| This study explored the experiences and perceptions of ten healthcare providers (physicians, nurses and nursing assistants) who cared for six dying patients in general medical-surgical units of an acute care hospital. Audio taped in-depth interviews in which the participants told their personal stories were transcribed verbatim and analyzed using Riessman's method of narrative analysis.;The narratives provided substantial evidence that the death of a patient is a significant and meaningful event and suggested that after the death, providers may have feelings of sadness and empathy for the patients and families and sometimes relief that the suffering is over. The participants were interested in facilitating a "good death" for their patients by working toward and/or maintaining a sense of harmony among the patients, families and healthcare providers. If there was indecision or nonacceptance of the careplan, the provider felt uncomfortable and disharmony.;Some of the key factors that were identified by the analysis of the narratives which affected the providers' abilities to facilitate a good death and promote harmony are (1) experience and knowledge of the provider, (2) openness of dialogue among providers, patients and families (3) attention to comfort of the patient, (4) providing support to the family (5) consensus in the plan of care among providers and family and (6) the patient not dying alone.;The providers were also cognizant of other providers' roles in caring for patients at the end of life. Disharmony and conflict can ensue if one provider does not perceive the other is providing quality care. The providers felt a sense of harmony when they felt supported by others, respected and valued as a team member and the event of a patient's death is positive and meaningful.;The harmony/disharmony in these narratives illustrates the implications of many barriers in how the healthcare providers perceive the experiences. When harmony is achieved among the patient, family and staff, the experience for the healthcare provider is viewed as meaningful and positive. Disharmony increases the stress and emotional burden of the healthcare provider and can have repercussions on the quality of care the patient receives. |
