nursing pedagogy: a Heideggerian phenomenological study

Abstract

Intensive care nurses’ experiences of death in the ICU and the implications for a postgraduate nursing pedagogy: A Heideggerian phenomenological study.The study sought to understand the phenomenon of the experiences of ICU nurses dealing with the deaths of patients under their care who die in the ICU. Hedeggerian hermeneutic phenomenology was used as the philosophical underpinning of the study. Methodologically, van Manen’s (1990) six research stages in searching for the essence of a lived experience offered opportunities to inquire further about pedagogical issues. Information gathering was in the form of phenomenological conversations with a sample of ICU nurses and lived experience themes emerged during the unravelling of the ICU nurses’ narratives. Using Heidegger’s concept of the three modes of being: authenticity, inauthenticity and undifferentiatedness, five lived experience themes were recognised: 1. Care- authenticity ; 2. Suffering, Disenfranchisement and Cultural/religious unpreparedness-inauthenticity ; 3. Living with dying-undifferentiatedness Based on an analysis of the phenomenological conversations, motivation is made for the inclusion of death education into the current Postgraduate Critical Care Nursing curriculum to meet the need for improving, not only the professional nursing care for patients dying in the ICU, but also facilitating and supporting the self-care of the ICU student him/herself. Barnett and Coate’s (2005) concept of the ‘Engaged Curriculum in Higher Education’, utilising the schema of knowing, acting and being, was used as the educational framework within which to identify pedagogical offerings for introducing death education. Such pedagogical offerings would include the teaching and learning of the theories of death and dying; aspects of the dying process; cultural/spiritual/religious issues such as post-mortem care and bereavement self-care.The study contributes new knowledge about ICU nurses’ lived experiences of the deaths of patients under their care in the ICU resulting in the recognition of the need for the inclusion of death education into a Postgraduate Critical Care Nursing curriculum